DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184888

Role of multidetector computed tomography in evaluation of retroperitoneal masses

Diksha Chinwan, Poonam Vohra

Abstract


Background: Diagnostic imaging plays an important role in the evaluation of abdominal masses. Many imaging modalities are available ranging from conventional modalities to the cross-sectional modalities like USG, CT and MRI. The main principles of imaging are to determine the origin of mass, its measurement, extent, characterisation and assessment of its effect on contiguous organs. In the past, the mainstay was conventional imaging modalities like plain radiograph, Gastrointestinal contrast studies and I.V.U. Modern imaging modalities allow an early and accurate pre-operative diagnosis resulting in a higher rate of surgical resection and improvement of survival.

Methods: A Cross-sectional observational study was done in 30 patients. Patients of either sex of any age group who had presented with involvement of retroperitoneal organs detected by routine ultrasound and postoperative patients with recurrence were included in our study.

Results: Ultrasound is the initial imaging modality of choice since it is inexpensive, easy to perform and no radiation exposure. On USG, the retroperitoneal masses are classified as solid or cystic or mixed. Since most of the retroperitoneal masses have hetroechoic/mixed pattern, they cannot be characterized by ultrasound alone and hence need further evaluation.

Conclusions: Multidetector computed tomography is the imaging modality of choice for further evaluation and characterization. CT protocol for evaluation of the retroperitoneum consisted of both non-enhanced and contrast-enhanced scans for localisation and characterisation of the masses. Multiplanar reconstructions allowed the images to be viewed in any plane chosen including a curved plane thus helping in defining the exact location and extent of the lesion. With MIP and volume rendered images, the relationship of the vessels with the mass lesions was clearly visualized.


Keywords


Diagnostic imaging, Multidetector computed tomography, Retroperitoneal masses

Full Text:

PDF

References


Rajiah P, Sinha R, Cuevas C, J Dubinsky T, Bush W, Kolokythas O. Imaging of uncommon retroperitoneal masses. Radiogr Rev Publ Radiol Soc N Am Inc. 2011 Jul 1;31:949-76.

Coffin A, Boulay-Coletta I, Sebbag-Sfez D, Zins M. Radioanatomy of the retroperitoneal space. Diagn Inter Imaging. 2015 Feb 1;96(2):171-86.

Shaaban AM, Rezvani M, Tubay M, Elsayes KM, Woodward PJ, Menias CO. Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis. Radio Graphics. 2016 May 1;36(3):710-34.

Zagoria RJ, Wolfman NT, Karstaedt N, Hinn GC, Dyer RB, Chen YM. CT features of renal cell carcinoma with emphasis on relation to tumor size. Invest Radiol. 1990 Mar;25(3):261-6.

Hatimota P, Vashist S, Aggarwal K, Kapoor A, Gupta NP. Spectrum of US and CT findings in renal neoplasms with pathologic correlation. Indian J Radiol Imaging. 2005 Feb 1;15(1):117.

Tolia BM, Whitmore WF. Solitary metastasis from renal cell carcinoma. J Urol. 1975 Dec 1;114(6):836-8.

Szychot E, Apps J, Pritchard-Jones K. Wilms’ tumor: biology, diagnosis and treatment. Trans Pediatr. 2014 Jan;3(1):12-24.

Raza SA, Sohaib SA, Sahdev A, Bharwani N, Heenan S, Verma H, et al. Centrally infiltrating renal masses on CT: differentiating intrarenal transitional cell carcinoma from centrally located renal cell carcinoma. Am J Roentgenol. 2012 Apr 1;198(4):846-53.

Bosniak M, Megibow A, Hulnick D, Horii S, Raghavendra B. CT diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat. Am J Roentgenol. 1988 Sep 1;151(3):497-501.

Woo S, Cho JY. Imaging Findings of Common Benign Renal Tumors in the Era of Small Renal Masses: Differential Diagnosis from Small Renal Cell Carcinoma: Current Status and Future Perspectives. Korean J Radiol. 2015;16(1):99-113.

Korobkin M, Brodeur FJ, Yutzy GG, Francis IR, Quint LE, Dunnick NR, et al. Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol. 1996 Mar;166(3):531-6.

Fishman E, Deutch B, Hartman D, Goldman S, Zerhouni E, Siegelman S. Primary adrenocortical carcinoma: CT evaluation with clinical correlation. Am J Roentgenol. 1987 Mar 1;148(3):531-5.

Arkovitz MS, Johnson N, Garcia VF. Pancreatic Trauma in Children: Mechanisms of Injury. J Trauma Acute Care Surg. 1997 Jan;42(1):49.

Kayahara Masato, Nagakawa Takukazu, Ohta Tetsuo, Kitagawa Hirohisa, Ueno Keiichi, Tajima Hidehiro, et al. Analysis of paraaortic lymph node involvement in pancreatic carcinoma. Cancer. 2000 Nov 19;85(3):583-90.

Lee ES, Lee JM. Imaging diagnosis of pancreatic cancer: A state-of-the-art review. World J Gastroenterol WJG. 2014 Jun 28;20(24):7864-77.

Gebhard S, Coindre JM, Michels JJ, Terrier P, Bertrand G, Trassard M, et al. Pleomorphic liposarcoma:clinicopathologic,immunohistochemical, and follow-up analysis of 63 cases: a study from the French Federation of Cancer Centers Sarcoma Group. Am J Surg Pathol. 2002 May 1;26(5):601-16.

Tateishi U, Hasegawa T, Beppu Y, Satake M, Moriyama N. Primary dedifferentiated liposarcoma of the retroperitoneum: prognostic significance of computed tomography and magnetic resonance imaging features. J Comput Assist Tomogr. 2003 Oct;27(5):799.

Megibow A, Balthazar E, Hulnick D, Naidich D, Bosniak M. CT evaluation of gastrointestinal leiomyomas and leiomyosarcomas. Am J Roentgenol. 1985 Apr 1;144(4):727-31.

Erickson D, Kudva YC, Ebersold MJ, Thompson GB, Grant CS, Heerden V, et al. Benign paragangliomas: clinical presentation and treatment outcomes in 236 patients. J Clin Endocrinol Metab. 2001 Nov 1;86(11):5210-6.

Hayasaka K, Yamada T, Saitoh Y, Yoshikawa D, Aburano T, Hashimoto H, et al. CT evaluation of primary benign retroperitoneal tumor. Radiat Med. 1994;12(3):115-20.