Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma

Figure 4 The 62-year-old man with clear cell renal cell carcinoma of the left kidney (stage T1a, grade II). A: Transverse plain computed tomography image barely depicts lower pole left kidney mass (arrow), slightly hyperdense. This finding was appreciated after studying the post-contrast enhanced images; B: Coronal reformations during the corticomedullary; C: The nephrographic phase. The tumor (arrow) is seen enhancing strongly and heterogeneously during the corticomedullary phase, a finding strongly suggestive for the diagnosis of renal cell carcinoma (RCC). Hypervascular RCCs as in this case, may enhance to the same degree as the renal cortex and may be mistaken for normal renal parenchyma at the corticomedullary phase. The neoplasm is clearly delineated in the nephrographic phase, detected mainly hypodense, when compared to the contrast-enhancing normal renal parenchyma.