corticomedullary phase ct
Utility of Corticomedullary Phase of a CT Urogram in Detecting Transitional Cell Carcinoma (TCC) and Metastatic Disease. The detection rate for stones measuring 3-5 mm was 82-88% and 98% for stones ≥ 6 mm. By use of triphasic CT images, Hounsfield unit values were acquired in each phase. Sa represents the mean CT values of the corresponding layers of aorta in corticomedullary phase, nephrographic phase, and excretory phase respectively. Download scientific diagram | Unenhanced (A), corticomedullary phase CT scans showing a great amount of blood in the peri and para-renal left kidney zone, generated by a lesion of the kidney's . A 3. The attenuation of the mass is 49 HU on the corticomedullary phase (a), 40 HU on the virtual non-enhanced CT (b) and on the iodine image (c) the mass shows no enhancement. The masses were presented in the . Disease: Study phase: Physician name: Raghunandan Vikram. . This can be difficult to assess when the lesion is small and located in the renal cortex, which also enhances strongly. 11: A: Asymptomatic 38-year-old man - Axial-view contrast enhanced CT corticomedullary phase shows incomplete rotation on the left kidney - renal pelvis (P) is located anteriorly; B: Asymptomatic 52-year-old woman - Sagittal/Coronal-view contrast enhanced CT corticomedullary phase reveals in the right kidney renal pelvis (P) and renal vessels are located superiorly For general . Corticomedullary phase: kidneys only, axial, 3mm reconstruction section thickness with or without 50% overlap, at 40-70 seconds delay. Patchy enhancement of the corticomedullary interface is a classic sign of acute pyelonephritis and can be seen on arterial-phase imaging. Incomparison, renalmedullare-mainsverylowinattenuation. • The . MD Anderson Study Status . . 1. CT evaluation of the kidneys during the corticomedullary phase or at an intermediate phase between the corticomedullary and nephrographic phases has significant limitations. And the excretory phase was scanned 5 min after onset of contrast injection. Portal Venous Phase - (60s) Nephrogenic Phase - (100s), homogeneous appearance, contrast is exiting the cortical vasculature, filtered in the glomeruli and enters the Loop of Henle and collecting tubules. Results: In SSFP with Time-SLIP, corticomedullary contrast ratio was highest with TI of 1200 msec in eight subjects (40%), followed by 1100 msec in seven (35%) and 1000 msec in three (15%). 250 ml oral contrast immediately before the exam Adrenals The enhancement washout technique for CT characterization of adrenal masses include: 1. thin-section pre-contrast acquisition through the adrenals 2. Results: Significant differences were found in the attenuation ratios between RCC or TCC in the corticomedullary (P = 0.040) and nephrographic (P = 0.004) phases using three regions of interest (ROIs) of 10 mm (2) size. Clear cell RCCs also demonstrate rapid washout of contrast with T2 hypointensity on the excretory phase. The corticomedullary phase is the first and shortest phase of contrast enhancement. Note absence of CT in a 46-year-old man illustrates various enhancement phases in the kidneys. Disease: Study phase: Physician name: Raghunandan Vikram. Timing of CT-series is important in order to grab the right moment of maximal contrast differences between a lesion and the normal parenchyma. Utility of Corticomedullary Phase of a CT Urogram in Detecting Transitional Cell Carcinoma (TCC) and Metastatic Disease. However, on contrast-enhanced sonography, small vessels are enhanced at the renal lymphoma periphery . It occurs between 25 and 70 seconds after the initiation of contrast material injection. Protocols may include only the excretion phase, or may contain as many as 4 four phases, the plain CT study, corticomedullary, nephrographic and excretory. A, Unenhanced CT scan shows lesion (arrow) has slightly higher attenuation than renal parenchyma. Delayed (excretory) phase (5 min) of abdomen and pelvis Hematuria PURPOSE: To evaluate the role of thin-section helical computed tomography (CT) performed during the corticomedullary phase (CMP) and nephrographic phase (NP) of contrast enhancement in the detection and characterization of renal masses. To determine optimal scan delays for renal arterial-, corticomedullary-, and nephrographic-phase imaging with multi-detector row computed tomography (MDCT) of the kidney using a bolus-tracking technique. There is a large renal cell carcinoma in the right kidney which can be differentiated from the normal renal parenchyma by the heterogeneous and . Materials and Methods Double-phase helical CT (5 mm slice) of the corticomedullary phase (CMP) and late nephrographic phase (NP) was performed in 40 surgically resected renal neoplasms <3.5 cm. The presence of tiny fatty tissue cannot be determined on the basis of this CT image. As on CT, clear cell RCCs are hypervascular, show prominent enhancement on MRI, especially in the corticomedullary phase, unlike other RCC subtypes . This may be overcome by 1) Decreasing slice thickness 2) Increasing kVp To evaluate the role of thin-section helical computed tomography (CT) performed during the corticomedullary phase (CMP) and nephrographic phase (NP) of contrast enhancement in the detection and characterization of renal masses. . B,Nephrographic phase helicalCT scanobtained100secafterinitia-tionofcontrast injection reveals Therefore, it has been proposed that CTU including a corticomedullary phase (CMP), i.e. The CT contrast agent is an extracellular fluid contrast agent. Rapid advances in CT technology accelerated the research into the application of this new technology in the evaluation of the UUT and readily proved to be superior to other imaging modalities. • Sensitivity and NPV for bladder cancer detection were highest in corticomedullary phase . Initial single-phase CT image shows a 29-mm hyperdense lesion (arrow) in the right kidney, measuring 153 HUs. A 2. Objectives To retrospectively evaluate whether the early dark cortical band (EDCB) on CT can be a predictor to differentiate clear cell renal cell carcinoma (ccRCC) from fat poor angiomyolipoma (Fp-AML) and to detect peritumoral pseudocapsules in ccRCC. The lack of vessel enhancement in the corticomedullary phase may be a CT feature specific to canine renal lymphoma. Graph shows the process of obtaining tumor tissue from original images by manual segmentation in unenhanced, corticomedullary, nephrographic, and excretory phase from left to right Full size image Texture features extraction Texture features were extracted using PyRadiomics [ 11 ]. Note the close contact between the renal parenchyma and the D2 duodenum (long arrow) suggesting a fistula. For context, see en:Computed tomography of the abdomen and pelvis. Corticomedullary Phase - (40s) maximized corticomedullary differentiation Portal Venous Phase - (60s) Nephrogenic Phase - (100s), homogeneous appearance, contrast is exiting the cortical vasculature, filtered in the glomeruli and enters the Loop of Henle and collecting tubules Delayed or Excretory Phase - (5 min) Differential of Delayed Nephrogram On contrast-enhanced abdominal CT, the lower pole mass was composed of soft tissue components presenting moderate prolonged enhancement and abundant gross fat components . Delayed or Excretory Phase - (5 min) Contrast material was given 3 days previously, and both kidneys are in corticomedullary phase with absent pyelograms. The standard characteristics for this phase are: peak aortic attenuation: 290 - 360 HU 4,5,8. (a) In corticomedullary phase, most RCCs have a ratio lower than 1.0, whereas nearly all RO have a ratio higher than 1.0. Conclusion The detectability of renal stones ≥ 6 mm on contrast-enhanced CT is extremely high. Additionally, the highest accuracy (88%) was achieved in the corticomedullary phase images. This phase may be helpful in sub-typing renal cell carcinoma (RCC). (b, c) In a right . Renal veins are best visualised in corticomedullary phase and inferior vena cava is better visualized in nephrographic phase. The CT-images are of a patient who underwent two phases of arterial imaging at 18 and 35 seconds. . Materials and methods Renal CT scans and medical records of 33 patients were retrospectively reviewed. • The corticomedullary (or cortical) phase of enhancement occurs 25 to 70 seconds after contrast administration. PURPOSE: To evaluate thin-section computed tomography (CT) performed during the corticomedullary and nephrographic phases of contrast material enhancement in the characterization of renal masses. B and C, Corticomedullary (B) and nephrographic (C) phase contrast-enhanced CT scans show lesion (arrow) has no gross fat attenuation. Excretory phase imaging for CT urography study methods can range from 3 to 16 minutes after injection. Brief Summary: Tumors of the UUT are rare and usually presenting as micro- or macrohematuria either symptomatic or asymptomatic. MD Anderson Study Status . Department: Diagnostic Radiology. (Exclude for young patients) ± Venous (nephrographic) phase of abdomen only A P 4. Here, the . Corticomedullary-phase CT images provided much more valuable texture parameters than unenhanced images . Date: 15 May 2013: Source: Dongqing Wang (2013) Selected Topics on Computed Tomography ISBN: 9789535111023. corticomedullary phase is best to delineate subcategories of renal cell carcinomas further nephrogenic phase is best for optimal enhancement of the renal parenchyma, including the renal medulla, and will demonstrate enhancing components of a mass excretory phase will demonstrate enhancement of calyces, renal pelvis and ureters. The reported advantages of the corticomedullary phase are that it provides more vascular and perfusion information than the nephrographic phase [7], allows for better characterization of renal. The CT-images show an early arterial phase in comparison to a late arterial phase. Methods The EDCBs, which are comprised of unenhanced thin lines at the tumor-renal cortex border in the corticomedullary phase, on the CT . The late hepatic arterial phase occurs at about the same time as the corticomedullary phase, enteric phase, pancreatic phase, and splenic arciform enhancement phase. Fig. This growth pattern may be reflected in our findings. Most nonrenal abdominal helical CT scans are obtained late in the corticomedullary phase of renal enhancement because of the preferable enhancement of other parenchymal organs. Tanaka's team did find that the AUC value of the corticomedullary phase was higher than that of other phases (corticomedullary vs excretory, p = 0.022). Axial (a) unenhanced and (b) corticomedullary phase CT shows extensive intraparenchymal gas (arrows) in a poorly functioning enlarged left kidney. Department: Diagnostic Radiology. Computed tomography of the abdomen and pelvis is an application of computed tomography (CT) . The corticomedullary phase is characterized by enhancement of the renal cortex as well as the renal . A,Corticomedullary phase helical CTscanobtained40secafterinitia-tion ofcontrast injection shows briskenhancementofrenalcortex. Active Comparator: gold standard all series (unenhanced, corticomedullary, nephrographic and excretory phase) will be evaluated by a radiologist not involved in the experimental arm CMP, corticomedullary phase; LNP, late nephrographic phase; NPV, negative-predictive value; PPV, positive-predictive value. Tools Share Abstract PURPOSE: To evaluate the role of thin-section helical computed tomography (CT) performed during the corticomedullary phase (CMP) and nephrographic phase (NP) of contrast enhancement in the detection and characterization of renal masses. During the corticomedullary phase, ccRCCs with the loss of chromosome Y enhanced more than those without this anomaly (130.0 vs 102.5 HU, P =.04), and ccRCCs with trisomy 7 enhanced less than those without this anomaly (105.8 vs 139.3 HU, P =.04). If dedicated renal CT is requested for a suspected renal mass, the helical scan series to be obtained are unenhanced, corticomedullary and nephrographic phase images. For the tumours, significant differences were not observed in attenuation, noise or SNR between TNC and VNC images ( p > 0.05). ( B ) Corticomedullary phase (obtained 40-70 second delay after contrast injection, showing differential enhancement of the renal cortex and medulla). Conventional RCC metastases usually most conspicuous on arterial phase. Gas bubbles extend into the perinephric space. an arterial phase, could be comparable to cystoscopy in the detection of UBC with a higher sensitivity than CTU without CMP [ 13 ]. If dedicated renal CT is requested for a suspected renal mass, the helical scan series to be obtained are unenhanced, corticomedullary and nephrographic phase images. The CT images were acquired at three different scanning phases: (1) phase 1, unenhanced phase (UP), before the injection of the contrast agent; (2) phase 2, corticomedullary phase (CMP), 7 s after aortic enhancement exceeded 150 HU compared to baseline; and (3) phase 3, nephrographic phase (NP), 20 s after CMP. phase contrast-enhanced CT) assessed for subjective imaging findings by 2 blinded readers 12 Patients with triphasic renal protocol CT (including unenhanced CT and corticomedullary and . In all patients, 5-mm-thick, contiguous, high-tube-current (320-340-mA . CECT Phases Phase Timing Corticomedullary 30-70 sec Nephrogram 80-120 sec Excretory 3-15 mins or longer CECT Phases are required for renal mass characterization, visualization of ureteric obstructions and strictures, bladder wall abnormalities and infections and inflammations. Selected images from a renal mass specific protocol CT. Corticomedullary phase (axial 7a) demonstrates peripheral enhancement of the renal cortex with minimal opacification of the renal medulla. corticomedullary phase is best to delineate subcategories of renal cell carcinomas further nephrogenic phase is best for optimal enhancement of the renal parenchyma, including the renal medulla, and will demonstrate enhancing components of a mass excretory phase will demonstrate enhancement of calyces, renal pelvis and ureters. Download scientific diagram | Transversal a non-contrast, b corticomedullary phase and c nephrographic phase CT image of a 66-year-old female with a moderately complex renal cystic lesion (arrow . . 2. clinicaltrials.gov NCT No: N/A. Image analysis Xanthogranulomatous pyelonephritis in a 80-year-old woman with chronic pyuria. Transversal baseline a corticomedullary phase CT image of a 61-year-old male with a moderately complex renal cystic lesion showing minimal thickening and calcification of the wall without. (b) In nephrographic phase, the ratio of lesion-to-cortex attenuation is higher than in the corticomedullary phase in most RO, showing a prolonged enhancement pattern, whereas, nearly all RCCs show an early washout pattern. The kidneys have an attenuation of 30 to 50 Hounsfield units (HU) on unenhanced CT. On MRI, the renal cortices have low T1-weighted The kidneys have an attenuation of 30 to 50 Hounsfield units (HU) on unenhanced CT. . 3. Key Points • More bladder tumours are detected during the corticomedullary phase than during other phases . The patterns of CT attenuation value and homogeneity were correlated with the subtypes of neoplasms, microvessel density, and the existence of . Following noncontrast scanning, intravenous contrast is injected and a corticomedullary phase is obtained at approximately 70 seconds (figure 7a, 7b). MATERIALS AND METHODS: Renal CT scans and medical records of 33 patients were retrospectively reviewed. 27. Download as PowerPoint Open in Image Viewer Figure 17a. In contrast, the upper pole mass showed heterogeneous strong enhancement on the corticomedullary phase and wash-out on the excretory phase . Phase and delay time were as follows: Phase 1, unenhanced; Phase 2, postcontrast corticomedullary phase (CMP): 25-28 s after contrast agent was administrated; Phase 3, postcontrast nephrographic phase (NP): 65-70 s after contrast agent was administrated; and Phase 4, postcontrast excretory phase . Excretory phase: diaphragm to iliac crests, axial, 3mm reconstruction section thickness with or without 50% overlap, at 7-10 minute delay. In this phase, the spleen has heterogeneous enhancement, the kidneys are usually in the corticomedullary phase of enhancement, and hypervascular lesions are seen to best effect ( Figure 28-1, C ). The attenuation characteristics of RCC and TCC were compared to the attenuation of the normal renal cortex. Objective: Comparing the prediction models for the ISUP/WHO grade of clear cell renal cell carcinoma (ccRCC) based on CT radiomics and conventional contrast-enhanced CT (CECT). In all examinations, 5-mm-thick, contiguous, helical . Fig. A typical feature of clear cell carcinoma is strong enhancement in the corticomedullary phase. MATERIALS AND METHODS: A prospective study of 30 patients was undertaken with CT to characterize 31 "indeterminate" renal masses. This patient had a CT scan a . The LKR (lesion kidney ratio), CNR, and CT value of the corticomedullary and nephrographic phase were measured. All Science Journal Classification (ASJC) codes Phone Number: 1-877-MDA-6789. Phone Number: 1-877-MDA-6789. Arterial Phase - (30s) Corticomedullary Phase - (40s) maximized corticomedullary differentiation. ( C ) Nephrographic phase (100-120 seconds after contrast injection, with uniform enhancement of the entire renal parenchyma). A2, A3 and A4 represent the CT values of the aorta in corticomedullary phase, nephrographic phase, excretory phase respectively. . Information and next steps. 10-15 minute delayed post-contrast acquisition through the adrenals GI Deep Learning Differentiates Small Renal Masses on Multiphase CT Leesburg, VA, January 10, . the CT consist of four phases; non-enhanced, corticomedullary, nephrographic and excretory phase. Enhancement pattern is typically diagnostic of renal cell carcinoma. The corticomedullary phase scanning was performed once the arterial CT value reached 100 HU; the nephrographic phase was scanned 60 seconds later. English: Corticomedullary phase CT in axial and coronal plane, and parenchymal phase, of renal cell carcinoma. The corticomedullary phase is the first and shortest phase of contrast enhancement. Arterial (corticomedullary) phase of abdomen only Conventional clear cell RCCs and their metastases demonstrate arterial enhancement. The late arterial phase, also known as the corticomedullary phase or early venous portal phase, is a contrast-enhanced CT or MRI series, in which there is an optimal enhancement of structures that get their blood supply directly from the arterial system. The standard characteristics for this phase are: 4—Bilateral persistent nephrogram and delayed pyelogram in this 82-year-old man with acute tubular necrosis. The CT urography examination protocols is often tailored to the clinical question. This is due to the difference in beam attenuation between the dense bone of the skull and the tissue of the brain. Methods: The corticomedullary phase images of 119 cases of low-grade (I and II) and high-grade (III and IV) ccRCC based on 2016 ISUP/WHO pathological grading criteria were analyzed retrospectively. (b, c) In a right . Initial single-phase CT image shows a 29-mm hyperdense lesion (arrow) in the right kidney, measuring 153 HUs. Following noncontrast scanning, intravenous contrast is injected and a corticomedullary phase is obtained at approximately 70 seconds (figure 7a, 7b). A 4-phase low-dose computed tomographic (CT) urography was indicated. The patients were . An ideal late hepatic arterial phase sequence will have both hepatic artery and portal vein enhancement with no hepatic vein enhancement. Computed tomography of the abdomen and pelvis is an application of computed tomography (CT) . The presence of tiny fatty tissue cannot be determined on the basis of this CT image. Citation, DOI & article data The late arterial phase, also known as the corticomedullary phase or early venous portal phase, is a contrast-enhanced CT or MRI series, in which there is an optimal enhancement of structures that get their blood supply directly from the arterial system. We . It occurs between 25 and 70 seconds after the initiation of contrast material injection. Independent predictors among the clinical and CT findings for differentiating ccRCC from Fp-AML were identified using multivariate analyses. To compare corticomedullary phase images and low keV VMIs (40 to 100 keV) from the nephrographic phase, the attenuation, image noise, SNR and subjective lesion visibility of the tumours and renal arteries were evaluated. Arterial (corticomedullary) phase of abdomen and pelvis. Objective—To determine computed tomography . ( A ) Precontrast phase. . CMP, corticomedullary phase; LNP, late nephrographic phase; NPV, negative-predictive value; PPV, positive-predictive value. Poor enhancement of the right renal parenchyma without corticomedullary differentiation on the corticomedullary phase (a) and nephrogenic phase (b) images. It is common when imaging the posterior fossa of the brain for there to be streak artifacts. In addition to solid tumors, the CT and MRI findings of our 2 patients were similar to those of cavernous hemangiomas of the liver, including peripheral nodular enhancement in the corticomedullary phase, progressive centripetal enhancement in the nephrographic and delayed phases, and sometimes complete "filling in" in the delayed phase. One hundred and twenty-eight patients underwent three-phase CT scan of the kidney with eight-row MDCT after receiving 2 mL/kg of 300 mgI . clinicaltrials.gov NCT No: N/A. 400-600 ml oral contrast 45-90 minutes prior to the exam 2. The EDCBs, which are comprised of unenhanced thin lines at the tumor-renal cortex border in the corticomedullary phase, on the CT images of 342 patients who underwent partial nephrectomy were evaluated. In Bosniak v2019, the mass is considered indeterminate by a single-phase-enhanced CT. MRI (not shown) was performed and confirmed that the mass was a hemorrhagic cyst with no . In the CT urography protocol with enhancement-triggered scan, sensitivity and NPV were highest in the corticomedullary phase, and this phase should be used for bladder assessment. Tumor segmentation We constructed a dataset consisting of 1,035 CT images from 308 patients containing five major subtypes of renal tumors, including both benign and malignant tumors: oncocytoma, AML, clear cell RCC, papillary RCC, and chromophobe RCC. Renal veins are best visualised in corticomedullary phase and inferior vena cava is better visualized in nephrographic phase. For general . The corticomedullary phase is characterized by enhancement of the renal cortex as well as the renal . TCC demonstrates arterial enhancement and can occur anywhere from the kidneys to the urinary bladder.
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