Volumetric spiral computerized tomography in the diagnosis, staging and programmed therapy of kidney tumors: comparison with conventional CT

Introduction: The role of Spiral CT with bi-dimensional and three-dimensional reconstruction has considerably improved the location and definition of kidney masses, also those smaller than 1 cm, especially as compared with other diagnostic methods such as US and conventional CT. Materials and methods: This study has considered 23 patients, 7 women and 16 men, aged 23 to 85 years, who were divided into two groups; one group included 16 patients suffering from kidney neoplasm having a size smaller than 3 cm. All the patients were examined by means of conventional CT and subsequently with Spiral CT with bi-dimensional and three-dimensional reconstruction. Results: With respect to first group, Spiral CT did not add any useful information for the purpose of diagnosis or staging of the neoplasms as compared to conventional CT, although it allowed a better definition. On the contrary, in the second group Spiral CT gave better results in respect of the location and evaluation of the small kidney masses which may easily go undetected with CT test. Conclusions: The possibility to obtain, thanks to the Spiral CT, a study on the renal parenchyma both in nephrographic and corticomedullary stages, allowed to locate kidney masses which could be hidden by the medullary in the early stage of administration of contrast medium after a conventional CT test. The Spiral CT proved to be more effective in assessing the involvement of vessels, thanks to the bi-dimensional reconstruction and the better definition of the vessels. Furthermore, the possibility to obtain a single respiratory apnea during the test allowed to eliminate the false results caused by movement. Three dimensional reconstruction by means of the Spiral CT proved to better than that obtained with conventional CT since the former system allows to detect thinner layer and, consequently, to obtain more precise data also to the purposes of a possible conservative surgery.