Journal of Ultrasound in Medicine, Vol 12, Issue 7 403-409, Copyright © 1993 by American Institute of Ultrasound in Medicine
Color flow sonographic mapping of intravascular extension of malignant renal tumors
J. P. McGahan, L. C. Blake, R. deVere White, E. O. Gerscovich and W. E. Brant
Department of Radiology, University of California Davis Medical Center, Sacramento 95817.
The purpose of this study was to evaluate the possible role of CDFI in
identifying malignant renal tumor thrombus in the renal vein or the IVC.
This study involved 24 tumors in 23 patients, including 19 renal cell
carcinomas, four Wilms' tumors, and one rhabdoid tumor. CDFI had an overall
sensitivity of 95% in predicting combined renal vein and IVC tumor
involvement but was more sensitive in the renal vein alone (100%) than in
the IVC alone (89%). Specificity of CDFI was nearly equal for both renal
vein and IVC thrombus at 85%. The main limitation of CDFI was its inability
to predict venous tumor extension in large or bulky tumors. We would
recommend CDFI as a method of detecting renal vein or IVC thrombus at the
time of initial real-time sonographic detection of tumor. When CT or MR
imaging is equivocal, CDFI may be used to predict tumor thrombus in the
renal vein or IVC.
