Usefulness of Magnetic Resonance Imaging in the Diagnosis of Juxtaglomerular Cell Tumors: A Report of 10 Cases and Review of the Literature
| Autor: | Camille Bourillon, Anne-Laure Faucon, Michel Azizi, Stéphanie Baron, Christine Grataloup, Pauline Bernadet-Monrozies, Emmanuelle Vidal-Petiot, Laurence Amar |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent 030232 urology & nephrology Plasma renin activity Diagnosis Differential Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Effective diffusion coefficient Cyst 030212 general & internal medicine Secondary hyperaldosteronism medicine.diagnostic_test business.industry Magnetic resonance imaging Juxtaglomerular apparatus Middle Aged medicine.disease Magnetic Resonance Imaging Juxtaglomerular Apparatus Kidney Neoplasms Hypokalemia medicine.anatomical_structure Nephrology Female Differential diagnosis medicine.symptom Nuclear medicine business |
| Zdroj: | American Journal of Kidney Diseases. 73:566-571 |
| ISSN: | 0272-6386 |
| DOI: | 10.1053/j.ajkd.2018.09.005 |
| Popis: | Juxtaglomerular cell tumors (JCTs), a rare but potentially curable cause of hypertension, are difficult to diagnose because they may be missed or misidentified as a cyst by computed tomography (CT). Their magnetic resonance imaging (MRI) pattern has not been well described. We report the clinical, biological, and radiologic features of 10 patients with JCTs. Eight were women, and median age was 24.5 years. All had severe hypokalemic hypertension related to marked secondary hyperaldosteronism. Median plasma renin and aldosterone concentrations were 392 (minimum-maximum [min-max], 70.5-4,800) mIU/L and 1,490 (min-max, 671-2,492) pmol/L, respectively. Plasma prorenin concentration was 835.5 (min-max, 133-6,546) mIU/L. Median tumor size was 17.5mm. On CT, JCTs were spontaneously isodense, with little enhancement after contrast media injection. On MRI, JCTs were iso- (7/10) or hypointense (3/10) on T1-weighted images (WIs). On T2-WIs, JCTs were hypointense (2/10), isointense (4/10), or heterogeneously hyperintense (4/10). A thin peripheral "pseudo-capsule" (hypointense on T2-WIs) was observed in 6 of 10 cases. Contrast enhancement was low, slightly heterogeneous, and delayed. On diffusion-WIs, tumors were hyperintense with a restricted apparent diffusion coefficient. When hypertension with secondary hyperaldosteronism remains unexplained after CT, MRI of the kidney should be considered, especially for young women. |
| Databáze: | OpenAIRE |
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