|ECR 2019 / C-2493|
|Macroscopic fat containing lesions in the perirenal space|
A wide range of proliferative conditions can affect the perirenal space, individually or as a part of a systemic process. Therefore, the understanding of the normal anatomical, clinical and imaging features of this space is of vital importance in order to recognise and characterise the variations in normality and the various conditions, both benign and malignant, as well as those findings that are considered secondary to medical treatments that may occur in the complex and large perirenal space.
Radiologists play an important role in establishing a correct differential diagnosis, often with the use of non-invasive imaging techniques and no need of invasive diagnostic procedures. Moreover, early and accurate diagnosis is sometimes imperative, so as to identify malignant conditions that will benefit from an early treatment and prevent adverse effects.
Fat is easily recognised thanks to its characteristic appearance in the different imaging studies, and its presence in the retroperitoneum and more specifically in the perirenal space helps narrow differential diagnosis down.
US can sometimes be the first imaging technique to recognise a lesion or mass in the perirrenal space, but it is not used as a diagnostic technique itself.
CT is the imaging technique of choice for characterisation, diagnosis and follow-up if needed, of macroscopic fat containing lesions in the perirrenal space. But there are two occasions in which CT is not going to be capable of determining the presence of fat, which are the presence of small amounts of macroscopic fat and the microscopic fat.
In case that any of the situations mentioned above occurred, MR and specific fat-suppression sequences will be of great help to confirm or dismiss the presence of fat and consequently the diagnosis.
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