Association of CT Scan Parameters with the Risk of Renal Angiomyolipoma Rupture; a Brief Report
Archives of Academic Emergency Medicine,
Vol. 10 No. 1 (2022),
1 January 2022
,
Page e7
https://doi.org/10.22037/aaem.v10i1.1472
Abstract
Introduction: Rupture of renal angiomyolipoma (AML) is an emergency and life-threatening complication. This study aimed to evaluate the association of computed tomography (CT) scan parameters with the risk of rupture in renal AMLs.
Methods: In this retrospective cross-sectional study, patients who were referred to a referral university hospital with diagnosis of AML, between 2007 and 2019, were included. Patients were divided into ruptured and non-ruptured cases based on surgery and CT scan findings and the baseline characteristics as well as CT scan parameters were compared between the two groups.
Results: 20 AML patients with the mean age of 39.6 ± 12.5 years were included (75% female). The lesion was ruptured in 8 (40%) patients. The mean size of the lesion was 97.0 ± 15.9 mm in the ruptured and 72.0 ± 29.4 in the non-ruptured AML (p = 0.045). The mean fat density based on non-contrast enhanced CT (NCCT) scan (-56.1 ± 16.3 vs -74.9±24.1; p = 0.018) and contrast enhanced CT (CECT) scan (-20.8 ± 16.9 vs -50.5 ± 31.7; p = 0.016) was significantly higher in the ruptured cases. Total tumor density based on NCCT scan was significantly greater in the ruptured AMLs (19.6 ± 25.9 vs -22.7±41.6, p=0.033).
Conclusion: It seems that some CT scan parameters such as mean fat density and total tumor density could be used for differentiation between ruptured and non-ruptured AMLs.
- Angiomyolipoma
- kidney
- tomography, X-ray computed
- neoplasms
- rupture
- emergencies
How to Cite
References
Fittschen A, Wendlik I, Oeztuerk S, Kratzer W, Akinli AS, Haenle MM, et al. Prevalence of sporadic renal angiomyolipoma: a retrospective analysis of 61,389 in- and out-patients. Abdominal imaging. 2014;39(5):1009-13.
Flum AS, Hamoui N, Said MA, Yang XJ, Casalino DD, McGuire BB, et al. Update on the Diagnosis and Management of Renal Angiomyolipoma. The Journal of urology. 2016;195(4 Pt 1):834-46.
Yamakado K, Tanaka N, Nakagawa T, Kobayashi S, Yanagawa M, Takeda K. Renal angiomyolipoma: relationships between tumor size, aneurysm formation, and rupture. Radiology. 2002;225(1):78-82.
Dickinson M, Ruckle H, Beaghler M, Hadley HR. Renal angiomyolipoma: optimal treatment based on size and symptoms. Clinical nephrology. 1998;49(5):281-6.
Wang C, Li X, Peng L, Gou X, Fan J. An update on recent developments in rupture of renal angiomyolipoma. Medicine (Baltimore). 2018;97(16):e0497.
Fernández-Pello S, Hora M, Kuusk T, Tahbaz R, Dabestani S, Abu-Ghanem Y, et al. Management of sporadic renal angiomyolipomas: a systematic review of available evidence to guide recommendations from the European Association of Urology Renal Cell Carcinoma Guidelines Panel. European urology oncology. 2020;3(1):57-72.
Milner J, McNeil B, Alioto J, Proud K, Rubinas T, Picken M, et al. Fat poor renal angiomyolipoma: patient, computerized tomography and histological findings. The Journal of urology. 2006;176(3):905-9.
Gandhi SP, Pal BC, Patel KN, Sutariya H, Trivedi HL. Role of 64 slice multidetector computed tomography and angiography to establish relationship between tumor size, aneurysm formation and spontaneous rupture of renal angiomyolipomas: Single center experience. Urology annals. 2016;8(2):173.
Santos MMLd, Proença SMS, Reis MINPdA, Viana RMAL, Martins LMB, Colaço JMdR, et al. Spontaneous rupture of renal angiomyolipoma during pregnancy. Revista Brasileira de Ginecologia e Obstetrícia. 2014;36:377-80.
Zapardiel I, Delafuente-Valero J, Bajo-Arenas JM. Renal angiomyolipoma during pregnancy: review of the literature. Gynecologic and obstetric investigation. 2011;72(4):217-9.
Bosniak MA, Megibow AJ, Hulnick DH, Horii S, Raghavendra BN. CT diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat. AJR American journal of roentgenology. 1988;151(3):497-501.
Bagheri SM, Khajehasani F, Fatemi I, Ayoubpour MR. Tumoral vascular pattern in renal cell carcinoma and fat-poor renal angiomyolipoma as a novel helpful differentiating factor on contrast-enhanced CT scan. Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine. 2017;39(10):1010428317733144.
Lu CY, Min PQ, Wu B. CT evaluation of spontaneously ruptured renal angiomyolipomas with massive hemorrhage spreading into multi-retroperitoneal fascia and fascial spaces. Acta radiologica short reports. 2012;1(4):1-6.
Koo KC, Kim WT, Ham WS, Lee JS, Ju HJ, Choi YD. Trends of presentation and clinical outcome of treated renal angiomyolipoma. Yonsei medical journal. 2010;51(5):728-34.
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