Quiz: Kidneys & Bladder 2

Objectives: This course is a comprehensive review of the most important aspects of Genito-Urinary MRI, covering multiple organs and diagnoses. The knowledge required for general competence in interpreting GU MRI exams is delivered in 15 lectures by international experts on each topic.

1. Which are the indications for renal MRI? Select all that apply.*

Modality of choice for radiation-free workup of hematuria
Contra-indications for iodinated contrast
Radiation protection in paediatric population
Characterization of renal masses when CT and US are inconclusive
Differentiation of cystic versus solid lesions in pregnant patients
Assessment of Bosniak II or IIF cysts on CT scan.

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2. What is the current role of MRI of renal masses?*

To distinguish benign from malignant neoplasms
To replace ultrasound as the modality of choice for assessment of incidental renal lesions
To predict subtypes of renal masses
To confirm presence of suspected renal masses and detect internal enhancement
None of the above

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3. Which statement(s) is(are) CORRECT regarding fat containing renal lesions? Select all that apply.*

Loss of signal on GRE T1-weighted images (T1WI) is diagnostic for angiomyolipoma (AML).
Signal intensity (SI) index on GRE T1WI can be used to differentiate AML from clear cell RCC (ccRCC).
RCC can be differentiated from minimal fat AML using T2 SI ratio.
Combination of T2 SI ratio and Arterial-Delayed Enhancement Ratio increases accuracy of differentiating AML with minimal fat from papillary RCC (pRCC)
Presence of intralesional fat is 100% accurate in differentiating pRCC from ccRCC.
Necrosis in a fat-containing lesion excludes AML from differential diagnosis.

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4. Which statement(s) is(are) CORRECT regarding renal mass phenotypes? Select all that apply.*

Hemorrhagic cyst + enhancing papillary projections = Papillary RCC (pRCC)
Necrosis + septae and enhancing nodules = low grade clear cell RCC (ccRCC)
Hyper-intense on T2WI + avid enhancement = ccRCC or Oncocytoma
Hypo-intense on T2WI + low grade enhancement = pRCC
Hypo-intense on T2WI + Segmental enhancement inversion = Oncocytoma

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5. What information should be included in the radiology report for pre-surgical evaluation of a renal mass? Select all that apply.*

Lesion subtype, if possible
Arterial & venous anatomy
Side, Location and size of the lesion
Relationship of lesion margins compared to renal capsule and renal pelvis fat
Number and location of abnormal lymph nodes
Presence and extent of venous thrombus in renal veins and IVC
Presence of adrenal or distant metastases

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