Benign atypical cysts of the kidney: MRI aspects

The aim of this study was to assess the magnetic resonance imaging (MRI) characteristics of 13 benign complex renal cysts using T1 and T2-weighted images and contrast-enhanced images. The results have been compared to CT and ultrasonographic findings in all cases and correlated with histopathologic data in 12 cases. Five groups have been defined according to the MR features. Group 1: homogeneous low signal intensity on T1-weighted images and homogeneous high signal intensity on T2-weighted images mimicking simple cyst (n = 2); group 2: homogeneous high signal intensity on both T1 and T2-weighted images mimicking hemorrhagic cyst (n = 1); group 3: caracterised by high signal intensity on T1-weighted images and fluid-iron level on T2-weighted images (n = 3); group 4: characterised by fluid-iron level on both T1 and T2-weighted images (n = 3); group 5: pseudotumoral feature: heterogeneous signal intensity and/or wall contrast enhancement (n = 3). Among the 13 indeterminate lesions on ultrasonography and CT, MRI was of diagnostic value in 8 cases, whereas the 5 remaining cases remained indeterminate on MR images. Our results suggest that MRI can be useful in the diagnosis of benign complex cyst of the kidney presenting as indeterminate cystic lesion on other modalities.