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The Renal Sinus: Pathologic Spectrum and Multimodality Imaging Approach¹

¹ From the Departments of Radiology (S.E.R., J.Y.B., S.E.J., S.N.O., J.M.L.) and Pathology (Y.J.C., A.L.), College of Medicine, Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, South Korea. Recipient of a Cum Laude award for an education exhibit at the 2003 RSNA scientific assembly. Received February 4, 2004; revision requested April 2 and received May 7; accepted May 12. All authors have no financial relationships to disclose. Address correspondence to J.Y.B. (e-mail: jybyun@catholic.ac.kr).

Various pathologic conditions can occur in the renal sinus, primarily originating in the constituents of the renal sinus, and the renal sinus can be secondarily involved by surrounding renal parenchymal and adjacent retroperitoneal lesions. Lipomatosis and cysts are common renal sinus lesions with little clinical significance, but differentiation from other pathologic conditions is important. Renal vascular lesions such as renal artery aneurysm or arteriovenous fistula can mimic other parapelvic or peripelvic lesions at excretory urography, but their vascular nature is evident at color Doppler ultrasonography, contrast material–enhanced computed tomography (CT), and magnetic resonance (MR) imaging. Although most tumors originating in the renal pelvis are transitional cell carcinoma or squamous cell carcinoma, renal parenchymal tumors such as renal cell carcinoma or benign multilocular cystic nephroma have a tendency to grow into the renal sinus. Rare tumors of mesenchymal origin can develop in the renal sinus, but their imaging findings are nonspecific. The observation of renal sinus fat is important for detecting a small tumor located in that area and determining the exact tumor stage. Multiplanar CT or MR images can allow exact evaluation of the extent of complex renal sinus disease.

© RSNA, 2004

Index Terms: Aneurysm, renal, 814.73 • Arteriovenous malformations, renal, 814.1494, 814.494 • Kidney, cysts, 814.311 • Kidney, hemorrhage, 814.4132, 814.64 • Kidney neoplasms, diagnosis, 814.30 • Lipoma and lipomatosis, 814.894 • Nephritis, 814.212 • Urinoma, 814.3116, 814.415

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