0:00

Dr. Farnaz, I just want to quickly define the

0:03

phases of enhancement in the kidney,

0:06

which are similar to phases of enhancement

0:08

of the liver with slightly different names.

0:10

So, arterial enhancement, what

0:12

do you think, 30 to 40 seconds?

0:14

Yep, around 40 seconds.

0:15

And that's where hypervascular, uh, masses

0:18

like renal cell carcinoma, the nasty ones.

0:20

The more vascular they are, the nastier they are.

0:23

That's where they live.

0:24

So, an arterial enhancement phase

0:26

can be potentially very important.

0:29

Then the next phase would be the

0:30

nephrogenic phase, about 85 to 90 seconds.

0:34

And then finally, the excretory phase

0:36

is gonna be about 2 to 4 minutes.

0:38

Now, the portal venous phase, which many of us are

0:39

used to, 60 to 90 seconds as an analogous, uh, term.

0:44

So, when you're measuring lesions,

0:46

which we're gonna do throughout this entire

0:48

vignette series, where you measure matters.

0:51

So, if you have a really hypervascular lesion,

0:54

like a classic aggressive renal cell carcinoma,

0:57

you might measure it in the arterial phase,

1:00

and then see if it washes out progressively over

1:02

time if the Hounsfield unit drops properly.

1:05

On the other hand, a hypovascular lesion may

1:07

show up better a little bit later in the middle.

1:10

Maybe a minute and a half,

1:11

two minutes, two and a half minutes.

1:13

And then you might follow that into the delayed

1:15

excretory phase to see if that has a drop.

1:18

So, it may be beneficial to do serial measurements.

1:21

Arterial to nephrogenic phase,

1:24

nephrogenic phase to excretory phase.

1:26

38 00:01:27,490 --> 00:01:29,510 Any other comments about, you know, phases?

1:29

No, I think that's it.

1:30

Alright, Pomeranz and Farnazzo out.