Fig. 3.

Images in a 79-year old woman with a clear cell renal cell carcinoma (RCC) and bland inferior vena cava (IVC) thrombus without wall invasion. The RCC extends from the right kidney into the infrahepatic IVC. a axial T2-weighted HASTE image. b T1-weighted contrast-enhanced 3D GRE (VIBE) image and (c), the coronal T2-weighted HASTE image for anatomic reference. Note that the thrombus is floating in the IVC and that there is no complete obstruction of the caval lumen (a, c). The contrast-enhanced image (b) demonstrates that there is no enhancement of the tumor thrombus, contact to or breach of the vessel wall, so that IVC wall invasion appears unlikely. During extended nephrectomy, this thrombus could be easily removed from the IVC without necessitating segmental resection. HASTE = Half-Fourier-acquired singe-shot turbo spin echo, VIBE = Volumetric interpolated breath-hold examination