【摘要】 目的 探讨CT和MR检查在囊性肾癌Bosniak分级诊断中的应用价值,提高对囊性肾癌的影像学特点的认识。方法 回顾性分析2013年1月至2016年1月21例经手术病理证实的囊性肾癌(21个病灶)患者的临床资料,所有患者均在半年内同时进行CT和MRI检查,并按Bosniak分类法进行分级。男15例,女6例;年龄23~66岁,平均年龄45.9岁。结果 手术患者中CT分级为囊肿恶性Ⅱ级1例(4.8%)、Ⅲ级8例(38.1%)、Ⅳ级12例(57.1%)。MR分级为囊肿恶性Ⅱf级0例、Ⅲ级6例(28.6%)、Ⅳ级15例(71.4%)。4例囊性肾癌的CT和MR的分级不相符,其中,1例由Ⅱf级(CT分级)上升为Ⅲ级(MR分级),3例由Ⅲ级(CT分级)上升为Ⅳ级(MR分级)。结论 CT和MR对囊性肾癌的Bosniak分级诊断具有相似的临床应用价值,CT增强评估结合MR评估有助于提高囊性肾癌的诊断准确率及临床治疗方案的决策。更多还原

【Abstract】 Objective To investigate the value of CT and magnetic resonance(MR) imaging in the evaluation of cystic renal cell carcinoma by using the Bosniak classification system and to increase the understanding of the CT and MR features of cystic renal cell carcinoma.Methods The present study retrospectively analyzed 21 cystic renal cell carcinoma in 21 patients(6 women,15 men; mean age,45.9 years; range,23-66years),who had undergone both computed tomography(CT) and MR examinations within 6 months.and ultimately received surgical treatment.For each lesion,size of both cyst and solid component,appearing of calcification,number of septa,thickness of wall and septa,and presence of enhancement were analyzed.Each lesion was categorized(Bosniak classification) on CT and MR respectively.The MR findings were compared with CT and pathological results.Results On MR,there were 6 category Ⅲ and 15 category Ⅳ lesions.On CT,there were 1 category ⅡF,8category Ⅲ and 12 category Ⅳ lesions.Findings on CT and MR images were different in 4(19%) lesions.Among them,1 category ⅡF lesions on CT were upgraded to category Ⅲ on MR images,and the other 3 category Ⅲ lesions on CT were classified as category Ⅳ on MR.In these lesions,MRI depicted increased wall/septa thickness(n=4) and enhanced mural nodule or soft-tissue components(n=3) compared with CT,resulted in a classification upgrade.Based on the pathological results,1 of category ⅡF(4.8%),8 of category Ⅲ(38.1%) and 12 category Ⅳ(57.1%)lesions on CT images were malignant.On MR,6 of category Ⅲ(28.6%) and 15 category Ⅳ(71.4%) lesions were malignant.Conclusion CT and MR imaging findings are similar in the majority of cystic renal cell carcinoma.It is necessary to combine MR features with CT findings in evaluation and management of these cases with renal cystic masses.更多还原