超声造影结合Bosniak标准在良恶性肾囊性病变鉴别诊断中的价值

目的 评价超声造影鉴别良恶性肾囊性病变的准确性,探讨超声造影结合Bosniak标准分级诊断肾囊性病变的可行性.资料与方法 对30例患者的36个肾囊性病灶进行超声造影,分析良恶性肾囊性病变的超声造影征象;按照Bosniak标准对超声造影的表现进行分级诊断,计算其敏感性、特异性、诊断符合率、阳性预测值、阳性似然比、Kappa值及验后概率,分析该方法分级诊断肾囊性病变的准确性.结果 超声造影可显示常规超声不能发现的囊内分隔及实性结构.超声造影结合Bosniak标准诊断肾囊性病变的敏感性、特异性、诊断符合率、阳性预测值、阳性似然比分别为92.9％、90.9％、94.8％、86.7％、10.2,Kappa=0.83;应用超声造影结合Bosniak标准可提高肾囊性病变良恶性诊断的验后概率.结论 超声造影结合Bosniak标准可以提高鉴别诊断肾囊性病变良恶性的准确性.

Value of Contrast Enhanced Ultrasonography Combined with Bosniak System in the Differential Diagnosis of Benign and Malignant Renal Cystic Lesions

Purpose To evaluate contrast enhanced ultrasonography(CEUS) in differential diagnosing renal cystic lesions,and identify the diagnosis classification of renal cystic lesions with Bosniak.Materials and Methods Thirty patients with 36 renal cystic masses were detected with CEUS.All masses were graded according to features of CEUS with Bosniak criteria.The sensitivity,specificity,accuracy,positive predictive value,positive likelihood ratio,Kappa value and posterior probability were calculated.This method was testified the authenticity and reliability.Results CEUSshowed more separated and solid structure in renal cystic mass than conventional ultrasound.CEUS combined with Bosniak system had a sensitivity,specificity,accuracy,positive predictive value,positive likelihood ratio of 92.9%,90.9%,94.8%,86.7%,10.2,Kappa value was 0.83.CEUS combined with Bosniak classification improved the posterior probability of differential diagnosis in renal cystic mass.Conclusion CEUS with Bosniak classification can improve the diagnosis accuracy in benign and malignant renal cyst mass.