肾脏不典型囊性病变的Bosniak分级CT评价

目的探讨依据Bosniak分级标准用CT评价肾脏不典型囊性病变的诊断及处理。方法由两位放射诊断医生通过协商按Bosniak分级标准对65个病灶进行分类，并与临床随访和手术结果比较，计算该标准对是否需要手术切除判断的敏感性、特异性、准确性及阳性预测值、阴性预测值。结果本组病变中，按Bosniak分级标准诊断为Ⅱ级34个，ⅡF7个，Ⅲ级15个，Ⅳ级9个。对是否需要手术治疗的判断敏感性、特异性、准确性、阳性预测值和阴性预测值分别是83．3％、92．7％、89．2％、87．0％和90．5％。结论按Bosniak分级标准的CT表现，能准确地将需手术治疗的肾脏不典型囊性病变与仅需随访的病变加以区分。

CT assessment of atypical renal cystic lesions based on Bosniak classification system

Objective To investigate the value of the Bosniak classification system in diagnosis and management of incidental renal atypical cystic lesions according to CT findings. Methods Sixty-five atypical cystic lesions of kidney in 53 patients, whose outcome was confirmed by chnincal follow-up or surgery, were enrolled in this study. The lesions were categorized by two radiologists in consensus using the Bosniak classification system according to their CT features. Sensitivity, specificity, accuracy, positive predictive value(PPV)and negative predictive value(NPV)were calculated comparing with clinical outcome. Results The lesions were classified into 34 category Ⅱ, 7 categories ⅡF, 15 categories Ⅲ, and 9 categories Ⅳ. Comparing with clinical outcome, sensitivity, specificity and accuracy were 83.3%、 92.7 % and 89.2 %, respectively, with a PPV of 87.0 % and a NPV of 90.5 %. Conclusion Of the incidental renal atypical cystic lesions, the lesions requiring surgery can be accurately separated from those that can be safely followed up using the Bosniak classification system according to their CT features.