| 周玲,李安琴,梁萍,胡道予,李震,许楚瓯.MRI鉴别诊断良恶性Bosniak Ⅲ级肾囊性病变[J].中国医学影像技术,2019,35(11):1693~1697 |
| MRI鉴别诊断良恶性Bosniak Ⅲ级肾囊性病变 |
| MRI differential diagnosis of benign or malignant Bosniak Ⅲ renal cystic lesions |
| 投稿时间：2019-01-25 修订日期：2019-09-26 |
| DOI：10.13929/j.1003-3289.201901157 |
| 中文关键词: 肾肿瘤 磁共振成像 诊断,鉴别 |
| 英文关键词:kidney neoplasms magnetic resonance imaging diagnosis, differential |
| 基金项目:国家自然科学基金（81771801、81571642、81701657、81801695）。 |
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| 中文摘要: |
| 目的 探讨MRI显示囊内小结节（>3 mm）对Bosniak Ⅲ级肾囊性病变良恶性的鉴别诊断价值。方法 回顾性分析48例Bosniak Ⅲ级肾脏囊性病变患者的临床资料。根据MRI是否显示其内有>3 mm结节，将病灶分为囊内结节型和非结节型，对比观察其恶性率、病灶最大径、T2WI和/或T1WI信号不均匀及DWI弥散受限情况。结果 48例Bosniak Ⅲ级肾脏囊性病变患者共58个病灶，囊内非结节型病灶33个，恶性5个（5/33，15.15%）；囊内结节型25个，恶性17个（17/25，68.00%）；囊内结节型病灶恶性率高于囊内非结节型（χ2=16.847，P<0.001）。囊内结节型病灶最大径平均值为49.20 mm，囊内非结节型病灶为51.00 mm，二者差异无统计学意义（P>0.05）。囊内非结节型病灶内T2WI和/或T1WI信号不均匀12个（12/33，36.36%），囊内结节型15个（15/25，60.00%），二者比较差异无统计学意义（P>0.05）。囊内非结节型、囊内结节型病灶中DWI呈高信号（即弥散受限）分别为4个（4/8，50.00%）、10个（10/11，90.91%），二者比较差异有统计学意义（P<0.05）。结论 Bosniak Ⅲ级肾囊性病变中囊内结节型（即囊内>3 mm小结节）具有更高的恶性风险，DWI对其良恶性鉴别有一定意义。 |
| 英文摘要: |
| Objective To investigate the value of MRI depicting intracystic small nodules (>3 mm) in differential diagnosis of benign or malignant Bosniak Ⅲ renal cystic lesions. Methods Clinical data of 48 patients with Bosniak Ⅲ renal cystic lesions were analyzed retrospectively. According to MRI displaying>3 mm nodules inside or not, the lesions were divided into intracystic nodular and non-intracystic nodular types. The malignant rate, the maximum diameter, inhomogeneous signal of T2WI and/or T1WI and restricted diffusion of DWI were recorded and compared between the two types. Results There were 58 lesions in 48 cases of Bosniak Ⅲ cystic lesions, among them 33 cases were found with non-intracystic nodular lesions (5 was malignant) and 25 with intracystic nodular lesions (17 was malignant). The malignant rate of intracystic nodular lesions was higher than that of non-intracystic nodular lesions (χ2=16.847, P<0.001). The mean diameter of intracystic nodular lesions was 49.20 mm, and 51.00 mm in the non-intracystic nodular lesions (P>0.05). The inhomogeneous signal intensity of T2WI and/or T1WI were observed in 12 (12/33, 36.36%) of non-intracystic nodular lesions and 15 (15/25, 60.00%)of intracystic nodular lesions (P>0.05). In the non-intracystic nodular lesions and intracystic nodular lesions, 4 (4/8, 50.00%) and 10 (10/11, 90.91%) showed high signal intensity on the DWI images respectively (P<0.05). Conclusion Renal cystic lesions with intracystic nodule (>3 mm) has a higher risk of malignancy, and DWI has a certain significance for the differentiation of benign and malignant lesions. |
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