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)。
作者单位E-mail
周玲 湖北文理学院附属医院 襄阳市中心医院放射影像科, 湖北 襄阳 441021  
李安琴 华中科技大学同济医学院附属同济医院放射科, 湖北 武汉 430030  
梁萍 华中科技大学同济医学院附属同济医院放射科, 湖北 武汉 430030  
胡道予 华中科技大学同济医学院附属同济医院放射科, 湖北 武汉 430030  
李震 华中科技大学同济医学院附属同济医院放射科, 湖北 武汉 430030  
许楚瓯 华中科技大学同济医学院附属同济医院放射科, 湖北 武汉 430030 xchuou@163.com 
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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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