Nuhn P, Sterzik A, Stief C G, Staehler M, D'Anastasi M
Urologische Klinik und Poliklinik, Campus Großhadern, Ludwig-Maximilians-Universität München, Klinikum der LMU, Marchioninistraße 15, 81377, München, Deutschland,
Urologe A. 2015 Jul;54(7):972-82. doi: 10.1007/s00120-015-3866-4.
Cross-sectional imaging modalities including multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are the diagnostic standard in detection, characterization, and staging of renal masses due to their high sensitivity and specificity. Currently, most renal masses are incidentally diagnosed by imaging for other medical reasons. Recent developments have improved image acquisition with high resolution, while simultaneously reducing radiation dose. CT imaging is the most accessible cross-sectional imaging method and is, therefore, the standard technique. MRI is indicated in patients who are allergic to intravenous CT contrast medium, in patients with renal insufficiency, or in younger patients. Further characterization of renal masses is possible with functional imaging including dual energy CT, perfusion CT, or diffusion-weighted MRI. Contrast-enhanced ultrasound allows detection of even subtle enhancement in hypovascular lesions with high sensitivity and can add valuable information to CT and MRI studies.
包括多排螺旋计算机断层扫描(MDCT)和磁共振成像(MRI)在内的横断面成像方式,因其高敏感性和特异性,是肾肿块检测、特征描述及分期的诊断标准。目前,大多数肾肿块是在因其他医疗原因进行成像检查时偶然发现的。最近的进展提高了高分辨率图像采集能力,同时降低了辐射剂量。CT成像是最常用的横断面成像方法,因此是标准技术。对于对静脉注射CT造影剂过敏的患者、肾功能不全患者或年轻患者,建议使用MRI。通过包括双能CT、灌注CT或扩散加权MRI在内的功能成像,可以进一步明确肾肿块的特征。超声造影能够以高敏感性检测到低血供病变中甚至细微的强化,可为CT和MRI检查提供有价值的信息。