Ziegelmüller B K, Spek A, Szabados B, Casuscelli J, Clevert D-A, Staehler M
Urologische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
Urologe A. 2018 Mar;57(3):274-279. doi: 10.1007/s00120-018-0585-7.
The incidence of small renal masses has been rising over the last few decades. At the same time, mortality of renal cell carcinoma (RCC) is decreasing. These trends can be explained by the availability of improved therapeutic measures and the good prognosis of small renal masses (SRM) turning out to be histopathologically benign or of low malignancy in many cases.
The aim of this article is to present epidemiology and diagnostic assessment of SRM.
Statistics, basic research, guidelines.
The incidence of SRM is rising due to the widespread use of imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS). Sensitivity is excellent for CEUS and for CECT in the characterization of SRM, while good specificity values can be reached by MRI. For characterization of complex cystic renal masses, CEUS has good diagnostic accuracy.
Due to improved diagnostic possibilities, SRMs can be diagnosed in early asymptomatic stages. As SRM have a good prognosis and often are of low malignancy therapy, options should be carefully considered; especially in older patients, active surveillance should considered.
在过去几十年中,小肾肿块的发病率一直在上升。与此同时,肾细胞癌(RCC)的死亡率正在下降。这些趋势可以通过改进治疗措施的可用性以及小肾肿块(SRM)在许多情况下病理组织学上为良性或低恶性的良好预后来解释。
本文旨在介绍SRM的流行病学和诊断评估。
统计、基础研究、指南。
由于计算机断层扫描(CT)、磁共振成像(MRI)和对比增强超声(CEUS)等成像技术的广泛应用,SRM的发病率正在上升。CEUS和CT增强扫描在SRM特征性诊断方面敏感性极佳,而MRI可达到良好的特异性值。对于复杂囊性肾肿块的特征性诊断,CEUS具有良好的诊断准确性。
由于诊断可能性的提高,SRM可以在早期无症状阶段被诊断出来。由于SRM预后良好且通常恶性程度较低,治疗方案应仔细考虑;特别是在老年患者中,应考虑主动监测。