Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.
Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Yee Zen Hospital, Taoyuan, Taiwan, ROC; Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan, ROC.
J Chin Med Assoc. 2018 Dec;81(12):1017-1026. doi: 10.1016/j.jcma.2018.04.008. Epub 2018 Jul 13.
Renal cysts are common incidental findings in clinical practice. Most renal cysts detected in medical imaging are benign simple cysts. However, some are complicated by hemorrhage or infection or are associated with calcification. In these instances, difficulties can be encountered distinguishing the complicated cysts from cystic renal tumors such as cystic renal cell carcinoma, multilocular cystic nephroma, and mixed epithelial and stromal tumors. The Bosniak classification is widely used to categorize cystic renal lesions but is used to classify those discovered via computed tomography. Ultrasonography (US) and color Doppler US are the most frequently used imaging techniques for abdominal surveys and long-term follow-up because of their noninvasiveness, relatively low cost, wide availability, and frequently, lack of contrast medium. Herein, we review the features of various cystic lesions of the kidney that can be found using US, discuss differential diagnoses using US, and propose a feature-oriented algorithmic approach to classifying renal cystic lesions using US.
肾脏囊肿在临床实践中是常见的偶发发现。在医学影像学中检测到的大多数肾脏囊肿是良性单纯性囊肿。然而，有些囊肿会合并出血或感染，或与钙化有关。在这些情况下，区分复杂囊肿与囊性肾肿瘤（如囊性肾细胞癌、多房性囊性肾瘤和混合上皮和基质肿瘤）可能会遇到困难。Bosniak 分类广泛用于分类囊性肾脏病变，但用于分类通过计算机断层扫描发现的病变。超声检查（US）和彩色多普勒超声是腹部检查和长期随访最常使用的成像技术，因为它们具有非侵入性、相对较低的成本、广泛的可用性，并且通常不需要造影剂。在此，我们回顾了使用 US 可以发现的各种肾脏囊性病变的特征，讨论了使用 US 进行的鉴别诊断，并提出了一种基于特征的算法，用于使用 US 对肾脏囊性病变进行分类。
