Charité - Universitätsmedizin Berlin, Corporate Member of FreieUniversität Berlin, Humbold, Universitätzu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany.
Department of Nephrology, University Hospital Regensburg, Regensburg, Germany.
Clin Hemorheol Microcirc. 2020;75(4):419-429. doi: 10.3233/CH-190764.
Contrast-enhanced-ultrasound (CEUS) has been frequently used in assessment of cystic renal lesions.
The aim of this study was to investigate the Bosniak classification in CEUS compared to CT and MRI in a multi-center setting.
Bosniak classification in CEUS examinations of cystic renal lesions were compared to imaging findings in computed-tomography (ceCT) and magnetic-resonance-imaging (ceMRI). Imaging results were correlated to histopathological reports. All examinations were performed by experts (EFSUMB level 3) using up-to-date CEUS examination-protocols.
Overall, 173 cystic renal lesions were compared to subgroups CT (n = 87) and MRI (n = 86). Using Bosniak-classification 64/87 renal cysts (73.6%) were rated equal compared to CT with upgrade of four lesions (4.6%) and downgrade of 19 lesions (21.8%) by CT (Intra-class-correlation [ICC] coefficient of 0.824 [p < 0.001]). CEUS compared to MRI, presenting different scoring especially in classes Bosniak IIF (n = 16/31) and Bosniak III (n = 16/28) with an ICC coefficient of 0.651 (p < 0.001).
CEUS can visualize even finest septal and small nodular wall enhancement, which may result in an upgrade of cystic lesions into a higher Bosniak class compared to CT or MRI. Thus, a modification of the Bosniak classification on CEUS may reduce unnecessary biopsies and surgery.
超声造影（CEUS）已广泛应用于囊性肾病变的评估。
本研究旨在探讨多中心条件下 CEUS 与 CT 和 MRI 对 Bosniak 分类的对比。
将 CEUS 检查中囊性肾病变的 Bosniak 分类与计算机断层扫描（ceCT）和磁共振成像（ceMRI）的影像学结果进行比较。影像学结果与组织病理学报告相关联。所有检查均由专家（EFSUMB 3 级）使用最新的 CEUS 检查方案进行。
总体而言，173 个囊性肾病变与 CT 亚组（n = 87）和 MRI 亚组（n = 86）进行了比较。使用 Bosniak 分类，87 个肾囊肿中有 64 个（73.6%）与 CT 结果相等，CT 升级了 4 个病变（4.6%），降级了 19 个病变（21.8%）（ICC 系数为 0.824，p < 0.001）。CEUS 与 MRI 相比，特别是在 Bosniak IIF 类（n = 16/31）和 Bosniak III 类（n = 16/28）中，评分存在差异，ICC 系数为 0.651（p < 0.001）。
CEUS 可以显示甚至最细的分隔和小的结节状壁增强，这可能导致囊性病变在 Bosniak 分类中升级为更高的等级，与 CT 或 MRI 相比。因此，CEUS 上 Bosniak 分类的修改可能会减少不必要的活检和手术。
