Járay Ákos, Farkas Péter István, Semjén Dávid, Botz Bálint
Department of Medical Imaging, Medical School, University of Pécs, Ifjúság út 13, Pécs, H-7624, Hungary.
Department of Pathology, Medical School, University of Pécs, Szigeti út 12, Pécs, H-7624, Hungary.
BMC Med Imaging. 2025 Aug 29;25(1):358. doi: 10.1186/s12880-025-01905-9.
Contrast-enhanced ultrasound (CEUS) is increasingly used in the characterization of cystic renal lesions. Bosniak IIF lesions warrant follow-up, and their reported progression rate remains variable.
In this single-center retrospective study we assessed renal CEUS exams (SonoVue) with a diagnosis of Bosniak IIF lesion, conducted between 2015 and 2020. 56 patients (59 lesions) met inclusion criteria. Patient demographics, lesion morphology, follow-up adherence, and outcomes were evaluated.
Significant (p = 0.037) positive correlation was found between patient age and lesion size. 33.9% of patients were immediately lost to follow-up, and they tended to be younger, albeit not significantly (p = 0.09). Recommendation for follow-up imaging was indicated in 66.1% of the initial radiological reports. Follow-up adherence was not significantly lower for lesions with absent recommendation (55% vs. 70.27%, p = 0.26). Fewer (52%) female vs. male (74.19%) patients had a follow-up recommendation (p = 0.1, not significant). 10.8% of the followed lesions demonstrated progression within 5 years. Lesion reevaluation according to the 2020 European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) criteria resulted in 77.36% agreement with 22.2% of lesions being downgraded, and a single lesion being upgraded (p = 0.0015, significant).
Follow-up adherence of Bosniak IIF cystic renal lesions was found to be suboptimal, with potential gender disparities. Standardization of follow-up recommendation in the report is an unmet need. Progression rate remains low, but is expected to change with the adoption of novel CEUS-specific criteria. The EFSUMB criteria in particular can improve selection of truly indeterminate lesions.
Retrospectively registered.
超声造影（CEUS）在肾囊性病变的特征描述中应用越来越广泛。博斯尼亚克IIF类病变需要进行随访，但其报道的进展率仍存在差异。
在这项单中心回顾性研究中，我们评估了2015年至2020年间诊断为博斯尼亚克IIF类病变的肾脏CEUS检查（声诺维）。56例患者（59个病变）符合纳入标准。评估了患者的人口统计学特征、病变形态、随访依从性和结果。
发现患者年龄与病变大小之间存在显著正相关（p = 0.037）。33.9%的患者立即失访，他们往往更年轻，尽管差异不显著（p = 0.09）。66.1%的初始放射学报告中指出了进行随访成像的建议。对于未给出建议的病变，随访依从性并无显著降低（55%对70.27%，p = 0.26）。有随访建议的女性患者（52%）少于男性患者（74.19%）（p = 0.1，不显著）。10.8%的随访病变在5年内出现进展。根据2020年欧洲医学与生物学超声学会（EFSUMB）标准对病变进行重新评估，结果显示一致性为77.36%，22.2%的病变降级，单个病变升级（p = 0.0015，显著）。
发现博斯尼亚克IIF类肾囊性病变的随访依从性欠佳，可能存在性别差异。报告中随访建议的标准化是一项未满足的需求。进展率仍然较低，但随着采用新的CEUS特异性标准，预计会有所变化。特别是EFSUMB标准可以改善真正不确定病变的选择。
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