Evaluation of Cystic Renal Masses: Comparison of CT and MR Imaging by Using the Bosniak Classification System

Israel, Gary M.; Hindman, Nicole; Bosniak, Morton A.

doi:10.1148/radiol.2312031025

Cited by 358 publications

(227 citation statements)

References 11 publications

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“…11,12,15,[23][24][25][26][27]31,33,34,39,40,42,43,47,51,59 However, the literature is thought to overestimate the true risk of malignancy among category II cysts, as the majority were managed conservatively or had features that made them too complex to be categorized as a Bosniak II cyst. 6,12,26,29,31,32,35,38,59 Importantly, even if malignant, most behave in a relatively benign fashion. Consequently, similar to category I cysts, a followup for properly classified Bosniak II cysts is not warranted (Level of evidence: 3; Recommendation: C) and intervention is not recommended unless the patient is symptomatic.…”

Section: Bosniak Category IImentioning

confidence: 99%

CUA guideline on the management of cystic renal lesions

Richard¹,

Violette²,

Jewett³

et al. 2017

CUAJ

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Section: Bosniak Category IImentioning

confidence: 99%

CUA guideline on the management of cystic renal lesions

Richard¹,

Violette²,

Jewett³

et al. 2017

CUAJ

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“…In the two patients with complex cysts, the specialist opted for following them up by means of magnetic resonance imaging (MRI). CT follow-up has shown to be an effective form of management of patients with moderately complex renal cysts (22) , and CT and MRI demonstrate similar findings in the majority of renal cysts (31) . However in some cases, MRI demonstrated additional findings such as parietal thickening or septa, determining a change in the Bosniak classification and for this reason this imaging method has been utilized in the follow-up of these patients (31) .…”

Section: Discussionmentioning

confidence: 92%

O valor da fase sem contraste na tomografia computadorizada do abdome

et al. 2008

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OBJECTIVE: To determine the role of the unenhanced phase of abdominal computed tomography in patients without a definite diagnosis or undergoing tumor staging. MATERIALS AND METHODS: A prospective and transversal study was developed with 100 consecutive patients submitted to unenhanced and contrastenhanced abdominal computed tomography. Two observers evaluated all the computed tomography images in the contrast-enhanced phase (first analysis) and, later, in the unenhanced phase (second analysis) in an attempt to establish the primary and secondary diagnoses as a function of the clinical indication for the study. The frequency of changes in the diagnoses resulting from a combined analysis of the images in the pre-and post-contrast phases was evaluated. Cases with changes in the diagnosis were reviewed by clinical specialists for determining possible changes in the therapeutic approach. RESULTS: Primary and secondary diagnoses were changed in respectively 1 and 18 cases (p = 1.000; p = 0.143) as follows: steatosis, adrenal nodules, nephrolithiasis, renal cysts and hepatic calcification. In the cases where the unenhanced phase changed the diagnosis, the specialists changed the therapeutic approach in 14 of the 19 patients (73%) (p = 0.038). CONCLUSION: No significant change was observed in the primary or secondary diagnosis as a result of the findings in the unenhanced phase. However, changes in secondary diagnoses affected the therapeutic approach adopted by the specialists. Keywords: Computed tomography; Contrast media; Abdomen.OBJETIVO: Determinar o valor agregado da fase sem meio de contraste da tomografia computadorizada do abdome em pacientes sem diagnóstico determinado ou em estadiamento tumoral. MATERIAIS E MÉTODOS: Estudo prospectivo e transversal em 100 pacientes consecutivos submetidos a tomografia computadorizada abdominal sem e com meio de contraste intravenoso. Dois examinadores avaliaram todos os exames, procurando estabelecer, através da fase com meio de contraste intravenoso (primeira análise) e posteriormente através da fase sem contraste (segunda análise), o diagnóstico principal e os secundários em função da indicação clínica do exame. Mediu-se a freqüência de mudança diagnóstica decorrente da análise combinada das fases pré-e pós-contraste intravenoso. Casos que tiveram mudança diagnóstica foram avaliados por especialistas clínicos para determinar se implicaria mudanças de conduta. RESULTADOS: Diagnósticos principal e secundário foram modificados em 1 e 18 casos, respectivamente (p = 1,000; p = 0,143). Os diagnósticos modificados foram: esteatose, definição de nódulo em adrenal, nefrolitíase, classificação de cistos renais e calcificação hepática. Nos casos em que a fase sem contraste modificou o diagnóstico, os especialistas mudaram sua conduta em 14/19 (73%) dos pacientes (p = 0,038). CONCLUSÃO: A fase sem contraste não modificou significativamente o diagnóstico principal ou secundário. Porém, as mudanças nos diagnós-ticos secundários influenciaram na conduta adotada pelos especialistas. Unite...

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“…Эту нозологию следует дифференцировать с по-ликистозом почек, простыми кистами почек и ПКР, ассоциированным с кистой. Благодаря применению КТ и магнитно-резонансной томографии возможно выделить группу больных с наличием кистозного по-ражения почек, представляющих интерес в соответст-вии с системой классификации по Bosniak и требую-щих немедленного или отсроченного хирургического лечения [10,11]. Кроме того, отметим, что в настоя-щем исследовании прослежена тенденция к наличию сопутствующего кистозного поражения паренхима-тозных органов (19 (59,4 %) из 32 больных).…”

Section: Discussionunclassified