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Eur J Radiol. 2007 Feb;61(2):310-4. Epub 2006 Nov 13.

Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US.

Author information

1
The Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, Republic of Korea. rapark@skku.edu

Abstract

OBJECTIVES:

To compare retrospectively the imaging features of computed tomography (CT) and contrast-enhanced US (CEUS) imaging for the assessment of cystic renal masses using the Bosniak classification system.

MATERIALS AND METHODS:

The CT and CEUS images of 31 pathologically confirmed cystic renal masses in 31 patients were retrospectively analyzed for septa numbers, wall and/or septa thickness, enhancement degree, and for the presence of a solid component by consensus between two radiologists using the Bosniak classification. Diagnostic accuracies of CT and CEUS for malignant cystic tumor were calculated and compared using McNemar test.

RESULTS:

Diagnostic accuracies of CT and CEUS for malignant renal tumor were 74% and 90%, respectively, but there were not statistically different (P>0.05). CEUS and CT images showed same Bosniak classification in 23 (74%) lesions and there were differences in 8 (26%) lesions, all of which were upgraded by CEUS; one lesion from I to IV, two lesions from II to IV, two lesions from IIF to III, and three lesions from III to IV. CEUS images depicted more septa in 10 (32%) lesions, more thickened wall and/or septa in 4 (13%) lesions, and stronger enhancement in 19 (61%) lesions. Moreover, for six lesions, solid component was detected by CEUS but not by CT.

CONCLUSION:

CEUS might better visualize septa number, septa and/or wall thickness, solid component and the enhancement of some renal cystic masses than CT, resulting in upgrade of Bosniak classification and affecting their treatment plan.

PMID:
17097844
DOI:
10.1016/j.ejrad.2006.10.004
[Indexed for MEDLINE]

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