Comparative Study Of CT And MRI Imaging Of Cystic Renal Mass With Bosniak Classification

objective: To analyze cystic renal mass (CRM) CT and MR images and compared with Bosniak classification, contrast the advantages and disadvantages of CT and MRI, evaluate clinical significance for the identification of benign and malignant lesions, provide reliable inspection method for clinical diagnosis and theoretical basis. Materials and methods:116 cases of patients with cystic renal mass of our hospital from January 2008 to August 2014 were analyzed retrospectively. All cases of cystic renal mass were proved by postoperative pathology. Among them,72 cases of male, female in 44 cases. Aged 6-63, the average 45 years old.2 cases presenting with macroscopic haematuria,9 cases with abdominal mass,46 cases with renal area unwell,59 cases of routine physical examination detected. In less than 2 weeks, all were performed MSCT and MRI scan and enhance. Observe patients’ gender, age, clinical manifestation, gross pathology, MSCT and MR imaging findings, including the lesion site, size, shape, boundary, separation, calcification, solid nodules, and the density of the relationship between the surrounding tissue, scan or signal, strengthening degree and characteristics, etc. Three seniorly radiology doctors judged Bosniak classification standard, based on between MSCT and MRI image,and statistical classification results,compared with pathological results, data analysis, statistical methods using chi-square test.Results:Of 116 cases of cystic renal mass,96 cases of renal cyst (Single cavity 77 cases, multilocular 19 cases) and cystic renal carcinoma 20 cases (Single cavity 9 cases, multilocular 11 cases).72 males and 44 females.Aged 6-63years, average age 45years. Routine physical examination detected 59 cases,46 cases of renal area unwell, macroscopic hematuria in 2 cases,9 cases of abdominal mass. Lengther to 0.8-12cm, average 2.4cm. circular 85 cases, oval 15 cases, shape of grape 6 cases. Upper pole of renal 21 cases, middle of renal 66 cases,lower pole of renal 29 cases.87 cases In renal cortex,29 cases in the renal medulla.Dotted or strip calcified in cystic wall 23 cases, without calcification 93 cases.Nodules in cystic wall 13 cases, no nodules in cystic wall 103 cases. Multilocular 30 cases, including septum thickening of 11 cases; Single cavity 86 cases. MSCT examination performance: Boundary clear 93 cases,23 cases of boundary is not clear; Cystic uniform density 102 cases,14 cases were mixed high and low density;Cystic wall without enhancement 65 cases, cystic wall slight enhancement the 40 cases, septa or nodule different enhancement 11 cases. MRI performance: Boundary clear 103 cases,13 cases of boundary is not clear. Cystic wall without enhancement 60 cases, cystic wall slight enhancement the 47 cases, septa or nodule different enhancement 9 cases. According to the CT scan and enhanced scan, according to the Bosniak evaluation for classification,65 case of class 1,24 case of class Ⅱ, 16 case of class Ⅲ,11case of class IV;According to the MRI scan and enhanced scan, according to the Bosniak evaluation for classification,60 case of class 1,35 case of class Ⅱ, 12 case of class Ⅲ,9 case of class IV.The test of Chi-square show that it was differences that judgment Bosniak classification base on CT and MRI images of pathological coincidence rate.P<0.05. Conclusion:For cystic renal mass, CT and MRI scan is difficult to diagnose the nature, enhanced scanning significance is bigger. MRI enhancement showed lesions details more clearly, diagnostic accuracy is higher than CT, is more advantageous to qualitative diagnosis, especially for characteristic lesions can confirm the diagnosis, evaluation Bosniak classification more accurate,provide reliable reference basis for clinical treatment.