Abstract
The classification of cystic renal masses according to computed tomography data, which allows to stratify them depending on the risk of malignancy, was created by M.A. Bosniak in 1986 and modified in 1994. Various groups of researchers have carried out meta-analysis based on the results of applying the proposed classification during the time that has passed since the publication of the last version. Taking into account the information received, which revealed a number of limitations and disadvantages of the previously used method for systematizing renal cystic masses, as well as in connection with the development of medical imaging methods, updated diagnostic algorithms were formulated, which served as the basis for the Bosniak 2019 classification. It is expected that the use of Bosniak 2019 will optimize stratification renal lesions of the cystic structure and reduce the number of removed benign tumors, can be used as a basis for the future research to further improve the classification and its congruence with the requirements of clinical specialists.
Highlights
The classification of cystic renal masses according to computed tomography data, which allows to stratify them depending on the risk of malignancy, was created by M.A
Taking into account the information received, which revealed a number of limitations and disadvantages of the previously used method for systematizing renal cystic masses, as well as in connection with the development of medical imaging methods, updated diagnostic algorithms were formulated, which served as the basis for the Bosniak 2019 classification
Cystic mass in the left kidney with multiple thin septa (IIF Bosniak 2019): a – CT scan, venous phase; б – unenhanced T2 weighted fat saturated MRI scan
Summary
Классификация Bosniak 2019: обновленные алгоритмы диагностики кистозных образований почек. Введение Классификация Bosniak была предложена более 30 лет назад для стратификации риска малигнизации кистозных образований почек по данным компьютерной томографии (КТ) [1]. При оценке кистозных очагов категорий Bosniak II, IIF и III результаты значительно разнились, и час тота расхождений варьировала от 6 до 75 %, что, по мнению авторов, было значимой погрешностью [7] и, в свою очередь, продиктовало необходимость дальнейшего усовершенствования системы унифицированной оценки кистозных образований почек. Основанием для пересмотра классификации Bosniak послужила необходимость усовершенствования критериев дифференциальной диагнос тики кистозных образований почек по данным медицинской визуализации, что в перспективе позволит сократить количество хирургических вмешательств у пациентов с доброкачественными новообразованиями. Важность пересмотра критерия измеримого контрастного усиления септ или капсулы обусловлена тем, что в ряде случаев именно этот параметр является решающим для отнесения образований с низким злокачественным потенциалом к категориям Bosniak III и IV, требующих выбора хирургической стратегии.
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