The current radiological approach to renal cysts.
The current radiological approach to renal cysts.
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目前治疗肾囊肿的放射学方法。
DOI：
10.1148/radiology.158.1.3510019
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发表时间：
1986
期刊：
影响因子：
19.7
通讯作者：
M. Bosniak
中科院分区：
文献类型：
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作者：
M. Bosniak
自20世纪50年代以来，肾囊肿的放射学诊断（及其与肾肿瘤的鉴别）已经取得了长足的进步，当时对于使用尿路造影检测到的每个肾脏肿块，除非临床禁忌，否则采用手术探查的方法。肾断层摄影、肾血管造影及囊肿穿刺术在随后的几年中有助于囊肿与肿瘤的鉴别。然而，在大多数情况下，超声和CT（或必要时结合这些）已成为评估肾脏肿块的主要诊断技术，并且使用它们，我们从未如此准确，无创和相对经济有效。CT的广泛应用使得许多小肾癌的偶然发现成为可能，切除这些小肾癌将提高肾实质肿瘤患者的总体治愈率。另一方面，我们也发现了比以前更多的囊肿。因此，我们必须警惕，不要发现我们无法确定良性放射学诊断的病变，因为这只会再次增加探查手术的需要。因此，必须非常小心地进行影像学检查，根据严格的标准进行诊断，并获得更多的困难病变经验，以便确定适当的治疗方法。如果我们能够做到这一点，那么现在的放射学时代就可以被记住，因为在肾脏肿块的评估方面取得了巨大进步，从而改善了患者的管理和疾病的治疗。
The radiologic diagnosis of renal cysts (and their differentiation from renal neoplasms) has come a long way since the 1950s when the approach was surgical exploration, unless clinically contraindicated, for every renal mass detected using urography. Nephrotomography, renal angiography, and cyst puncture have contributed over the ensuing years to the differentiation of cyst from tumor. However, for the most part, sonography and CT (or a combination of these when necessary) have become the main diagnostic techniques for evaluating renal masses, and with their use we have never been more accurate, noninvasive, and relatively economically efficient. The more widespread use of CT has enabled serendipitous discovery of many small renal carcinomas, the removal of which should result in an improvement in the overall cure rate of patients with renal parenchymal neoplasms. On the other hand, we are also discovering many more cysts than we have previously. We must be on guard, therefore, against discovering lesions for which we are unable to establish a radiologic diagnosis of benignity, because this will only increase the need for exploratory surgery once again. It is thus imperative that imaging studies be performed with great care, that diagnoses be based on rigid criteria, and that more experience with difficult lesions be gained so that the proper approach to treatment will be determined. If we are able to accomplish this, then the present radiologic age can be remembered as a time when great advances in the evaluation of renal masses were made, with resultant improved patient management and cure of disease.