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Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.
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Background: The purpose of present study was to identify sonologically, the cystic and non-cystic renal mass lesions, to attempt differentiating benign lesions from the malignant ones and to correlate ultrasound findings with ultra sonographically guided cytological or pathological findings.Methods: In this hospital based prospective observational study, all the patients with confirmed renal mass were subjected to USG guided fine needle aspiration cytology (FNAC). All the patients presenting with lump in abdomen, haematuria or pain in abdomen, wherein the clinical diagnosis of renal mass was being considered by the clinician, were enrolled for the study. Total 54 participants were enrolled. Those with confirmed renal mass were subjected to USG guided FNAC and which was carried out in supine position by transabdominal route in all patients.Results: About 42 participants were retained for final analysis; since FNAC was not possible in 12 patients. Pain in abdomen (36, 85.7%), mass in abdomen (34, 81%) were the most predominant clinical findings. Mixed echogenicity was the commonest echo pattern (42, 77.7%) on ultrasonography. Histopathologic/cytologic examination of the 39 malignant cases confirmed renal cell carcinoma (18, 46.5%) to be the commonest malignancy, followed by Wilms’ tumour (10, 26%). Out of the 39 cases in which clinico-radiological diagnoses were correlated with histo-cytological diagnoses, it was found to be consistent in 30 (77%) cases and inconsistent in 9 (23.1%) cases.Conclusions: Fine needle aspiration cytology/biopsy performed under ultrasonography guidance demonstrates high diagnostic accuracy. It is hence recommended as part of fundamental approach to the diagnosis of non-cystic renal mass.
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Hydatid cyst is a parasitic disease caused by the tapeworm Echinococcus granulosus. Hydatid cyst disease mostly involves the liver and the lung, while renal involvement is rare. Hydatid disease may present in unusual ways and lead to diagnostic diffi culty and management problems. A high index of suspicion for hydatid disease should be maintained while evaluating complex cystic renal masses. Herein we present an interesting case who was diagnosed to have a simple renal cyst on contrast-enhanced computed tomogram, which turned out to be a renal hydatid cyst. Despite modern imaging methods, isolated renal hydatid disease might still cause diagnostic dilemma and hydatid cysts can be found in unusual localization. Th is case was managed laparoscopically.