Objective To compare diagnostic performance of CT and MRI for cystic renal masses using the Bosniak classification system. Methods CT and MRI data of 30 cases (42 cystic renal masses) with pathologically or clinically follow-up confirmed were retrospectively reviewed. Diagnostic performance of both modalities was compared using receiver operating characteristic curve. Results Six, twenty four, nine, and three lesions were classified as Bosniak Ⅰ, Ⅱ, ⅡF, Ⅲ and Ⅳ respectively under CT. And false positive number was zero while false negative number was 14 with pathological correlation. Eight, eighteen, ten and six lesions were classified as Bosniak Ⅰ, Ⅱ, ⅡF, Ⅲ and Ⅳ respectively under MRI. And false positive number was zero while false negative number was 11 with pathological correlation. The area under the receiver operating characteristic curve for MRI was larger than CT. Both specificity and sensitivity of the former were higher than those of the latter. Conclusion Diagnostic performance of Bosniak classification with MRI is higher than that of Bosniak classification with CT. Bosniak classification with MRI is recommended as soon as condition permits.%目的 比较CT下Bosniak分级和MRI下Bosniak分级对肾脏囊性病变的诊断性能.方法 回顾性分析30例(共42个肾脏囊性病灶)同时具备CT和MRI影像资料,并以术后病理或临床随访作为最终诊断,采用ROC曲线比较二种检查模式的诊断性能.结果 CT下Bosniak分级Ⅰ～Ⅳ级分别为6个、24个、9个、3个,对照病理结果其假阳性病灶数0个,假阴性病灶数14个.MRI下Bosniak分级Ⅰ～Ⅳ级分别8个、18个、10个、6个,对照病理结果其假阳性病灶数0个,假阴性病灶数11个.MRI下Bosniak分级的曲线下面积大于CT下Bosniak分级,前者的特异度和敏感度均高于后者.结论 MRI下Bosniak分级对于肾脏囊性病变的诊断性能高于CT下Bosniak分级,在条件允许的情况下应首先采用MRI下Bosniak分级.
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