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Rofo 2003; 175(7): 892-903
DOI: 10.1055/s-2003-40425
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Zystische Nierenläsionen

Cystic Renal LesionsB.  Kreft1 , H.  H.  Schild1
  • 1Radiologische Klinik der Universität Bonn
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Publication History

Publication Date:
08 July 2003 (online)

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Zusammenfassung

Bei zystischen Nierenläsionen handelt es sich meist um einfache oder komplizierte Zysten, die sowohl solitär als auch im Rahmen von zystischen Nierenerkrankungen auftreten. Zu einem geringeren Anteil liegen benigne oder maligne zystische Raumforderungen vor. Die Klassifikation von zystischen Läsionen (Kategorie l - IV) anhand von sonographischen und computertomographischen Kriterien nach Bosniak ist sehr nützlich für die Charakterisierung der Läsion und für die Entscheidung über das therapeutische Vorgehen. Das Hauptziel dabei ist, operative Eingriffe bei Zysten der Kategorie II zu vermeiden und diese von den Zysten der Kategorie III bzw. IV zu differenzieren, die eine operative Exploration benötigen. Bei der Abklärung zystischer Nierenläsionen ist die Sonographie die Untersuchungsmodalität der Wahl, da unter Beachtung der entsprechenden Kriterien der Bosniak-Klassifikation eine sichere und ökonomisch sinnvolle Diagnose der sehr häufigen einfachen Zyste gestellt werden kann. Falls der Verdacht auf eine komplizierte Zyste oder einen zystischen Tumor gestellt wird, sollte eine dreiphasige kontrastverstärkte Spiral-CT der Nieren erfolgen. Die MRT besitzt gegenüber der CT Vorteile in der Dignitätsbeurteilung komplexer zystischer Raumforderungen.

Abstract

Cystic renal lesions are most often simple or complicated cysts, which can be seen solitary or as part of cystic renal diesease. The minority of these lesions are benign or malignant cystic tumors. The classification of cystic renal masses by Bosniak (category l - IV) based on specific ultrasound and CT featueres is very useful for the characterization of the lesion and for the therapeutic decision. The main objective of this classification is to differentiate nonsurgical (category II) from surgical cystic masses (category III/IV). Ultrasound is the first modality of choice in the diagnostic work-up of cystic renal masses, because an accurate and economically reasonable diagnosis of the frequent simple cyst can be made by maintaining rigid ultrasound criteria of the Bosniak classification. If a complicated cyst or a cystic tumor is suspected a threephasic contrast-enhanced CT of the kidneys should be performed. MRI is superior to CT in the characterization of complex cystic masses.

Key words

Cystic renal lesions CT - MRT - renal cysts renal tumors

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PD Dr. Burkhard Kreft

Radiologische Klinik der Universität Bonn

Sigmund-Freud-Straße 25

53105 Bonn

Phone: + 49-228-2876672

Fax: + 49-228-2876093

Email: Kreft@ukb.uni-bonn.de

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