在病理确认的CT分类囊中验证更新的波斯尼亚克分类 (2019年)
James Lucocq1, Leo Morgan1, Ketan Rathod2
1Department of General Surgery, Victoria Hospital Kirkcaldy, Kirkcaldy, UK.
Scottish medical journal
|December 19, 2023
概括
与2005年版本 (v2005) 相比,2019年波斯尼亚克分类 (v2019) 更好地对恶性囊进行分类,并减少对良性囊的不必要手术. 然而,对于v2019的观察者间协议仍然是一个挑战.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 波斯尼亚克分类系统分层囊复杂性和恶性瘤风险.
- 2019年更新 (v2019) 旨在完善囊分类和减少良性囊切除的标准.
- 2005年版本 (v2005) 作为囊分类的先前标准.
研究的目的:
- 为了比较博斯尼亚克分类v2005和v2019的诊断准确性.
- 评估两个波斯尼亚分类版本之间的观察者间协议.
- 评估v2019对对恶性和良性囊的分类的影响.
主要方法:
- 囊被分类使用波斯尼亚克v2005和v2019两个标准.
- 诊断的准确性是通过比较分类与组织病理学分析来确定的.
- 对于这两种分类系统,计算了观察者之间的一致性.
主要成果:
- 研究队列中的恶性瘤率为83.6%.
- 与v2005.5.049相比,Bosniak v2019显示了恶性囊的显著更高的分类为Bosniak IV (68.9%与47.1%,p=0.049)
- 2019年表现出减少良性囊切除的趋势 (13.5%vs15.7%),但观察者之间的一致性较低 (kappa=0.43vskappa=0.70).
结论:
- 更新的博斯尼亚克分类v2019增强了恶性脏囊的分类,并降低了良性囊切除的速度.
- 尽管囊分类得到了改进,但与v2019的较低观察者间协议对其临床应用构成了持续的挑战.
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