Version May 2024
| Category I – Simple benign cyst with the following features: |
| Hairline thin wall. |
| Density less than 20 Hounsfield units (similar to water). |
| Does not contain septa, calcification, or solid components. |
| Does not enhance. |
| Category II – Cystic lesions with the following features: |
| A few hairline thin septa. |
| "Perceived" enhancement may be present. There is no measurable enhancement. |
| Uniformly high attenuation lesions <3 cm that are well marginated and do not enhance fall into this category. |
| Category IIF – Minimally complicated cysts that do not neatly fall into category II. These lesions are generally well marginated but have some suspicious features that require follow-up: |
| Multiple hairline thin septa or minimal smooth thickening of the wall or septa. |
| "Perceived" enhancement of septa or wall may be present. |
| Thick and nodular calcification of the wall or septa, but no measurable contrast enhancement is present. |
| Totally intrarenal, nonenhancing, high attenuation lesions >3 cm in diameter fall into this category. |
| Category III – Cystic masses that typically undergo surgical evaluation, although many lesions are benign. These lesions show the following: |
| Thickened irregular or smooth walls or septa in which measurable enhancement is present. |
| Category IV – These mostly malignant lesions have the following features: |
| All category III criteria. |
| Enhancing soft-tissue components adjacent to, but independent of, the wall or septum. |
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