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Zhang H, Zhang C, Liu Y, Li L, Duan JX, Zhao JN. Comparison of CT-guided intracystic lidocaine pre-injection versus conventional US-guided single-session ethanol sclerotherapy for simple hepatic cysts. Sci Rep 2025; 15:13303. [PMID: 40247096 PMCID: PMC12006388 DOI: 10.1038/s41598-025-98140-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 04/09/2025] [Indexed: 04/19/2025] Open
Abstract
This study aimed to compare a modified CT-guided technique incorporating intracystic lidocaine for pain control versus a conventional ultrasound-guided method for single-session ethanol sclerotherapy of simple hepatic cysts (SHCs), to seek refinements in technical strategies. 113 patients with SHCs underwent ethanol sclerotherapy between January 2019 and June 2023 at two centers. Center A utilized a modified CT-guided technique with intracystic lidocaine pre-injection into the cyst. Center B employed a conventional ultrasound-guided method with pigtail catheter drainage. Primary endpoints included pain during ethanol injection, procedural duration, and safety, while secondary endpoints assessed cyst volume reduction and symptom relief. 99 eligible patients (Center A/B, n = 43/56) were included in the analysis. The modified technique at Center A resulted in significantly lower median VAS scores (1.2 ± 1.2) compared to Center B (5.1 ± 1.1; p < 0.01) during ethanol injection. Ethanol exposure and procedural durations were also shorter at Center A (11.2 ± 1.6 min and 29.9 ± 4.3 min) than at Center B (20.5 ± 3.4 min and 40.6 ± 4.2 min; p < 0.01). No complications were observed at Center A. Both centers achieved similar success rates in reducing cyst size and relieving symptoms at the 6-month follow-up. The modified CT-guided percutaneous single-session ethanol sclerotherapy technique for SHCs significantly reduces pain and procedural duration compared to the conventional method, with similar efficacy and safety profiles.
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Affiliation(s)
- Hao Zhang
- Department of Radiology, Dianjiang People's Hospital of Chongqing, 116 North Street, Guixi Street, Dianjiang County, Chongqing, 408300, People's Republic of China.
| | - Chi Zhang
- Class 21, Grade 2025, Chongqing Yangjiaping Middle School, Chongqing, 400050, People's Republic of China
| | - Ye Liu
- Department of Radiology, Dianjiang People's Hospital of Chongqing, 116 North Street, Guixi Street, Dianjiang County, Chongqing, 408300, People's Republic of China
| | - Lin Li
- Department of Pharmacy, Dianjiang People's Hospital of Chongqing, 116 North Street, Guixi Street, Dianjiang County, Chongqing, 408300, People's Republic of China.
| | - Jian-Xue Duan
- Department of Hepatobiliary Surgery, Dianjiang People's Hospital of Chongqing, Chongqing, 408300, People's Republic of China
| | - Jian-Ning Zhao
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, No. 6, Panxi Seven Branch Road, Jiangbei District, Chongqing, 400013, People's Republic of China.
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Yoon S, Kwak J, Im D, Yoon H. Review of outcomes of using lower ethanol concentration (83%) in percutaneous ultrasound-guided renal cyst sclerotherapy in dogs. J Vet Sci 2023; 24:e61. [PMID: 37638709 PMCID: PMC10556289 DOI: 10.4142/jvs.23045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/26/2023] [Accepted: 06/26/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Percutaneous renal cyst sclerotherapy (PRCS) as a treatment for renal cysts is usually performed with a high concentration of ethanol (≥ 90%). This study reviewed cases in which a lower concentration of ethanol (83%) was used for the procedure in dogs. METHODS Records of cases of renal cysts treated by sclerotherapy using 83% ethanol in dogs were reviewed. Outcomes of the treatment were evaluated by comparing volumes of renal cysts before the procedure and the volumes after treatment, using ultrasound images with the volume reduction rates classified as follows: < 50% of initial volume (failed); ≥ 50% but < 80% of initial volume (partial success); ≥ 80% but < 95% of initial volume (great success); ≥ 95% of initial volume (complete success). RESULTS Out of nine dog kidneys, renal cysts sclerotherapy with 83% ethanol achieved partial success in one kidney, great success in four, and complete success in the other four. No side effect was observed. The mean of the volume-reduction rates was 90.00 ± 11.00 while the minimum and maximum reduction rates were 65% and 100%, respectively. CONCLUSIONS The lower ethanol concentration (83%) is good for disinfecting kidneys in PRCS.
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Affiliation(s)
- Sanghyeon Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Jungmin Kwak
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Deokho Im
- Nel Animal Medical Center, Anyang 14065, Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea.
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Karakas HM, Yildirim G. Percutaneous treatment of simple renal cysts with 24-h-interval ethanol sclerotherapy. Radiol Bras 2023; 56:8-12. [PMID: 36926362 PMCID: PMC10013184 DOI: 10.1590/0100-3984.2022.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/15/2022] [Indexed: 03/17/2023] Open
Abstract
Objective To investigate the efficacy of 24-h interval multiple-session ethanol sclerotherapy for the treatment of simple renal cysts. Materials and Methods The study sample included 58 patients (mean age, 65.37 ± 11.95 years). We included 76 simple renal cysts that were treated with percutaneous aspiration with a minimum of two sessions of 95% ethanol sclerotherapy in a 24-h interval between sessions. Patients were evaluated at 1, 3, and 6 months after the intervention for the efficacy of the treatment. Treatment success was defined as a complete regression of a cyst or a > 50% reduction in its volume, with no recurrence of symptoms. Results The mean preprocedural cyst size was 72.98 ± 25.14 mm, and the mean preprocedural cyst volume was 205.76 ± 244.15 mL. The mean volume of ethanol used in the first sclerotherapy session was 62.76 ± 30.71 mL. The mean fluid accumulation in the cysts at the end of the first 24-h interval was 4.66 ± 7.13 mL. The mean quantity of ethanol used in the second sclerotherapy session was 26.48 ± 22.2 mL. A third sclerotherapy session was required in only 10 (13.2%) of the cysts. The mean follow-up period was 52.84 ± 37.83 months. The rate of complete regression was 97.4% for the whole sample at the end of the follow-up. Conclusion Ethanol ablation with 24-h intervals is a safe and effective treatment option in the minimally invasive percutaneous treatment of simple renal cysts.
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Affiliation(s)
- Hakki Muammer Karakas
- Department of Radiology, University of Health Sciences, Fatih
Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Gulsah Yildirim
- Department of Radiology, University of Health Sciences, Fatih
Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
- Department of Radiology, University of Health Sciences, Istanbul
Training and Research Hospital, Istanbul, Turkey
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4
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Brown D, Nalagatla S, Stonier T, Tsampoukas G, Al-Ansari A, Amer T, Aboumarzouk OM. Radiologically guided percutaneous aspiration and sclerotherapy of symptomatic simple renal cysts: a systematic review of outcomes. Abdom Radiol (NY) 2021; 46:2875-2890. [PMID: 33544165 DOI: 10.1007/s00261-021-02953-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 11/30/2022]
Abstract
Simple renal cysts are common benign lesions of the kidney with up to 4% of patients developing symptoms necessitating intervention including pain and haematuria. We conducted a systematic review of the literature to determine the efficacy and safety of aspiration-sclerotherapy of symptomatic simple renal cysts. A systematic review using Cochrane guidelines was conducted on published literature from 1990 to 2020. RCTs, cohort studies and case series meeting the inclusion criteria were reviewed and cumulative analysis of outcomes was performed. A total of 4071 patients from 57 studies underwent aspiration ± sclerotherapy for their simple renal cysts. 87.7% of patients who had aspiration with sclerotherapy demonstrated 'treatment success' with a >50% reduction in cyst size and complete resolution of symptoms. 453 minor, transient complications occurred (11.2%) whilst a major complication rate of less than 0.1% (4 patients) was reported. Pooled analysis of all available current literature demonstrates that aspiration-sclerotherapy is a safe and effective first-line therapy for symptomatic simple renal cysts. Although we are unable to compare those undergoing aspiration alone to aspiration-sclerotherapy, it is evident the use of a sclerosing agent is integral to treatment success; however, the optimum agent, volume, injection frequency, and dwelling time are yet to be defined. Cyst size should be considered when discussing treatment options; however, we conclude it reasonable for aspiration-sclerotherapy to be used in the first instance in all cases of symptomatic simple renal cysts. Furthermore, we propose definitions of treatment outcome measures in order to allow direct comparative analysis across future studies.
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Affiliation(s)
- Dominic Brown
- Department of Urology, Broomfield Hospital, Chelmsford, UK.
| | - Sarika Nalagatla
- Department of Urology, University Hospital Monklands, Glasgow, UK
| | - Thomas Stonier
- Department of Urology, St George's Hospital, Tooting, London, UK
| | | | - Abdulla Al-Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Tarik Amer
- Department of Urology, University Hospital Monklands, Glasgow, UK
| | - Omar M Aboumarzouk
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- University of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, Scotland, UK
- College of Medicine, Qatar University, Doha, Qatar
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Furumaya A, van Rosmalen BV, de Graeff JJ, Haring MPD, de Meijer VE, van Gulik TM, Verheij J, Besselink MG, van Delden OM, Erdmann JI. Systematic review on percutaneous aspiration and sclerotherapy versus surgery in symptomatic simple hepatic cysts. HPB (Oxford) 2021; 23:11-24. [PMID: 32830070 DOI: 10.1016/j.hpb.2020.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Simple hepatic cysts (SHC) may cause pain and bloating and thus impair quality of life. Whereas current guidelines recommend laparoscopic cyst deroofing, percutaneous aspiration and sclerotherapy (PAS) may be used as a less invasive alternative. This review aimed to assess the efficacy of PAS and surgical management in patients with symptomatic SHC. METHODS A systematic search in PubMed and Embase was performed according to PRISMA-guidelines. Studies reporting symptoms were included. Methodological quality was assessed by the MINORS-tool. Primary outcomes were symptom relief, symptomatic recurrence and quality of life, for which a meta-analysis of proportions was performed. RESULTS In total, 736 patients from 34 studies were included of whom 265 (36%) underwent PAS, 348 (47%) laparoscopic cyst deroofing, and 123 (17%) open surgical management. During weighted mean follow-up of 26.1, 38.2 and 21.3 months, symptoms persisted in 3.5%, 2.1%, 4.2%, for PAS, laparoscopic and open surgical management, respectively. Major complication rates were 0.8%, 1.7%, and 2.4% and cyst recurrence rates were 0.0%, 5.6%, and 7.7%, respectively. CONCLUSION Outcomes of PAS for symptomatic SHC appear to be excellent. Studies including a step-up approach which reserves laparoscopic cyst deroofing for symptomatic recurrence after one or two PAS procedures are needed.
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Affiliation(s)
- Alicia Furumaya
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Belle V van Rosmalen
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Jan Jaap de Graeff
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Martijn P D Haring
- Department of Surgery, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Vincent E de Meijer
- Department of Surgery, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Thomas M van Gulik
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Joanne Verheij
- Department of Pathology, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Marc G Besselink
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Otto M van Delden
- Department of Interventional Radiology, Amsterdam UMC, University of Amsterdam, Netherlands
| | - Joris I Erdmann
- Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands.
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A Painless and Time-Saving Modified Technique for Simple Renal Cyst Treatment with Single-session Ethanol Sclerotherapy. Sci Rep 2020; 10:5019. [PMID: 32193472 PMCID: PMC7081224 DOI: 10.1038/s41598-020-61842-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/03/2020] [Indexed: 11/08/2022] Open
Abstract
Percutaneous puncture ethanol sclerotherapy is a simple, effective, minimally invasive, and inexpensive procedure to manage symptomatic simple renal cysts. We modified specific technical aspects to balance certain potential intraprocedural factors for ensuring minimal procedural pain and duration as well as maximal clinical therapeutic effects and evaluated the safety and efficacy of this modified technique. A total of 84 eligible patients underwent computed tomography-guided single-session ethanol sclerotherapy using the conventional (group A) or modified (group B) technique. In group B, the puncture route was modified from tansparenchymal to direct for reducing renal injury, and preinjection of low-dose intracystic lidocaine was used to control distending pain caused by ethanol injections; therefore, greater ethanol volumes could be injected for improving the resistance and contact of ethanol with the cyst wall, precluding the need for patient repositioning multiple times to decrease procedural duration. Visual analog scale score for pain and procedural time were significantly higher in group A than in group B. The complication rate was slightly higher in group A than in group B, but the success rate was comparable between the two groups. These results suggest that the modified technique is painless, time-saving, and injury-reducing and can thus improve medical care.
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Yodoya M, Hiraki T, Iguchi T, Fujiwara H, Matsui Y, Masaoka Y, Sakurai J, Mitsuhashi T, Gobara H, Kanazawa S. Disappearance of Renal Cysts Included in Ice Ball During Cryoablation of Renal-Cell Carcinoma: A Potential Therapy for Symptomatic Renal Cysts? J Vasc Interv Radiol 2017; 28:869-876. [PMID: 28366658 DOI: 10.1016/j.jvir.2017.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/19/2017] [Accepted: 02/19/2017] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To retrospectively evaluate the effect of cryoablation of renal-cell carcinoma on nearby renal cysts with the goal to investigate the potential for an alternative therapy to treat symptomatic renal cysts. MATERIALS AND METHODS The study population comprised 46 cysts (mean size, 12 mm; range, 5-43 mm) that were within or near the ice ball during cryoablation in 22 patients. Size change of each cyst was evaluated via enhanced CT or MR imaging before and 1, 3, 6, and 12 months after cryoablation. Forty-one cysts were also followed after 12 months. Variables including positional relationship between the cyst and the ice ball were evaluated via linear regression analysis using generalized estimating equation models to determine which factors affected cyst shrinkage rate at 12 months. RESULTS Fifteen, 12, and 19 cysts were completely included in, partially included in, or excluded from the ice ball, respectively. The overall shrinkage rate was 62%, and 57% of cysts (26 of 46) had disappeared at 12 months. Only the relationship between the cyst and the ice ball was significantly (P < .001) associated with cyst shrinkage rate. Cyst disappearance rates at 12 months were 100% (15 of 15), 67% (8 of 12), and 16% (3 of 19) for cysts completely included, partially included, and excluded from the ice ball, respectively. Among the 22 cysts that disappeared at 12 months and continued to be followed, none recurred after 12 months. CONCLUSIONS All renal cysts that were completely included in the ice ball disappeared after cryoablation, demonstrating the potential utility of cryoablation as an alternative therapy for symptomatic renal cysts.
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Affiliation(s)
- Mitsuko Yodoya
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Takao Hiraki
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Toshihiro Iguchi
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Hiroyasu Fujiwara
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Yusuke Matsui
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Yoshihisa Masaoka
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Jun Sakurai
- Center for Innovative Clinical Medicine, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Hideo Gobara
- Division of Medical Informatics, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
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Dell'Atti L. Comparison between the use of 99% ethanol and 3% polidocanol in percutaneous echoguided sclerotherapy treatment of simple renal cysts. Urol Ann 2015; 7:310-4. [PMID: 26229316 PMCID: PMC4518365 DOI: 10.4103/0974-7796.152026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/10/2014] [Indexed: 11/04/2022] Open
Abstract
AIM In this study, we compared and valued efficacy and safety of percutaneous echoguided sclerotherapy (PES) using 3% polidocanol with that using 99% ethanol in the treatment of patients with simple renal cysts. MATERIALS AND METHODS PES was performed for 65 simple renal cysts. Under ultrasonographic guidance the cyst was punctured using an 18 gauge needle. Sclerotherapy was performed with ethanol in 55% (36/65) of cases and with polidocanol in the remaining 45% (29/65). Patients were followed up with an ultrasound examination at 4 months, 8 months, and then at yearly intervals. A reduction of 50% or greater in cyst diameter was considered successful. RESULTS The median followup period for the ethanol and polidocanol groups was 24.6 and 22.8 months, respectively. The successful outcome ratio of the polidocanol group was significantly higher (90% vs. 61%, respectively) than the one of the ethanol group (P = 0.003). The partial regression of the ethanol and polidocanol groups were 6% versus 7%, respectively. The failure ratio of the polidocanol group was significantly lower (3% vs. 33%, respectively) than that of the ethanol group (P = 0.004). Neither infectious complications nor hyperthermia occurred in all treated cases. However, these methods are not completely free from symptoms. All these symptoms disappeared few hours after the procedure. CONCLUSIONS Polidocanol is a safe and effective sclerosing agent for renal cysts, with superior clinical results than ethanol. Therefore, polidocanol can be an alternative to ethanol in sclerotherapy of renal cysts.
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Affiliation(s)
- Lucio Dell'Atti
- Department of Urology, Arcispedale "S. Anna", Cona 44124, Ferrara, Italy
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Yu JH, Du Y, Li Y, Yang HF, Xu XX, Zheng HJ, Li B. Effectiveness of CT-guided sclerotherapy with estimated ethanol concentration for treatment of symptomatic simple hepatic cysts. Clin Res Hepatol Gastroenterol 2014; 38:190-4. [PMID: 24210773 DOI: 10.1016/j.clinre.2013.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/10/2013] [Accepted: 09/18/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The mean Hounsfield value of 99.9% ethanol did get down to -190 Hounsfield units (HU), there was a linear correlation between ethanol concentration and Hounsfield values. We aimed to evaluate whether sclerotherapy with estimated ethanol concentration was helpful in improving the success rate for treatment of symptomatic simple hepatic cysts. METHODS Forty-five patients with 52 symptomatic simple hepatic cysts were enrolled in this study. Twenty-one patients (24 cysts, group A) were treated by sclerotherapy without estimated ethanol concentration and 24 patients (28 cysts, group B) with estimated ethanol concentration. The Chi-square test and Mann-Whitney U test were used to compare the difference in characteristics and treatment outcomes of the subjects between these two groups. RESULTS The mean cyst size before and after treatment were 8.4cm and 2.3cm, respectively, in group A, and 8.2cm and 0.8cm, respectively, in group B. There was no significant difference in the initial size of hepatic cysts between the groups. However, the final size was significantly smaller in group B (P=0.022). The mean ethanol exposure time was 18.3minutes in group B, which was less than that in group A (P<0.001). The success rate was significantly higher in group B (96.4%) than in group A (70.8%) (P=0.03). There were no major complications in either group. CONCLUSION CT-guided sclerotherapy with estimated ethanol concentration yields better results than those without estimated ethanol concentration in the treatment of symptomatic simple hepatic cysts.
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Affiliation(s)
- Jin Hong Yu
- Department of Ultrasound, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
| | - Yong Du
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
| | - Yang Li
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
| | - Han Feng Yang
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
| | - Xiao Xue Xu
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
| | - Hou Jun Zheng
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
| | - Bing Li
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, 63, Wenhua Road, Nanchong City 637000, Sichuan Province, China.
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10
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Yu JH, Du Y, Li Y, Yang HF, Xu XX, Zheng HJ. CT-guided sclerotherapy for simple renal cysts: value of ethanol concentration monitoring. Korean J Radiol 2014; 15:80-6. [PMID: 24497796 PMCID: PMC3909866 DOI: 10.3348/kjr.2014.15.1.80] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 09/03/2013] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of our study was to evaluate the differences between sclerotherapy with and without ethanol concentration monitoring for the treatment of simple renal cysts. Materials and Methods Sixty-seven patients with 70 simple renal cysts were randomly assigned to two groups in a 12-month prospective controlled trial. One group (group A) was treated with computed tomography (CT)-guided sclerotherapy without ethanol concentration monitoring (33 patients with 35 cysts), whereas the other group (group B) had ethanol concentration monitoring (34 patients with 35 cysts) during the procedure. Treatment outcomes between the two groups were compared 12 months later with follow-up ultrasound examination. Results After the 12-month follow-up period, the overall success rate was 74.3% in group A and 94.3% in group B (p = 0.022). The mean cyst size before and after treatment was 8.6 ± 2.0 cm and 2.3 ± 2.9 cm, respectively, in group A, and 8.4 ± 1.7 cm and 0.8 ± 1.9 cm, respectively, in group B. The final size of the cysts in group B was significantly smaller than that in group A (p = 0.015). The likelihood of treatment with ethanol concentration monitoring being successful was approximately 16 times higher than without ethanol concentration monitoring (p = 0.026; odds ratio = 15.7; 95% confidence interval: 1.38-179.49). There were no major complications in either group. Conclusion Monitoring of Hounsfield units (HU) of ethanol by CT is an effective method in the treatment of simple renal cysts with ethanol sclerotherapy. The ethanol sclerotherapy procedure can be terminated at the point of clear fluid aspiration because the HU (-190) of CT scan corresponds to it.
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Affiliation(s)
- Jin Hong Yu
- Department of Ultrasound, the Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China
| | - Yong Du
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China
| | - Yang Li
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China
| | - Han Feng Yang
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China
| | - Xiao Xue Xu
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China
| | - Hou Jun Zheng
- Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province 637000, China
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Li L, Chen CC, Zeng XQ. One-year results of single-session sclerotherapy with bleomycin in simple renal cysts. J Vasc Interv Radiol 2013. [PMID: 23177112 DOI: 10.1016/j.jvir.2012.08.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To evaluate the efficacy and safety of single-session percutaneous needle aspiration and single-injection bleomycin sclerotherapy for the treatment of simple renal cysts. MATERIALS AND METHODS A total of 66 renal cysts in 53 patients were treated by single-session percutaneous needle aspiration and single-injection bleomycin sclerotherapy under computed tomography (CT) guidance. Symptomatic (n = 31) and asymptomatic cysts (n = 22) with maximum diameters greater than 5 cm were treated. As much liquid content of each cyst was aspirated as possible, and bleomycin was injected and remained in the cyst. Follow-up was performed with ultrasonography or CT every 3 months until 1 year, and cyst volume was calculated before and after sclerotherapy. Therapeutic response was assessed by cyst volume reduction rate (VRR) and classified as complete regression (CR; ie, invisible), near-CR (ie, VRR>85%), partial regression (PR; ie, VRR of 50%-85%), or no response (NR; ie, VRR<50%). Medical records were reviewed to analyze complications. RESULTS Cysts refilled partially in the initial stage after sclerotherapy and decreased gradually in size over the entire follow-up period. At 1-year follow-up, the overall response rate was 98.5% (65 of 66), with CR in 31 cysts (47.0%), near-CR in 24 cysts (36.4%), PR in 10 cysts (15.1%), and NR in one cyst (1.5%). No major complications were encountered. CONCLUSIONS Single-session percutaneous needle aspiration and single-injection bleomycin sclerotherapy is a simple, safe, effective, well tolerated alternative technique for management of simple renal cysts.
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Affiliation(s)
- Long Li
- Department of Radiology, Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces, Guangzhou Medical College, 268 Yanling Rd., Guangzhou, Guangdong 510507, China.
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EUS-guided pancreatic cyst ablation: a critical review (with video). Gastrointest Endosc 2013; 77:526-33. [PMID: 23321339 DOI: 10.1016/j.gie.2012.10.033] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 10/29/2012] [Indexed: 02/07/2023]
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Skolarikos A, Laguna MP, de la Rosette JJ. Conservative and radiological management of simple renal cysts: a comprehensive review. BJU Int 2012; 110:170-8. [DOI: 10.1111/j.1464-410x.2011.10847.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Renal cysts are a common imaging finding. Although most cysts never have symptoms, some cause pain, collecting system compression, hematuria, hypertension, and secondary infection. The mere presence of a cyst is not an indication for intervention, but treatment may be indicated in symptomatic patients or those with secondary obstruction. Urinomas generally are a contained collection of urine outside of the normal pathways where urine travels. As such, urinomas can arise anywhere from the upper abdomen down into the low pelvis and have a variety of etiologies. Ureteral obstruction with forniceal rupture and trauma (blunt, penetrating, or iatrogenic) are the most common causes of urinomas. When urinomas arise spontaneously, the likely cause varies with the patient's age. Blunt or penetrating trauma can cause perinephric urinomas by two mechanisms-direct disruption of the pelvis or collecting system or by degeneration of nonviable tissue. These urinomas are often perinephric, but can also occur in a subcapsular location. This review will discuss diagnosis, classification, and treatment of renal cysts and urinomas.
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Affiliation(s)
- Jessica Lee
- Mallinckrodt Institute of Radiology, St. Louis, Missouri
| | - Michael Darcy
- Mallinckrodt Institute of Radiology, St. Louis, Missouri
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