Korean J Radiol.  2007 Dec;8(6):512-519. 10.3348/kjr.2007.8.6.512.

Comparison of CT-Guided Sclerotherapy with Using 95% Ethanol and 20% Hypertonic Saline for Managing Simple Renal Cyst

• Egilmez H
• Gok V
• Oztoprak I
• Atalar M
• Cetin A
• Arslan M
• Gultekin Y
• Solak O

• KMID: 1089439
• DOI: http://doi.org/10.3348/kjr.2007.8.6.512

Abstract

OBJECTIVE: We wanted to compare the efficacies of 95% ethanol and 20% hypertonic saline (HS) sclerotherapies that were performed in a single session under CT guidance for the management of simple renal cysts. MATERIALS AND METHODS: A prospective series of 74 consecutive patients (average age: 57.6 +/- 8.1 years) with simple renal cysts were enrolled in this study. They were randomized into two groups and 95% ethanol or 20% HS, respectively, corresponding to 25% of the aspiration volume, was injected. Treatment success was determined six months later with follow-up clinical evaluation and performing ultrasonography. RESULTS: The sclerotherapy was accepted as technically successful without major complications in all except two patients who were excluded because of a communication between the simple renal cyst and the pelvicalyceal collecting system. Thirty-six patients in the ethanol group received sclerotherapy with 95% ethanol and 36 patients in the HS group underwent sclerotherapy with 20% HS. The complete regression ratio of the ethanol group was significantly higher (94% versus 72%, respectively) than that of the HS group. There was one patient with partial regression in each group. The failure ratio of the ethanol group was significantly lower (3% versus 25%, respectively) than that of the HS group. CONCLUSION: Ethanol sclerotherapy under CT guidance is a successful and safe procedure and it can be used for the treatment of simple renal cysts. Sclerotherapy with 95% ethanol is more effective than 20% HS sclerotherapy. Sclerotherapy with HS may be an option for patients preferring to undergo a less painful treatment procedure.

Keyword

Kidney, cyst; Kidney, interventional procedures; Sclerotherapy; Alcohol; Kidney, CT

MeSH Terms

Adult
Aged
Ethanol/administration & dosage/*therapeutic use
Female
Follow-Up Studies
Humans
Kidney/drug effects/radiography/ultrasonography
Kidney Diseases, Cystic/*drug therapy
Male
Middle Aged
Prospective Studies
Saline Solution, Hypertonic/administration & dosage
Sclerosing Solutions/administration & dosage/*therapeutic use
Sclerotherapy/adverse effects/*methods
Tomography, X-Ray Computed/*methods
Treatment Outcome

Figure

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  Fig. 1 Representative CT images of a 53-year-old male patient with a simple renal cyst. A. The simple renal cyst before aspiration. B. A 5.4-Fr pigtail catheter was inserted into the cyst. C. Contrast medium is instilled into the cyst to ensure that there was no communication with the pelvicalyceal collecting system, to exclude any leakage from the puncture site into the retroperitoneal cavity and to determine the presence of extravasation. D. The cyst disappeared after successful ethanol sclerotherapy.

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  Fig. 2 Scatter dot plot with median line graphics of the volume of the simple renal cysts in the ethanol and hypertonic saline groups. There was no significant difference of the cyst volume between the study groups (p = 0.995).

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  Fig. 3 The number of patients, with complete and partial regression and failure at six months follow-up after sclerotherapy, in the ethanol and hypertonic saline groups. Their percentages are also presented. aP = 0.024 vs. the complete regression ratio of the hypertonic saline group with using Fisher's exact test. bP = 0.014 vs. the failure ratio of the hypertonic saline group with using Fisher's exact test.

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