J Korean Soc Radiol.  2017 Aug;77(2):113-120. 10.3348/jksr.2017.77.2.113.

The Effect of Two-Injection Ethanol Sclerotherapy with 5-Minute Duration of Exposure Time in Simple Renal Cysts

• Lee SE
• Cho JH

• KMID: 2386748
• DOI: http://doi.org/10.3348/jksr.2017.77.2.113

Abstract

PURPOSE
To evaluate the results of two-injection ethanol sclerotherapy in simple renal cysts performed with 5-minute ethanol exposure time.
MATERIALS AND METHODS
We retrospectively reviewed 30 renal cysts in 30 patients treated by ethanol sclerotherapy between November 2002 and October 2015. Under ultrasound guidance, the renal cyst was punctured and a 7 Fr pigtail catheter was inserted, and then complete aspiration of the cystic fluid was performed. Then, 99.9% ethanol in a quantity amounting to 1/3-1/2 of the aspirated volume was infused into the cyst and it was immediately removed. The same amount of ethanol was re-infused and removed after 5 minutes. Follow-up examination was performed using ultrasound or CT images at least 3 months after the procedure and pre- and post-treatment cyst volumes were estimated. The therapeutic response was classified as either complete success (volume reduction, ≥ 95%), partial success (volume reduction, 50-95%), or failure (volume reduction, < 50%) based on the volume reduction rate.
RESULTS
The average volume reduction rate was 96.3%. The rates of complete success, partial success and failure were 80% (n = 24), 20% (n = 6), and 0% (n = 0), respectively. There was no complication except for minor flank pain.
CONCLUSION
Two-injection ethanol sclerotherapy with 5-minute exposure time represents a simple and effective treatment for simple renal cysts.

MeSH Terms

Catheters
Ethanol*
Flank Pain
Follow-Up Studies
Humans
Kidney Diseases, Cystic
Retrospective Studies
Sclerotherapy*
Ultrasonography
Ethanol

Figure

• 

  Fig. 1. A representative case of complete success in a 58-year-old woman. A. Pre-procedural contrast enhanced axial CT image shows a simple renal cyst with a volume of 449.78 mL (10 × 8.6 × 10 cm) in the right kidney. B, C. The renal cyst is punctured under ultrasound guidance (B) and a cystogram (C) shows neither extravasation of the contrast material nor a connection with the collecting system. D. At the 6-month follow-up, contrast enhanced axial CT image shows the remaining cyst with a volume of 3.14 mL (2.2 × 1.3 × 2.1 cm). Volume reduction rate is 99.3%.

• 

  Fig. 2. A representative case of partial success in a 56-year-old man. A. Pre-procedural contrast enhanced axial CT image shows a simple renal cyst with a volume of 234.3 mL (8 × 7 × 8 cm) in the left kidney. B. A 7Fr pigtail catheter is inserted into the renal cyst and a cystogram is obtained. C. At the 6-month follow-up, US image shows the remaining cyst with a volume of 41.49 mL (4.5 × 4.1 × 4.3 cm). Volume reduction rate is 82.3%.

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