CT引导下肾囊肿穿刺硬化剂治疗的评价

目的 :分析影响CT导引下穿刺硬化剂治疗肾囊肿疗效的因素和预防并发症的方法。方法 :对 96例 13 5个肾囊肿行CT导引下无水乙醇 (纯度 99.7% )硬化治疗 ,囊肿直径 2 .8～ 12 .0cm ,用 2 0G抽吸针穿刺 ,抽液后注入无水乙醇 ,注入量为抽出液的 2 5 .0 %。留置 15min后抽出注入的无水乙醇 ,重新注入少量无水乙醇保留。对于囊液大于 3 0 0ml的囊肿则多次冲洗 ,直至抽出液清亮。结果 :该组随访 5 1例 ,有效率 94.1% ,囊肿消失率 84.3 % ,无严重并发症发生。结论 :CT导引下穿刺硬化剂治疗肾囊肿方法简便 ,疗效好 ,并发症少 ,是一种非常有价值的治疗方法。     

CT引导下介入治疗肾囊肿的临床应用

目的探讨CT引导下穿刺硬化剂治疗肾囊肿的方法及疗效。方法经B超或CT诊断的78例84个肾囊肿在CT定位下经皮穿刺抽吸,行无水乙醇反复冲洗法硬化剂治疗,用18~22 G穿刺针抽吸,注入99.7%无水乙醇,注射量为抽出囊液量的25%~30%。术后每隔3个月复查,随访其疗效。结果其中79个囊肿一次穿刺成功,随访3个月~1年,复查见51例54个囊肿消失,22例24个囊肿缩小,4例4个囊肿未见缩小。有效率95.2%,消失率64.2%,无严重并发症。结论CT引导下经皮穿刺硬化剂治疗肾囊肿是一种安全、有效的治疗方法,具有较高的临床实用价值。     

肾囊肿乙酸注射硬化治疗的临床应用

目的 探讨乙酸作为肾囊肿硬化剂的作用,比较乙酸和无水乙醇硬化治疗的效果.方法 应用螺旋CT引导,对85例肾囊肿患者进行硬化治疗,其中43例采用无水乙醇作为硬化剂,42例采用50%乙酸作为硬化剂.所有患者抽净囊液后,注入硬化剂留置一定时间,然后将硬化剂抽出.结果 无水乙醇组中囊腔的消失率为55.8%(24/43),50%乙酸组的囊腔消失率为71.4%(30/42).无水乙醇组并发症的发生率为16.3%(7/43),50%乙酸组的发生率为4.8%(2/42).无水乙醇组硬化剂囊腔内的保留时间为(20±4)min,50%乙酸组的保留时间为(10±2)min.两组间差异有非常显著意义(P＜0.01).结论 50%乙酸作为硬化剂对肾囊肿进行硬化治疗,硬化效果好、不良反应小,可替代传统的无水乙醇硬化剂.     

CT引导下无水乙醇硬化术介入治疗肝肾囊肿的再认识

目的：探讨CT引导下无水乙醇硬化个介入治疗术对肝、肾囊肿的治疗方法及适应症、以提高治愈率。方法：经US或CT或MRI发现的158例188个肝、肾囊肿，在CT引导下穿刺经负压吸引后，放置引流管．注入无水酒精进行硬化治疗术，其中单发166例，多发22例。男72例，女86例。年龄12—78岁，平均年龄58岁。经一次治疗35例．两次治疗80例，三次治疗22例，注入量10-62ml，留置时间10-15min。结果：治疗后1周、1月、6月、12月经CT或US随访评价，在经治疗的囊肿中，治愈率和有效率与随访的时间和治疗次数呈正比关系。经一次治疗的囊肿中，1月、6月、12月囊肿的消失率分别是41．3％、76．1％、82．6％，而经1—3次治疗的囊肿消失率分别是82．6％、92．5％、94．4％。结论：（1）CT引导下无水乙醇介入硬化术，治疗肝、肾囊肿的次数与囊肿的消失率呈正比．（2）肝肾的多发囊肿也适用硬化治疗术。（3）严格掌握适应症，接治疗原则进行，则会提高治愈率，减少并发症。     

CT导引下置猪尾导管硬化治疗巨大肝肾囊肿疗效观察

目的探讨CT导引下穿刺置猪尾引流管硬化巨大肝肾囊肿安全性及疗效。方法CT导引下对17例巨大肝肾囊肿患者,穿刺置入7F猪尾导管引流,并且每日注射无水乙醇或乙酸1次。对于囊液<500ml者,每次注入硬化剂后夹闭引流管,24h后再开放引流。囊液大于500ml者,硬化后立即开放引流。所有患者24h引流量<10ml时,再次硬化后拔除引流管。其中肝囊肿平均拔管时间40d;肾囊肿10d。结果本组硬化治疗后6个月,复查B超示治愈17例,治愈率100%。无一例出血、感染及出现心脑血管并发症。结论CT导引下置猪尾巴管硬化治疗巨大肝肾囊肿简单安全、疗效满意。     

超声引导下经皮穿刺抽吸和注射无水乙醇治疗单纯性肾囊肿

目的评价超声引导下经皮穿刺抽吸和注射无水乙醇治疗单纯性肾囊肿的效果。方法46例单纯性肾囊肿患者(男性26例,女性20例,平均年龄65岁)均经超声引导经皮穿刺抽吸和注射无水乙醇硬化治疗。全部操作是在局部麻醉下完成的。治疗后,全部病人经超声或CT随访1至6个月。囊肿与治疗前比较,减小2/3以上为有效,完全消失为治愈。结果46个囊肿中,2个囊肿抽出液蛋白定性试验阴性,抽液后未注入无水乙醇,其余44个囊肿于治后1,3,6个月呈进行性缩小,6个月时复查有效率为100%,治愈率为90.6%。结论超声引导经皮穿刺抽吸和注射无水乙醇是治疗单纯性肾囊肿的一种操作简单、痛苦小、费用低、安全有效的方法,值得临床推广应用。     

CT引导下穿刺注射硬化剂治疗卵巢囊肿61例分析

CT引导下的囊肿抽吸和乙醇硬化治疗已成为肝囊肿和。肾囊肿的首选治疗方法,而卵巢囊肿的硬化剂治疗临床报道较少。2010年1月至2012年6月,我科利用CT下引导经皮穿刺注射硬化剂治疗卵巢囊肿患者61例,效果满意,报告如下。     

超声引导下应用无水乙醇和聚桂醇治疗单纯性肝、肾囊肿的疗效分析

目的：对比分析应用无水乙醇和聚桂醇治疗单纯性肝、肾囊肿的疗效和安全性。方法将81例单纯性肝、肾囊肿分为无水乙醇治疗组（30例）、聚桂醇治疗组（51例）,行超声引导下硬化治疗,对比观察疗效及不良反应。结果随访6个月后,两组在疗效上对比无统计学意义（P>0.05）,不良反应率聚桂醇组（9.8%）与无水乙醇组（40%）相比有统计学意义（P<0.01）。结论聚桂醇在单纯性肝、肾囊肿硬化治疗中安全、有效,是无水乙醇的有效替代品。     

CT导引下穿刺注射无水乙醇治疗肾囊肿

目的　评估CT导引经皮穿刺肾囊肿注射无水乙醇治疗的临床经验。方法　 4 4 5例 5 10个肾囊肿于CT导引下经皮穿刺肾囊肿抽液后注射无水乙醇治疗 ,4 4 5例中 385例为单发肾囊肿 ,5 3例多发肾囊肿 ,7例多囊肾。囊肿直径为 1.9～ 13.5cm。用 18～ 2 1G抽吸针穿刺抽吸 ,抽出囊液量为 3～780ml。注入 99.7%乙醇 ,乙醇量以抽出囊液的 2 5 %为合适。结果　本组 396例 (42 7个囊肿 )用CT扫描或超声检查随访 ,随访时间为 3个月到 1年以上 ,单发肾囊肿疗效为 97% ,其中囊腔消失为 82 % ,多发肾囊肿疗效为 95 % ,其中囊腔消失为 79% ,多囊肾疗效为 6 7%。并发症为局部疼痛 (2 8例 ) ,血尿 (4例 ) ,无严重并发症出现。结论　CT导引经皮穿刺肾囊肿乙醇治疗对单发肾囊肿和多发囊肿是一种有价值的治疗方法     

改良后CT引导下肝、肾囊肿的硬化剂治疗

目的探讨改良后cT引导下肝、肾囊肿硬化剂治疗的临床价值。方法应用改良后肝、肾囊肿的硬化剂治疗技术治疗肝、肾囊肿共计147例，随访3个月～1a，观察其疗效及并发症发生率。结果硬化治疗后，全部患者随访证实，总有效率99．3％，囊肿消失率84．3％，并发症发生率12．2％。结论改良后cT引导下肝、肾囊肿硬化剂治疗是一种安全、有效的方法，提高了疗效，降低了并发症发生率。     

Efficacy of Single-Session Percutaneous Drainage and 50% Acetic Acid Sclerotherapy for Treatment of Simple Renal Cysts

Purpose To evaluate the efficacy and long-term results of single-session 50% acetic acid sclerotherapy for the treatment of simple renal cysts, and to compare the therapeutic results of 5 and 20 min sclerosant dwell techniques. Methods During the past 9 years, 50% acetic acid sclerotherapy was performed on 67 cysts in 66 patients. An acetic acid volume corresponding to a mean of 23% of the aspirated cyst volume was injected into the cysts. A 20 min dwell time with position changes was performed in 32 cysts (31 patients; group I) and 8% of volume for a 5 min dwell time in 35 cysts (35 patients; group II). Three- and 6-month sonographic or CT follow-up was performed for a minimum of 1 year. Complete regression was defined as no remaining cyst measurable on sonography with or without a scar at the renal cortex. Partial regression was defined as a decreased cyst volume compared with that before sclerotherapy. The Mann-Whitney U-test was used to compare the therapeutic results between the two groups. Results For 67 simple renal cysts, complete regression on follow-up was observed in 21 of 32 cysts (66%; group I) and 22 of 35 cysts (63%; group II); the remaining 24 cysts all showed partial regression. The partial reduction rate of the cyst’s volume was 97.4% (91.3–99.4%) in group I and 96.9% (90.8–99.5 %) in group II. There were no procedure-related major complications, and no statistically significant differences in the complete regression and partial volume reduction rates between the two groups (p > 0.05). Conclusion Fifty percent acetic acid is an effective and safe sclerosing agent for simple renal cysts. Fifty percent acetic acid sclerotherapy with a 5 min sclerosant dwell time, using a volume of about 10% of the aspirated volume, is sufficient for satisfactory results of simple renal cyst sclerotherapy.     

Percutaneous US-guided combined ethanol and tetracycline injection for treating symptomatic simple and hydatid hepatic cysts

Introduction

Percutaneous treatment of simple or hydatid liver cysts is widely used in clinical practice and ethanol is the commonest sclerosant used. Abdominal discomfort and pain commonly occurs after ethanol injection which increase with increased ethanol volume.

Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy

This study compared percutaneous sclerotherapy using 50% acetic acid with that using 99% ethanol for patients with simple renal cysts. The study included 72 simple renal cysts in 64 patients (male/female ratio = 31/33; age range, 31-75 years). Under fluoroscopic guidance, the cyst fluid was aspirated completely. Sclerotherapy was then performed using 50% acetic acid for 32 cysts and 99% ethanol for 40 cysts. The volumes of each renal cyst before and after sclerotherapy were compared using ultrasonography or CT. Medical records were reviewed to analyse any complications. The mean follow-up period was 21.5 months (range, 3-75 months). The mean remnant volume of the cyst after sclerotherapy was 2.6% of the initial volume in the acetic acid group and 14.0% in the ethanol group. The rates of complete remission, partial remission and treatment failure were 90.6%, 9.4% and 0%, respectively, in the acetic acid group, and 60.0%, 30.0% and 10.0%, respectively, in the ethanol group. There were no complications related to sclerotherapy in either group. In conclusion, acetic acid is a safe and effective sclerosing agent, with clinical results superior to those of ethanol, and is an alternative to ethanol for sclerotherapy of renal cysts.     

Sclerotherapy for Simple Cysts with Use of Ethanolamine Oleate: Preliminary Experience

We evaluated the efficacy of ethanolamine oleate (EO) as a sclerosing agent for a symptomatic hepatic or renal cyst. Seven patients with symptomatic hepatic (n = 3) or renal cysts (n = 4) were treated by sclerotherapy with EO. The cyst size in the greater diameter ranged from 6 to 13 cm. The cyst was punctured under ultrasound guidance, and after all of the cyst’s content was aspirated, an iodized contrast agent was injected to check the absence of communication between the cyst and biliary tree, urinary tract, or vessels. Then, the solution of ethanolamine oleate–iopamidol mixture (EOI) of 10% of the volume of the cyst’s content was injected via catheter. After 30 min, the injected EOI was aspirated completely before catheter removal. A follow-up computed tomography scan was performed at 1 and 3 months after treatment. The volume of the cyst and its reduction rate was calculated. In addition, symptoms and complications were assessed. The volume of the cyst ranged from 64 to 636 ml (mean: 328 ml) before treatment. Three months after treatment, it ranged from 2 to 50 ml (mean: 15ml) and the reduction rate of the cyst’s volume was more than 90% on average. Symptoms caused by the cyst disappeared in all cases and no major complication was encountered. Although two patients had a low-grade fever after sclerotherapy, it was easily controlled. It is suggested that the sclerotherapy with EO might be a safe, effective, well-tolerated treatment for symptomatic hepatic or renal cysts.     

超声引导下聚多卡醇泡沫硬化治疗肾囊肿的临床应用价值

目的探讨超声引导下聚多卡醇泡沫在肾囊肿硬化治疗中的临床应用价值。 方法分析我院于2019年1月至2020年6月期间收治的42例肾囊肿患者，均在超声引导下行聚多卡醇泡沫硬化治疗，所有患者在术后1、3、6、12个月定期随访复查超声，根据囊肿的缩小率评价疗效。 结果42例患者的42个肾囊肿，术后1、3、6、12个月随访，治愈率分别为11.9%、35.7%、42.9%、59.5%；总有效率分别为59.5%、83.3%、92.9%、100.0%。Cox多因素回归分析显示囊肿容积的大小为影响聚多卡醇治疗效果的主要因素。 结论超声引导下聚多卡醇泡沫硬化治疗肾囊肿安全、有效，术后随访时间越长，治疗效果越显著，且囊肿容积越小，疗效越确切，值得在临床推广应用。     

Long-term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts

PURPOSE: To demonstrate the efficacy and long-term results of the single-session ethanol sclerotherapy in simple renal cysts. MATERIALS AND METHODS: Ninety-eight cysts in 97 patients (range: 18-76 years; mean age, 54 years) were included in the study. Indications were determined as flank pain in 74, hydronephrosis in 12, hypertension in 8, patient reassurance due to increasing cyst size in three patients. Mean follow-up period was 24.4 months. Procedures were performed with the guidance of fluoroscopy and ultrasonography at all times using 5-7 Fr pigtail catheters. After the cystogram that was obtained in all cases, 95% ethanol with a volume of 30-40% of the cyst volume was used as a sclerosing agent on an outpatient basis. Maximum volume of the injected ethanol was 200 ml. Follow-up examinations were performed 1, 3, 6 and 12 months after the procedure and once every year thereafter. RESULTS: Average cyst volume reduction was 93% at the end of the first year. The cysts disappeared completely in 17 (17.5%) patients. After the procedure, in 67 (90%) patients improvement in flank pain was noted. Sixty-one (82%) patients were free of pain and in 6 (8%) of them the pain decreased. Normotension was obtained in 7 (87.5%) of the 8 hypertensive patients and no hydronephrosis was detected in 10 (83.3%) of the 12 patients after the procedure. Second intervention was required in 2 (2%) patients due to recurrence of cysts and related symptoms. One (1%) patient had small retroperitoneal hematoma that resolved spontaneously and in another (1%) patient spontaneous hemorrhage was detected into the cyst 1 year after the procedure. No other complication was detected during the procedure and follow-up. CONCLUSION: Percutaneous treatment of simple renal cysts with single-session sclerotherapy is a safe, effective and minimally invasive procedure and can be used as an alternative to multiple-session sclerotherapy with comparable results. High volume, up to 200 ml ethanol can be used without adverse effects for large renal cysts.     

多层螺旋CT导向下经皮肾穿刺硬化治疗肾囊肿的临床价值

目的：探讨多层螺旋CT（MSCT）导向下经皮肾穿刺硬化治疗肾囊肿的方法及疗效。方法：经MSCT或MRI诊断的91例107个肾囊肿在MSCT导向下经皮穿刺抽吸、冲洗后注入无水乙醇（99.7%）,注入量为抽出囊液量的25%~30%。须多次抽吸冲洗,直至抽出液清亮。术后螺旋CT跟踪随访1年,评价其疗效。结果：本组107个囊肿穿刺成功率100%,其中71个囊肿在治疗后消失,34个囊肿较治疗前缩小,2个囊肿未见改变。治疗有效率98.1%。所有病例均未出现严重并发症。结论：MSCT引导下经皮肾穿刺硬化治疗肾囊肿是一种安全有效的治疗方法,有重要的临床应用价值。     

Acetic acid as a sclerosing agent for renal cysts: Comparison with ethanol in follow-up results

Purpose: To compare follow-up results of sclerotherapy for renal cyst using 50% acetic acid with those using 99% ethanol as sclerosing agents. Methods: Eighty-one patients underwent sclerotherapy and 58 patients, 23 males, 35 females, aged 6–76 years, having a total of 60 cysts, were included in this study; the others were lost to follow-up. The renal cysts were diagnosed by sonography, computed tomography (CT), or magnetic resonance imaging (MRI). Sclerotherapy was performed using 50% acetic acid for 32 cysts in 31 patients and 99% ethanol for 28 cysts in 27 patients. Under fluoroscopic guidance, cystic fluid was aspirated as completely as possible. After instillation of a sclerosing agent corresponding to 11.7%–25% (4–100 ml) of the aspirated volume, the patient changed position for 20 min and then the agent was removed. Patients were followed up by sonography for a period of 1–49 months. The volume of the renal cyst after sclerotherapy was compared with that of the renal cyst calculated before sclerotherapy. Medical records were reviewed to analyze complications. Results: The mean volume after sclerotherapy of the 17 cysts followed for 3–4 months in the acetic acid group was 5.1% of the initial volume, and for the 14 cysts in the ethanol group it was 10.2%. Complete regression during follow-up was shown in 21 cysts (66%) in the acetic acid group; the mean volume of these cysts before the procedure was 245 ml. The mean volume of the nine (32%) completely regressed cysts in the ethanol group was 184 ml. Mild flank pain, which occurred in three patients in each group, was the only complication and resolved the next day. Conclusion: Acetic acid was an effective and safe sclerosing agent for renal cysts, tending to induce faster and more complete regression than ethanol.     

Percutaneous aspiration and ethanol sclerotherapy of symptomatic hepatic cysts

Nineteen patients with 49 symptomatic non-neoplastic non-parasitic simple hepatic cysts were subjected to ultrasonographically guided percutaneous aspiration and temporary injection of 99% ethanol into the cyst. Small cysts were treated twice, the large ones three times at the same sitting. The volume of alcohol per injection varied from 20 to 100 ml, depending on the size of the cyst. A cure was usually achieved with one ethanol sclerotherapy treatment. Only minor side effects such as transient pain and temperature elevation occurred. Forty-seven of the 49 cysts could be treated adequately, and did not recur during a follow-up period af 12–40 months. The results indicate that aspiration an and ethanol sclerotherapy is the treatment of choice in patients with symptomatic non-neoplastic simple hepatic cysts or polycystic liver disease. Correspondence to: A. Leinonen