J Korean Soc Radiol.  2018 Mar;78(3):193-199. 10.3348/jksr.2018.78.3.193.

Predictors of the Frequency of Ethanol Injections for Renal Cyst Ablation: A Preliminary Study

• Kim YH
• Cho BS

• KMID: 2405722
• DOI: http://doi.org/10.3348/jksr.2018.78.3.193

Abstract

PURPOSE
To assess the factors facilitating the prediction of the frequency of ethanol injections in successful renal cyst ablation.
MATERIALS AND METHODS
We retrospectively reviewed the computed tomography and ultrasonography scans of 37 renal cysts. Two radiologists evaluated the characteristics of the presenting renal cysts, including size, calcification, septation, and lobulated configuration. Patients were divided into an "above-four" group and "below-three" group, according to the number of ethanol injections.
RESULTS
Among the 37 renal cysts, six belonged to the "above-four" group and 31 to the "below-three" group. The mean volume of "above-four" group was 409.48 cc and that of the other group was 301.64 cc. Seven renal cysts included three belonging to the "above-four" group, which showed calcification. Twelve renal cysts presented a multilocular appearance with thin septa, and included a cyst classified under the "above-four" group. Three renal cysts had lobulated configuration, with one of them belonging to the "above-four" group.
CONCLUSION
No significant correlation was found among the different factors in the prediction of the frequency of renal cyst ablation. However, calcification was the most useful parameter for prediction of the number of renal cyst ablations needed.

MeSH Terms

Ablation Techniques
Ethanol*
Humans
Kidney Diseases
Retrospective Studies
Sclerotherapy
Ultrasonography
Ethanol

Figure

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  Fig. 1. A 55-year-old woman with a Bosniak classification II lesion in the right kidney and she was performed four times ethanol injections. A, B. The renal cyst in the right kidney shows calcification (white arrows) and septa (black arrows) in non-contrast-enhanced (A) and contrast-enhanced (B) axial computed tomography scans. In addition, it has a lobulated margin (white arrowheads) with at least one lobule. C. Like the axial axis view, the coronal axis view shows a lobulated margin (arrowheads) with at least one lobule; since the lobulated margin is visible in two planes, this cyst was classified as a lobulated renal cyst with calcification and thin septa.

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  Fig. 2. A 57-year-old man with a Bosniak classification I lesion in the left kidney and he was performed two times ethanol injections. A. The contrast-enhanced computed tomography axial scan shows a lobulated margin (arrowheads). B, C. The coronal scan also shows a renal cyst with a lobulated margin (arrowheads) renal cyst; however, this is not accompanied by internal septa or calcification. Hence, this case was classified as a lobulated renal cyst in the left kidney without internal septa or calcification. D. Similarly, a sonogram performed during sclerotherapy also demonstrated a lobulated contour (arrowheads).

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  Fig. 3. A 71-year-old man with a Bosniak classification II lesion in the right kidney and he was performed two times ethanol injections. A, B. The axial and coronal contrast-enhanced CT scans show a renal cyst with internal linear density (white arrows). This was classified as a smooth margined renal cyst with thin septa and no calcification.

Reference

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