Comparison of CT-Guided Sclerotherapy with Using 95% Ethanol and 20% Hypertonic Saline for Managing Simple Renal Cyst Hulusi Egilmez, MD1 Vedat Gok, MD1 Ibrahim Oztoprak, MD1 Mehmet Atalar, MD1 Ali Cetin, MD2 Mubeccel Arslan, MD1 Yener Gultekin, MD3 Orhan Solak, MD1 Index terms : Kidney, cyst Kidney, interventional procedures Sclerotherapy Alcohol Kidney, CT Korean J Radiol 2007;8:512-519 Received July 2, 2006; accepted after revision December 27, 2006. Departments of 1Radiology, 2Obstetrics and Gynecology, and 3Urology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey Address reprint requests to: Hulusi Egilmez, MD, Department of Radiology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey. Tel. +346 2191300 Fax. +346 2191284 e-mail: hegilmez@cumhuriyet.edu.tr 512 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 (aver- age 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, respective- ly, corresponding to 25% of the aspiration volume, was injected. Treatment suc- cess was determined six months later with follow-up clinical evaluation and per- forming 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 signifi- cantly 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. S for approximately 65 to 70% of all of them (1). They often occur in imple renal cysts are the most common renal masses, and they account patients over the age of 50 as has been determined with performing postmortem examination or renal ultrasonography (US) (2, 3). Simple renal cysts are often incidentally discovered on US, CT or urography examinations that are performed for urinary tract problems or other abdominal problems. The characteristic appearance of simple renal cysts on US, CT and magnetic resonance imaging allows the radiologist to make an accurate diagnosis. US is commonly used to exclude the possibility of benign or malignant pathology because the kidney is readily accessible for US examination (4). A small proportion of simple renal cysts may be associated with symptoms, of which pain is the commonest. Hematuria, hypertension, pelvicalyceal obstruction and cyst rupture are less common symptoms (2). When cysts are very large, they may produce the mechanical effects of a space-occupying lesion. Percutaneous or surgical interven- Korean J Radiol 8(6), December 2007