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Objective:To explore the application value of dual contrast-enhanced ultrasound in the differential diagnosis of renal cystic lesions.Methods:Eighty-four cases with renal cysts who were diagnosed by routine ultrasound in Zhejiang Cancer Hospital and Zhejiang Xiaoshan Hospital from January 2019 to October 2020 were included in the study. Intravenous contrast-enhanced ultrasound and enhanced MRI were performed to differentiate benign and malignant cysts. Patients with benign cysts underuent intravenous pyelography and intracapsular contrast-enhanced ultrasound. Before sclerotheraphy to exclude renal pelvic cysts. The diagnostic results of dual radiography were compared with MRI and intravenous pyelography.Results:Among 84 patients with suspected renal cysts, the diagnostic accuracy of enhanced MRI for cystic renal cancer was 97.62%, and the sensitivity was 97.62%. The diagnostic accuracy of intravenous contrast-enhanced ultrasound was 98.81, the sensitivity was 100%, and the specificity was 98.73%. There was no statistically significant difference between the two groups (all P>0.05). 77 cases were diagnosed as benign renal cysts, the detection rate of intravenous pyelography was 9.1% (7/77), the detection rate of renal pelvic cysts by intracystic ultrasonography was 6.5% (5/77). With intravenous pyelography as the gold standard, the diagnostic accuracy of intracapsular contrast-enhanced ultrasound was 97.4% (75/77), the sensitivity was 71.4% (5/7), and the specificity was 100% (70/70). Conclusions:Compared with enhanced magnetic resonance and intravenous pyelography before renal cyst sclerosing therapy, there is no difference in diagnostic efficiency of double contrast ultrasound for benign and malignant cysts. The diagnostic efficiency of renal pelvic cysts is high, and the operation is convenient. It can identify cystic renal cancer and cysts from the renal pelvis and improve the safety of sclerotherapy.
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Objective To investigate the clinical effect of ultrasound-guided sclerosing therapy with injection of lauromacrogol for the treatment of pelvic encapsulated hydrops. Methods A total of 40 patients with pelvic encapsulated hydrops were enrolled in this study. Under ultrasonographic guidance , puncture aspiration of pelvic encapsulated hydrops was carried out in all patients , which was followed by lauromacrogol injection of appropriate dose, and the drainage catheter was kept in the hydrops cavity. The clinical results were evaluated at one, 2 and 3 months after the treatment. Results The success rate of puncturing was 100%. Six months after the treatment, the complete cure was obtained in 86.4%of patients, and the effective rate was 100%. Conclusion For the treatment of pelvic encapsulated hydrops , ultrasound-guided sclerosing therapy with injection of lauromacrogol is effective and safe with instant result and lower recurrence rate. Therefore, this technique should be recommended in clinical practice.
ABSTRACT
Intramuscular hemangiomas are benign vascular lesions of skeletal muscle and constitutes less than 1% of all hemangiomas. Of all intramuscular hemangiomas, 13-25% occur in the head and neck, presenting lesions of enlarging soft tissue mass associated with pain. Usually they do not exhibit cutaneous changes, such as bluish skin discoloration as seen in cutaneous and superficial subcutaneous lesions. Because of their infrequency, deep location and unfamiliar presentation, intramuscular hemangomas are seldom correctly diagnosed clinically. We encountered a case of intramasseteric hemangioma in a 14-year-old female. She presented intermittent painful swelling on the right preauricular area. Sialography showed a multiple calcified lesion of the soft tissue, while CT scan and MRI showed a tumor mass lying in the masseter muscle. Angiography showed blush lesion but no tumor feeding arteries. After 6 months of intra-lesional sclerosing therapy with alcohol, total regression of tumor was obtained. As we experienced in this case, percutaneous sclerotherapy with alcohol could be the first therapeutic alternative.
Subject(s)
Adolescent , Female , Humans , Angiography , Arteries , Deception , Head , Hemangioma , Magnetic Resonance Imaging , Masseter Muscle , Muscle, Skeletal , Neck , Salivary Gland Calculi , Sclerotherapy , Sialography , Skin , Tomography, X-Ray ComputedABSTRACT
Recently the percutaneous aspiration and instillation with 95% ethanol, for the sclerosing therapy of the renal simple cyst, was widely used because of high recurrence rate in simple needle aspiration. Ten patients were instillated with ethanol after aspiration. Ages of patients were between 37 to 77 years old. Chief complaints were flank pain, gross hematuria, indigestion, epigastric discomfort and hypertension. After local anesthesia, the cysts were punctured with a trocar needle and inserted 8.3 Fr. single J-catheter with guide wire in turn, under ultrasonic guidance. After complete aspiration of the fluid, 95% ethanol was instillated as much as 20-30% of the cystic volume, and kept for 20-30 minutes. The pigtail catheter was removed after one day. The aspirated volume was 166 ml in average and nearly identical to transudate. There was no bacteria or malignant cells. Follow-up period was 7+/-2 months in average. Five cases were completely cured, four cases recurred but the cyst was smaller(< 50% of the original size) and one recurred as its original size. The complications were transient flank pain and facial flushing. In conclusion, aspiration and instillation with ethanol was very easy, safe, fast and effective treatment for the simple renal cyst.
Subject(s)
Aged , Humans , Anesthesia, Local , Bacteria , Catheters , Dyspepsia , Ethanol , Exudates and Transudates , Flank Pain , Flushing , Follow-Up Studies , Hematuria , Hypertension , Needles , Recurrence , Surgical Instruments , UltrasonicsABSTRACT
We analysed 3,130 patients with simple renal cyst who were discovered in 27,216 men receiving routine ultrasound examination in our hospital. Incidence of simple renal cyst was 11.5% in all populations and ratio of male to female was 1.8: 1. Patients age ranged from 14 to 91 years (average age 63.8 years) and number of renal cysts were increased after fifth decade in both sexes. Size of cysts were increasing along with age. And 201 cases visiting Urology Department were examined on symptoms. Symptoms associated with simple renal cysts were : none( 77.6% ), pain ( 11.4% ), gross hematuria( 4.0% ) and epigastric discomfort( 3.0% ). Benign renal cysts were treated with percutaneous aspiration in 9 cases, percutaneous aspiration with sclerosing agent in 13 cases and only follow-up in asymptomatic 29 cases. All were followed by ultrasound from 6 to 38 months(average 27 months). Overall efficacy were 44.4% with aspiration and 92.2 % with combined therapy. Sclerosing therapy using 99% ethanol seems to be a safe and effective way to prevent reaccumulation of cystic fluid in symptomatic cases. But routine follow-up is sufficient in asymptomatic cases, since simple renal cysts increase slowly in size.
Subject(s)
Female , Humans , Male , Ethanol , Follow-Up Studies , Incidence , Ultrasonography , UrologyABSTRACT
Percutaneous treatment of benign renal cysts has been proposed as a method of reducing the morbidity associated with surgical treatment. The results of percutaneous aspiration and sclerosing therapy of 12 benign renal cysts and 5 infected renal cysts were reviewed. Percutaneous aspiration and daily sclerosing therapy with 99% ethanol for 4-5 days were performed in 12 benign renal cysts. Sclerosing therapy with 10% tetracycline solution following aspiration was done in the remaining 5 infected renal cysts. The aspirates were analyzed for color, total lipid, protein. lactic acid dehydrogenase (LDH). amylase. glucose and smear/culture. Also, cell block was performed for detection of malignant cells. All laboratory data were transudate except 5 infected renal cysts. Cytologic and bacteriological findings were negative except 1 infected renal cyst which had positive E. coli. All were followed by ultrasound or CT from 3 to 48 months (mean follow-up 26 months). In The 17 renal cysts, 9 cysts (53%) disappeared completely and 4 cysts (24%) decreased to half the original volume within 3 months period. In the 10 cysts who had been followed for 6 months. 4 cysts (40%) were collapsed completely and 2 cysts (20%) were reduced to half rhe original volume. The cystic cavity disappeared completely in 4 of 8 cysts (50%) and was decreased to half the original volume in 2 of 8 cysts (25%) for l year period. Overall efficacy was 71%. In summary, percutaneous aspiration and sclerosing therapy using 99% ethanol or 10% tetracycline solution was effective in the treatment of benign renal cysts and infected renal cysts. Also, differential diagnosis with malignant tumor was easily made by analysis of cystic fluid. In the recurred cysts, aspiration and sclerosing therapy were performed without significant complication and morbidity, repeatedly. But long-term follow-up evaluation will be necessary to document the results of aspiration with sclerosing therapy because of the diverse natural history of the renal cyst.