Prediction of hepatic cyst recurrence after minocycline hydrochloride aspiration sclerotherapy using cyst computed tomography values.
OBJECTIVE
Polycystic liver disease (PLD) occasionally leads to abdominal pain, distention, and discomfort due to massively enlarged cysts. Patients with a small number of large liver cysts, which correspond to Gigot's classification type 1 PLD, are reported to be good candidates for treatment by aspiration sclerotherapy. However, there is a 21% reported recurrence rate of an enlarged cyst. A rule to predict outcome of aspiration sclerotherapy is explored in this study.


METHODS
The medical records of patients with autosomal dominant polycystic kidney disease or isolated polycystic liver disease, who underwent minocycline hydrochloride cyst aspiration sclerotherapy for their symptomatic PLD, were retrospectively analyzed. Changes in the volume of cysts from before to 1 year after treatment were calculated using computed tomography (CT) images. Mean CT values of the largest planes of cysts were also calculated. Specific gravity and other laboratory parameters of aspirated cyst fluid were also retrospectively investigated.


RESULTS
In total, 12 patients were selected and 21 cysts were analyzed that received aspiration sclerotherapy. Mean CT values more than 13.34 HU were predictive for 1-year non-sustainability of a cyst volume of less than 30% compared with the volume prior to the therapy. Specific gravity had good positive correlation with mean CT value and other laboratory parameters indicating exudative properties were also high in recurred cysts.


CONCLUSIONS
The CT values of cysts may become an aid in appropriate selection of therapy in patients with symptomatic polycystic disease by distinguishing cysts that are resistant to aspiration sclerotherapy.
Nephrology Center, Toranomon Hospital Kajigaya, Japan.
Takashi
T
Iijima
Nephrology Center, Toranomon Hospital Kajigaya, Japan.
Tatsuya
T
Suwabe
Nephrology Center, Toranomon Hospital Kajigaya, Japan.
Keiichi
K
Sumida
Nephrology Center, Toranomon Hospital Kajigaya, Japan.
Noriko
N
Hayami
Nephrology Center, Toranomon Hospital Kajigaya, Japan.
Koki
K
Mise
Nephrology Center, Toranomon Hospital Kajigaya, Japan.
Junichi
J
Hoshino
Nephrology Center, Toranomon Hospital Kajigaya, Japan.|Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Kenmei
K
Takaichi
Nephrology Center, Toranomon Hospital Kajigaya, Japan.|Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Yoshifumi
Y
Ubara
isolated polycystic liver disease; polycystic kidney disease; puncture and aspiration