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Serial Ethanol Ablation of Multiple Hepatic Cysts as an Alternative to Liver Transplantation

James V. Ferris1

1 Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213.



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  		Fig. 1A. —51-year-old woman with painful hepatomegaly from polycystic liver disease. At initial evaluation, CT scan obtained during portal venous phase shows innumerable bilobar hepatic cysts, precluding feasible surgical plane. Cysts in lateral (l), medial (m), and posterior (p) segments of liver were eventually ablated with alcohol to alleviate pain at costal margins and right flank.

 


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  		Fig. 1B. —51-year-old woman with painful hepatomegaly from polycystic liver disease. Cyst catheter sinogram shows opacification of two cysts in lateral (l) and medial (m) segments of liver (arrows at liver margin). Neither contrast material extravasation nor communication to biliary tract that would contraindicate subsequent alcohol ablation can be seen.

 


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  		Fig. 1C. —51-year-old woman with painful hepatomegaly from polycystic liver disease. Unenhanced CT image shows extensive capsular retraction and negligible fluid recurrence in treated cysts at 22 months (arrows) and at 36 months (arrowhead) after last alcohol treatment.

 


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  		Fig. 1D. —51-year-old woman with painful hepatomegaly from polycystic liver disease. CT image obtained during portal venous phase shows persistent lack of reaccumulation in treated cysts at 52 months (arrows denote calcifications) and 66 months (arrowhead) after last ethanol ablation.

 

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