Magnetic Resonance Image for Preoperative Localization of Insulinoma

胰島素瘤為胰臟最常見的神經內分泌瘤。如何定位胰島素瘤對於外科醫師而言是最具挑戰性的，本研究的目的在於比較不同的影像檢查方法在術前對胰島素瘤定位結果。凡被診斷為胰島素瘤的患者其臨床症狀皆被紀錄及分析。我們分析各種影像檢查方法的敏感度，包含腹部超音波、經內視鏡超音波、電腦斷層攝影及核磁共振造影。總共有二十一位病患接受手術並確認為胰島素瘤，其中僅一人在術前未確定腫瘤的位置，腫瘤的直徑平均為1.5公分，分布從0.8公分至3.0公分；腹部超音波的、經內視鏡超音波、電腦斷層攝影的敏感度分別為33.3%、61.5%及38.5%：核磁共振造影的敏感度為85.7%，核磁共振造影在評估腫瘤的大小有較好的相對應性：核磁共振造影對小於1.6公分有較好的偵測率：胰島素瘤在腫瘤切除後的預後相當的好。核磁共振造影及核磁共振膽管胰臟造影不僅可以準確的定位出胰島素瘤的位置而且可以觀察出腫瘤與附近重要器官：例如總膽管及胰管的相關位置，它是花費較低而有效的檢查且具非侵犯性的優點。

關鍵字

無資料

並列摘要

Objective: Insulinoma is the most common functional neuroendocrine tumor of the pancreas. The problem for the surgeons is the preoperative localizing of the tumor requiring surgical treatment. The aim of this study was to evaluate the results of the various image modalities for preoperative localization of insulinoma. Methods: Patients were diagnosed with insulinoma at the study institute and the clinical records were analyzed retrospectively. The sensitivities of the different diagnostic image modalities included abdominal ultrasonography (US), endoscopic ultrasonography (EUS), computed tomography (CT) scans, and magnetic resonance image (MRI). Results: Twenty-one patients who underwent surgical resection were included in this study. Only one of the patients failed preoperative localization. The sensitivities of US, EUS, and CT were 33.3%, 61.5%, and 38.5% respectively, but the sensitivity of MRI was 85.7% (p＜0.05). The mean tumor size was 1.5 cm, ranging from 0.8 cm to 3.0 cm. For tumors less than 1.6 cm, MRI had a better detection rate. The prognosis of insulinomas was excellent after surgical resection. Conclusions: In this study MRI with MR cholagiopancreaticograpghy (MRCP) offered the accurate pinpointing of insulinomas and related vital structures such as pancreatic ducts and common bile ducts. This is both cost-effective and noninvasive.

並列關鍵字

Insulinoma ； magnetic resonance image

國際替代計量

Magnetic Resonance Image for Preoperative Localization of Insulinoma

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