Insulinoma: Imaging Features and Correlation with Pathological Findings (Analysis of 8 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xie ^1,2 , TU Yuan ³ , HUANG Zixing ¹ , SONG Bin ¹ , ZHONG Huanhuan ¹ , ZHAO Shuang ¹

1.Department of Radiology， West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;;
2.Department of Radiology, Chengdu No.2 People’s Hospital, Chengdu 610017, Sichuan Province, China;;
3.Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

Keywords：

Pancreas neoplasm; Insulinoma; Tomography; X-ray computed; Magnetic resonance imaging

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ObjectiveTo investigate the imaging features of insulinoma on multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) with correlation of pathology. MethodsAll images of 8 patients confirmed by surgery and pathology were retrospectively analyzed with correlation of pathology. MSCT scans were performed in 4 patients and MR scans in 6 patients, among which 2 patients accepted both MSCT and MRI examinations. ResultsInsulinoma in all patients manifested as solitary lesions with diameters of 0.5-3.5 cm. Four lesions demonstrated isodensity or hypodensity on plain MSCT, with significant enhancement on arterial phase, and relative isodensity or slight hyperdensity on portal phase and delay phase. On plain MRI, lesions demonstrated hyperintensity on T1WI, slight hyperintensity or hyperintensity on T2WI. The enhanced patterns of insulinoma were similar to the findings on MSCT. ConclusionsThe imaging characteristics of insulinoma reflect the pathological features. MSCT and MRI are effective in the diagnosis of inslinoma, and MRI can show more diagnostic information.

Citation： ZHANG Xie ,TU Yuan,HUANG Zixing,SONG Bin,ZHONG Huanhuan,ZHAO Shuang. Insulinoma: Imaging Features and Correlation with Pathological Findings (Analysis of 8 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(3): 336-340. doi: Copy

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24.	Thoeni RF, Mueller Lisse UG, Chan R, et al. Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity [J]. Radiology, 2000, 214(2): 483490.
25.	Anaye A, Mathieu A, Closset J, et al. Successful preoperative localization of a small pancreatic insulinoma by diffusionweighted MRI [J]. JOP, 2009, 10(5): 528531.
26.	宋彬, 徐隽, 闵鹏秋. 胰腺的血管系统 [J]. 中国医学计算机成像杂志, 2002, 8(4): 217222.

1. Berends FJ, Cuesta MA, Kazemier G, et al. Laparoscopic detection and resection of insulinomas [J]. Surgery, 2000, 128(3): 386391.
2. Stark DD, Moss AA, Goldberg HI, et al. CT of pancreatic islet cell tumors [J]. Radiology, 1984, 150(2): 491494.
3. Gualdi GF, Casciani E, Polettini E. Imaging of neuroendocrine tumors [J]. Clin Ter, 2001, 152(2): 107121.
4. 权毅, 严律南. 胰岛素瘤的诊断和治疗(附15例报告) [J]. 中国普外基础与临床杂志, 2000, 7(6): 364366.
5. 高鹏, 王正娥, 周艳贞. 胰岛素瘤的诊断和治疗(附25例报告) [J]. 中国普外基础与临床杂志, 1999, 6(6): 357358.
6. Shin JJ, Gorden P, Libutti SK. Insulinoma: pathophysiology, localization and management [J]. Future Oncol, 2010, 6(2): 229237.
7. Ehehalt F, Saeger HD, Schmidt CM, et al. Neuroendocrine tumors of the pancreas [J]. Oncologist, 2009, 14(5): 456467.
8. Rockall AG, Reznek RH. Imaging of neuroendocrine tumours (CT/MR/US) [J]. Best Pract Res Clin Endocrinol Metab, 2007, 21(1): 4368.
9. Rothmund M, Angelini L, Brunt M, et al. Surgery for benign insulinoma: an international reviews [J]. World J Surg, 1990, 14(3): 393398.
10. Bottger TC, Weber W, Beyer J, et al. Value of tumors localization in patients with insulinoma [J]. World J Surg, 1990, 14(1): 107112.
11. McAuley G, Delaney H, Colville J, et al. Multimodality preoperative imaging of pancreatic insulinomas [J]. Clin Radiol, 2005, 60(10): 10391050.
12. Sun MR, Brennan DD, Kruskal JB, et al. Intraoperative ultrasonography of the pancreas [J]. Radiographics, 2010, 30(7): 19351953.
13. 李俊来, 董宝玮, 唐杰, 等. 术中超声在胰岛素瘤定位诊断中的价值 [J]. 中华超声影像学杂志, 2000, 9(6): 340342.
14. 于晓玲, 梁萍, 董宝玮, 等. 超声造影诊断胰腺局灶性病变的价值 [J]. 中国医学影像学杂志, 2008, 16(3): 170173.
15. D’Onofrio M, Zamboni G, Tognolini A, et al. Massforming pancreatitis: value of contrastenhanced ultrasonography [J]. World J Gastroenterol, 2006, 12(26): 41814184.
16. Sofuni A, Iijima H, Moriyasu F, et al. Differential diagnosis of pancreatic tumors using ultrasound contrast imaging [J]. J Gastroenterol, 2005, 40(5): 518525.
17. Ichikawa T, Peterson MS, Federle MP, et al. Islet cell tumor of the pancreas: biphasic CT versus MR imaging in tumor detection [J]. Radiology, 2000, 216(1): 163171.
18. Jyotsna VP, Rangel N, Pal S, et al. Insulinoma: diagnosis and surgical treatment. Retrospective analysis of 31 cases [J]. Indian J Gastroenterol, 2006, 25(5): 244247.
19. StaffordJohnson DB, Francis IR, Eckhauser FE, et al. Dualphase helical CT of nonfunctioning islet cell tumors [J]. J Comput Assist Tomogr, 1998, 22(1): 335339.
20. Sheth S, Hruban RK, Fishman EK. Helical CT of islet cell tumors of the pancreas: typical and atypical manifestations [J]. AJR Am J Roentgenol, 2002, 179(3): 725730.
21. 龙学颖, 李宜雄, 王宪伟, 等. 胰岛素瘤术前CT定位诊断的回顾性分析 [J]. 中南大学学报(医学版), 2009, 34(2): 165171.
22. 孙春峰, 吴志远, 陆健, 等. 螺旋CT三期增强扫描在小胰岛细胞瘤(直径≤2 cm)诊断中的价值 [J]. 临床放射学杂志, 2010, 29(5): 624628．.
23. 李传福, 张红蕾, 刘松涛, 等. 胰岛素瘤的MRI诊断 [J]. 中华放射学杂志, 2001, 35(2): 99102.
24. Thoeni RF, Mueller Lisse UG, Chan R, et al. Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity [J]. Radiology, 2000, 214(2): 483490.
25. Anaye A, Mathieu A, Closset J, et al. Successful preoperative localization of a small pancreatic insulinoma by diffusionweighted MRI [J]. JOP, 2009, 10(5): 528531.
26. 宋彬, 徐隽, 闵鹏秋. 胰腺的血管系统 [J]. 中国医学计算机成像杂志, 2002, 8(4): 217222.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Insulinoma: Imaging Features and Correlation with Pathological Findings (Analysis of 8 Cases)

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