胰岛素瘤的定位方法评估

THE ASSESSMENT OF LOCALITIVE METHODS IN INSULINOMAS

目的：探讨胰岛素瘤各种定位方法的优缺点，以提高胰岛素瘤的定位准确性。方法：1990年4月-1999年月 经手术和闰同理证实的28例胰岛素瘤患者行术产有B超、CT、MRI、DSA、术中扪诊、术中超声（IOUS）和胰岛素测定（PVS）检查，并对手术结果进行分析。结果：US、CT、MRI和DSA的定位率分别为28.6%(8/28)、32.2%(9/28)、41.7%(5/12)和50.0%(5/10)，而术中扪诊、IOUS和PVS的定位率分别为82.1%（23/28）、92.3%(12/13）和92.3%(24/16)，术中定位率比术前明显提高。结论：胰岛素瘤的术前定位率较低，不仅强调多种影像学重复检查，机时术中定位诊断极其重要，IOUS不但能提高肿瘤的定位敏感性，还可减少术后并发症。

Objective\ To detect all methods of localization in the insulinomas,and promote the rate of localization in insulinomas.Methods\ Between April 1990 and April 1999,28 patients of insulinomas that confirmed by operation and pathology.US,CT,MRI and DSA were used for preoperative diagnosis,IOUS,PVS and touching were used for intraoperative diagnosis,and analyzed the results of operation.Results\ The rates of localization were 28.6% with US,32.2% with CT,41.7% with MRI,50.0% with DSA,82.1% with touching,and 92.3% with IOUS and PVS.The rates of preoperative were higher than that intraoperative.Conclusion\ The rates of localization were so lower in preoperative diagnosis that did not be detected repeatedly,but intraoperative diagnosis was very vital.IOUS not only to promote the localizative sensitivity,but also to discrease the rates of operative complication.