胰岛素瘤的螺旋CT诊断(附6例报告)

Dual-phase spiral CT in the diagnosis of insulinoma

目的:探讨螺旋CT双期增强扫描诊断胰岛素瘤的价值。材料和方法:对6例临床诊断为胰岛素瘤的患者均于术前行胰腺螺旋CT双期增强扫描,动脉期延迟25～30s,静脉期延迟60～70s开始扫描。观察并比较平扫、动脉期、静脉期肿瘤的检出情况及影像表现。所有病例均经手术和病理证实为胰岛素瘤。结果:螺旋CT双期增强扫描发现肿瘤4例,均单发,结果阴性2例。3例动脉期、静脉期肿瘤显著增强,肿瘤与胰腺实质的平均CT值之比动脉期大于静脉期,1例表现为胰尾部局限性膨隆,肿瘤动、静脉期强化不显著。平扫发现1例,肿瘤与胰腺实质呈等密度。结论:螺旋CT双期增强扫描提高了胰岛素瘤的检出率,对胰岛素瘤术前定位有较高的价值。

Objective:To evaluate the usefulness of dual-phase spiral CT in the diagnosis of insulinoma .Materials and Methods:Six patients diagnosed as insulinoma clinically received dual-phase spiral CT examination before operation.Arterial phase was performed at25～30s after injection of the contrast medium,the venous phase was performed at60～70s after the injection.The results of unenhanced and enhanced scans were compared.All cases were proved by surgical operation and pathology.Results:Four tumors were found in the dual-phase spiral CT,the other two cases had negative results.Three tu-mors enhanced obviously in both arterial phase and venous phase.The ratio of the average CT number between tumor and pancreas in the arterial phase was higher than that in the venous phase.One tumor in the arterial phase and venous phase the enhancement was not obvious,only showed local enlargement of pancreas tail.In the non-enhanced phase one tumor was found,in whom the CT number of tumor was equal to pancreas.Conclusion:Dual-phase spiral CT improved the detection of insulinoma.It is important to locate insulinoma in the pancreas before operation.