The value of multidetector-row CT in the preoperative detection of pancreatic insulinomas

• Published in: Radiologia medica Vol. 114; no. 8; pp. 1232 - 1238
• Main Authors: Liu, Y., Song, Q., Jin, H.T., Lin, X.Z., Chen, K.M.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.12.2009
• Subjects: Abdominal Radiology/Radiologia Addominale; Adolescent; Adult; Aged; Child; Diagnosis, Differential; Diagnostic Radiology; Female; Humans; Imaging; Insulinoma - diagnosis; Insulinoma - diagnostic imaging; Insulinoma - surgery; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - surgery; Predictive Value of Tests; Preoperative Period; Radiology; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasound; Tomografia computerizzata; Insulinomas; Pancreas; Pancreas neoplasms; Computed X-ray tomography; Tumori pancreatici; Insulinomi
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-009-0466-7

Purpose The authors sought to quantitatively analyse enhancement characteristics of pancreatic insulinomas in different phases and determine the value of multidetector-row computed tomography (CT) for detecting insulinomas. Materials and methods Forty-six patients with surgically proven insulinomas diagnosed between 2002 and 2007 were retrospectively reviewed. These patients underwent single-phase (group 1) or dual-phase (group 2) helical CT scanning. Results Sensitivity for detecting insulinomas in group 2 was superior to that in group 1 ( p <0.05).The sensitivity for insulinoma detection in the arterial phase was superior to that in the portal-venous phase ( p <0.05). The mean attenuation values of the insulinomas and normal pancreas during the unenhanced arterial and portal-venous phases were, respectively, 40.5±8.75 HU (Hounsfield units), 114.48±27.30 HU, 112.19±19.52 HU and 44.56±6.48 HU, 81.16±15.22 HU, 90.54±13.80 HU, and there was statistical difference between them ( p =0.000). The contrast enhancement of insulinomas in the arterial and portal-venous phases was 74.03±29.51 HU and 70.90±21.93 HU, respectively, and there was no statistical difference between them ( p =0.499). The tumour to normal-pancreas attenuation differences in the arterial and portal-venous phases were respectively 33.32±20.96 HU and 20.58±16.32 HU, respectively, and there was statistical difference between them ( p =0.011). Conclusions Dual-phase CT has a promising sensitivity in detecting pancreatic insulinomas. The acquisition of images in the arterial phase is more helpful for detecting insulinomas.