Hypoglycemia MRI: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hypoglycemia}} | {{Hypoglycemia}} | ||
{{CMG}} | {{CMG}};{{AE}} {{MAD}} | ||
==Overview== | ==Overview== | ||
MRI | [[Magnetic resonance imaging|MRI]] is helpful in the diagnosis of [[insulinoma]] in the case of failed [[Computed tomography|CT.]] [[Magnetic resonance imaging|MRI]] has better sensitivity than [[Computed tomography|CT scan]]. [[Insulinoma]] shows low intensity on T1 weighted and high intensity on T2 weighted signals, having better visualization on T1 and T2 weighted images with [[fat]] suppression. Large tumors (≥ 2 cm) exhibit typically homogenous pattern and ring enhancement. A similar pattern is seen in metastatic lesion as of primary [[tumor]]. | ||
== MRI == | == MRI == | ||
MRI may | * [[Magnetic resonance imaging|MRI]] is helpful in the diagnosis of [[insulinoma]] in the case of failed [[Computed tomography|CT.]] | ||
* MRI is superior in detecting [[insulinoma]] and has greater [[Sensitivity (tests)|sensitivity]]. The sensitivity has increased to 94%. | |||
* Findings of [[Magnetic resonance imaging|MRI]] suggestive of [[insulinoma]] include:<sup>[[Insulinoma MRI#cite note-pmid16179163-3|[3]]]</sup><ref name="pmid157636952">{{cite journal| author=Noone TC, Hosey J, Firat Z, Semelka RC| title=Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. | journal=Best Pract Res Clin Endocrinol Metab | year= 2005 | volume= 19 | issue= 2 | pages= 195-211 | pmid=15763695 | doi=10.1016/j.beem.2004.11.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15763695 }}</ref> | |||
**T1 typically shows enhancement, although contrast enhancement may not improve [[tumor]] visualization.<ref name="pmid23590041">{{cite journal| author=Pongprasobchai S, Lertwattanarak R, Pausawasdi N, Prachayakul V| title=Diagnosis and localization of insulinoma in Thai patients: performance of endoscopic ultrasonography compared to computed tomography and magnetic resonance imaging. | journal=J Med Assoc Thai | year= 2013 | volume= 96 Suppl 2 | issue= | pages= S187-93 | pmid=23590041 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23590041 }}</ref> | |||
**T1 and T2 relaxation times for [[Islet cell|islet-cell]] tumor-like [[insulinoma]] has lower protein and proton concentration time. <sup>[[Insulinoma MRI#cite note-pmid16179163-3|[3]]]</sup> | |||
**Homogeneous enhancement is exhibited commonly in insulinoma. Enhancement patterns are due to hypervascularity.<ref name="pmid10671597">{{cite journal| author=Thoeni RF, Mueller-Lisse UG, Chan R, Do NK, Shyn PB| title=Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. | journal=Radiology | year= 2000 | volume= 214 | issue= 2 | pages= 483-90 | pmid=10671597 | doi=10.1148/radiology.214.2.r00fe32483 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10671597 }}</ref> | |||
**[[Metastasis|Metastatic]] lesions in [[lymph nodes]] are homogeneous when small and show ring enhancement if the [[tumor]] is more than 2 cm.<ref name="pmid15763695">{{cite journal| author=Noone TC, Hosey J, Firat Z, Semelka RC| title=Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. | journal=Best Pract Res Clin Endocrinol Metab | year= 2005 | volume= 19 | issue= 2 | pages= 195-211 | pmid=15763695 | doi=10.1016/j.beem.2004.11.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15763695 }}</ref> | |||
[[File:Metastatic insulinomaGIF.gif|center|300px|thumb|MRI showing metastatic insulinoma, source: Case courtesy of Dr Maxime St-Amant, Radiopaedia.org, rID: 19080]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 16:03, 16 November 2017
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Hypoglycemia MRI On the Web |
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American Roentgen Ray Society Images of Hypoglycemia MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
MRI is helpful in the diagnosis of insulinoma in the case of failed CT. MRI has better sensitivity than CT scan. Insulinoma shows low intensity on T1 weighted and high intensity on T2 weighted signals, having better visualization on T1 and T2 weighted images with fat suppression. Large tumors (≥ 2 cm) exhibit typically homogenous pattern and ring enhancement. A similar pattern is seen in metastatic lesion as of primary tumor.
MRI
- MRI is helpful in the diagnosis of insulinoma in the case of failed CT.
- MRI is superior in detecting insulinoma and has greater sensitivity. The sensitivity has increased to 94%.
- Findings of MRI suggestive of insulinoma include:[3][1]
- T1 typically shows enhancement, although contrast enhancement may not improve tumor visualization.[2]
- T1 and T2 relaxation times for islet-cell tumor-like insulinoma has lower protein and proton concentration time. [3]
- Homogeneous enhancement is exhibited commonly in insulinoma. Enhancement patterns are due to hypervascularity.[3]
- Metastatic lesions in lymph nodes are homogeneous when small and show ring enhancement if the tumor is more than 2 cm.[4]
References
- ↑ Noone TC, Hosey J, Firat Z, Semelka RC (2005). "Imaging and localization of islet-cell tumours of the pancreas on CT and MRI". Best Pract Res Clin Endocrinol Metab. 19 (2): 195–211. doi:10.1016/j.beem.2004.11.013. PMID 15763695.
- ↑ Pongprasobchai S, Lertwattanarak R, Pausawasdi N, Prachayakul V (2013). "Diagnosis and localization of insulinoma in Thai patients: performance of endoscopic ultrasonography compared to computed tomography and magnetic resonance imaging". J Med Assoc Thai. 96 Suppl 2: S187–93. PMID 23590041.
- ↑ Thoeni RF, Mueller-Lisse UG, Chan R, Do NK, Shyn PB (2000). "Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity". Radiology. 214 (2): 483–90. doi:10.1148/radiology.214.2.r00fe32483. PMID 10671597.
- ↑ Noone TC, Hosey J, Firat Z, Semelka RC (2005). "Imaging and localization of islet-cell tumours of the pancreas on CT and MRI". Best Pract Res Clin Endocrinol Metab. 19 (2): 195–211. doi:10.1016/j.beem.2004.11.013. PMID 15763695.