Hypoglycemia CT: Difference between revisions
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* A negative imaging study does not exclude [[insulinoma]] and patient need more tests. | * A negative imaging study does not exclude [[insulinoma]] and patient need more tests. | ||
* [[Computed tomography|CT]] shows hyperattenuating on arterial phase so arterial or [[pancreatic]] phase imaging may aid in better detection. Some may show [[calcification]].<ref name="pmid9534694">{{cite journal| author=King AD, Ko GT, Yeung VT, Chow CC, Griffith J, Cockram CS| title=Dual phase spiral CT in the detection of small insulinomas of the pancreas. | journal=Br J Radiol | year= 1998 | volume= 71 | issue= 841 | pages= 20-3 | pmid=9534694 | doi=10.1259/bjr.71.841.9534694 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9534694 }}</ref> | * [[Computed tomography|CT]] shows hyperattenuating on arterial phase so arterial or [[pancreatic]] phase imaging may aid in better detection. Some may show [[calcification]].<ref name="pmid9534694">{{cite journal| author=King AD, Ko GT, Yeung VT, Chow CC, Griffith J, Cockram CS| title=Dual phase spiral CT in the detection of small insulinomas of the pancreas. | journal=Br J Radiol | year= 1998 | volume= 71 | issue= 841 | pages= 20-3 | pmid=9534694 | doi=10.1259/bjr.71.841.9534694 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9534694 }}</ref> | ||
* [[Sensitivity (tests)|Sensitivity]] of CT scan for diagnosing [[insulinoma]] was 33-64%. With the recent advances in technology and knowledge of rapid contrast-enhanced CT scan in early phase has increased the sentivity to 80%. <sup>[[Insulinoma CT#cite note-pmid23430217-1|[1]]]</sup>Most insulinomas are smaller,<1.3 cm (50%) and many of these are non-contour forming. therefore CT scan is less effective in diagnosing them than MRI.<sup>[[Insulinoma CT#cite note-pmid16179163-2|[2]]][[Insulinoma CT#cite note-pmid15763695-3|[3]]]</sup> | |||
* Abdominal Contrast enhanced CT(CECT) scan may be helpful in the diagnosis of insulinoma. Findings on CT scan suggestive of insulinoma include<sup>[[Insulinoma CT#cite note-pmid23430217-1|[1]]]</sup>: | |||
* Greater degree of enhancement(hyper-attenuation) than parenchyma of the rest of [[pancreas]](as its hypervascular)during the vascular phases of the contrast | |||
* Atypically can appear hypovascular and hypodense lesions after the administration of contrast, as compared to hyperdense lesions before the administration; cystic masses, and calcified masses(in [[malignant]] lesions when they are [[nodular]] and discrete)<sup>[[Insulinoma CT#cite note-pmid16179163-2|[2]]][[Insulinoma CT#cite note-pmid15763695-3|[3]]]</sup> | |||
* [[Computed tomography|CT]] quality have been improved with techology advances with using dual-phase thin-section multdetector [[Computed tomography|CT]] having senstivity of 94.4% as compared to 57% for dual-phase multidetector without thin sections and 28.6% with sequential CT.<sup>[[Insulinoma CT#cite note-pmid16179163-2|[2]]][[Insulinoma CT#cite note-pmid16498592-4|[4]]]</sup> | |||
* It is helpful for detetcting [[Metastasis|metastasis.]] | |||
[[File:Insulinoma CT gif.gif|center|500px|thumb|CT showing insulinoma, source: Case courtesy of Dr J. Ray Ballinger, Radiopaedia.org, rID: 23627]] | [[File:Insulinoma CT gif.gif|center|500px|thumb|CT showing insulinoma, source: Case courtesy of Dr J. Ray Ballinger, Radiopaedia.org, rID: 23627]] | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 22:37, 19 September 2017
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Hypoglycemia Microchapters |
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Hypoglycemia CT On the Web |
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American Roentgen Ray Society Images of Hypoglycemia CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Ultrasound, Computed tomography and MRI can differentiate between insulinoma and islet-cell hypertrophy.
CT
- Hypoglycemia caused by endogenous insulin the differential diagnosis includes insulinoma and islet-cell hypertrophy.
- Ultrasound, Computed tomography and MRI can differentiate between both.[1]
- A negative imaging study does not exclude insulinoma and patient need more tests.
- CT shows hyperattenuating on arterial phase so arterial or pancreatic phase imaging may aid in better detection. Some may show calcification.[2]
- Sensitivity of CT scan for diagnosing insulinoma was 33-64%. With the recent advances in technology and knowledge of rapid contrast-enhanced CT scan in early phase has increased the sentivity to 80%. [1]Most insulinomas are smaller,<1.3 cm (50%) and many of these are non-contour forming. therefore CT scan is less effective in diagnosing them than MRI.[2][3]
- Abdominal Contrast enhanced CT(CECT) scan may be helpful in the diagnosis of insulinoma. Findings on CT scan suggestive of insulinoma include[1]:
- Greater degree of enhancement(hyper-attenuation) than parenchyma of the rest of pancreas(as its hypervascular)during the vascular phases of the contrast
- Atypically can appear hypovascular and hypodense lesions after the administration of contrast, as compared to hyperdense lesions before the administration; cystic masses, and calcified masses(in malignant lesions when they are nodular and discrete)[2][3]
- CT quality have been improved with techology advances with using dual-phase thin-section multdetector CT having senstivity of 94.4% as compared to 57% for dual-phase multidetector without thin sections and 28.6% with sequential CT.[2][4]
- It is helpful for detetcting metastasis.
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.
- ↑ King AD, Ko GT, Yeung VT, Chow CC, Griffith J, Cockram CS (1998). "Dual phase spiral CT in the detection of small insulinomas of the pancreas". Br J Radiol. 71 (841): 20–3. doi:10.1259/bjr.71.841.9534694. PMID 9534694.