胰岛细胞瘤影像学幻灯片.ppt

胰岛细胞瘤的影像学检查方法 王 鹤 Pancreatic Endocrine Tumors: Radiologic- Clinicopathologic Correlation. RadioGraphics 2010; 30:1445–1464 胰岛细胞瘤 大小 无症状胰岛细胞瘤 3cm 有症状胰岛细胞瘤 5cm 体积 1%–2% 血供 10%–15% 3个10% 评价良恶性的标准 对周围组织器官的侵犯 大小 淋巴结 远处转移 肿瘤的大小决定良恶性、预后，评价是否有症状无意义 腹部BUS EUS King AD,?Ko GT,?Yeung VT,?et al. Dual?phase?spiral?CT?in the?detection?of?small?insulinomas?of the pancreas. Br J Radiol.?1998;71(841):20-23. Takuya Hosoki. Dynamic CT of Pancreatic Tumors. AJR 140:959-965, May 1983. Maarten Brom, Wim J. G. Oyen, Lieke Joosten. 68Ga-labelled exendin-3, a new agent for the detection of insulinomas with PET. Eur J Nucl Med Mol Imaging (2010) 37:1345–1355 术前定位的意义 Rothmund M, Angelini L, Brunt LM, et al. Surgery for benign insulinoma: an international review. World J Surg 1990; 14: 393–399. Druce MR,?Muthuppalaniappan VM,?OLeary B,?et al. Diagnosis?and?localisation?of?insulinoma: the?value?of?modern?magnetic?resonance?imaging?inconjunction?with?calcium?stimulation catheterisation. Eur J Endocrinol.?2010 May;162(5):971-978. 体型与周围组织的影响 增强BUS应用不普遍 门脉期显示较清晰 龙学颖，李宜雄，王宪伟，等。胰岛素瘤术前ＣＴ定位诊断的回顾性分析中南大学学报（医学版）J CentSouth Univ(MedSci), 2009,34(2). 谢 谢！ 胃泌素瘤 转移 * * Rodney H Reznek. CT/MRI of neuroendocrine tumours. Cancer Imaging (2006) 6, S163–S177. 95%的患者，能够在术中检出 仔细观察 触诊 术中超声 第二次手术后，不能检出的病灶为0.5%。 双期增强CT+内镜超声 Hervé Gouya, Olivier Vignaux, Joelle AuguiCT, et al. Endoscopic Sonography, and a Combined Protocol for Preoperative Evaluation of Pancreatic Insulinomas. AJR,2003;181:987–992 Tomoaki Ichikawa, Mark S. Peterson, Michael P. Federle, et al. Islet Cell Tumor of the Pancreas: Biphasic CT versus MR Imaging in Tumor Detection. Radiology 2000; 216:163–171 CT CT