Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling.
A total of 42 islet-cell tumors were examined between 1972 and 1984. Problems of localization were only encountered in 31 tumors less than 2 cm in diameter. Of 31 small tumors, 27 were correctly localized using a combined diagnostic approach: ultrasound was successful in 12/20 tumors, CT in 9/21, angiography in 20/31, intraarterial digital subtraction angiography in 1/2, and pancreatic venous sampling in 13/16. The smallest tumor found by ultrasound and CT was 7 mm in diameter. Intraoperative ultrasound demonstrated all 9 insulinomas examined. Currently, the most useful techniques for localizing small islet-cell tumors are ultrasound, CT, and angiography. CT is particularly useful for tumor staging. Improvement of non-invasive diagnostic techniques will obviate the need for transhepatic blood sampling.
Günther
R W
RW
Klose
K J
KJ
Rückert
K
K
Beyer
J
J
Kuhn
F P
FP
Klotter
H J
HJ
D007516:Adenoma, Islet Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000792:Angiography / Q000379:methods; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis / Q000000981:diagnostic imaging; D007432:Intraoperative Period; D010179:Pancreas / Q000098:blood supply; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010690:Phlebography; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D015043:Zollinger-Ellison Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging