Hypoglycemia MRI

Jump to navigation Jump to search

Hypoglycemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoglycemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypoglycemia MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypoglycemia MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypoglycemia MRI

CDC on Hypoglycemia MRI

Hypoglycemia MRI in the news

Blogs on Hypoglycemia MRI

Directions to Hospitals Treating Hypoglycemia

Risk calculators and risk factors for 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 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]
MRI showing metastatic insulinoma, source: Case courtesy of Dr Maxime St-Amant, Radiopaedia.org, rID: 19080


References

  1. 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.
  2. 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.
  3. 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.
  4. 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.