Multiple endocrine neoplasia type 1 CT
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Abdominal CT scan may be helpful in the diagnosis of multiple endocrine neoplasia type 1. Findings on CT scan suggestive of multiple endocrine neoplasia type 1 include thickened stomach rugal folds, multiple gastric nodules and calcified or cystic pancreatic tumors.
CT
Gastrointestinal Neuroendocrine Tumors
- CT is used for suspected gastric, enteric and pancreatic neuroendocrine tumors with pre and post IV iodinated contrast.[1]
- Bowel distension with fluid, either by oral intake (CT enterography) or via an nasojejunal tube (CT enteroclysis), improves detection of primary gastrointestinal neuroendocrine tumors.
Zollinger-Ellison Syndrome
- Common CT findings of Zollinger-Ellison syndrome include the following:[2]
Insulinoma
- They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection. Some may show calcification.[5]
Pancreatic Islet Cell Tumors
- Multiphase contrast enhanced thin slice cross-sectional imaging is ideal.
- Tumors tend to be smaller, hypervascular and may be calcified or cystic.[6]
Gastrinoma
- Gastinomas are usually malignant and as they are frequently multiple and often extrapancreatic (90% located in the gastrinoma triangle) they can be difficult to locate. As such multiphase contrast enhanced thin slice cross-sectional imaging is ideal.[7]
- Tumor size is variable, but the size of pancreatic lesions varies from 3-4 cm.
- The lesions are often hypervascular, so they may be visible on arterial phase CT and angiography.
Glucagonoma
- Common CT findings of gastrinoma include the following:[8]
Reference
- ↑ "Radiopedia2015 Gastrointestinal neuroendocrine tumours [Dr Dalia Ibrahim and Dr Jan Smith]".
- ↑ "Radiopedia2015 Zollinger-Ellison syndrome [Dr Henry Knipe]".
- ↑ 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.
- ↑ Fidler JL, Fletcher JG, Reading CC, Andrews JC, Thompson GB, Grant CS; et al. (2003). "Preoperative detection of pancreatic insulinomas on multiphasic helical CT". AJR Am J Roentgenol. 181 (3): 775–80. doi:10.2214/ajr.181.3.1810775. PMID 12933480.
- ↑ "Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".
- ↑ "Radiopedia2015 Endocrine tumours of the pancreas [Dr Yuranga Weerakkody and Radswiki]".
- ↑ "Radiopedia2015 Gastrinoma [Dr Frank Gaillard]".
- ↑ "Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".