Multiple endocrine neoplasia type 1 CT: Difference between revisions
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==Overview== | ==Overview== | ||
==CT== | ==CT== | ||
===Gastrointestinal Neuroendocrine Tumors=== | ===Gastrointestinal Neuroendocrine Tumors<ref name=Radiopaedia012015>{{cite web | title = Radiopedia2015 Gastrointestinal neuroendocrine tumours [Dr Dalia Ibrahim and Dr Jan Smith]| url = http://radiopaedia.org/articles/gastrointestinal-neuroendocrine-tumours-3 }}</ref>=== | ||
* Used for suspected gastric, enteric and pancreatic NETS pre and post IV iodinated contrast. | * Used for suspected gastric, enteric and pancreatic NETS pre and post IV iodinated contrast. | ||
* Bowel distension with fluid, either by oral intake (CT enterography) or via an Nasojejunal tube (CT enteroclysis) improves detection of primary GI NETS . | * Bowel distension with fluid, either by oral intake (CT enterography) or via an Nasojejunal tube (CT enteroclysis) improves detection of primary GI NETS . | ||
===Zollinger-Ellison Syndrome<ref name= | ===Zollinger-Ellison Syndrome<ref name=Radiopaedia022015>{{cite web | title = Radiopedia2015 Zollinger-Ellison syndrome [Dr Henry Knipe]| url = http://radiopaedia.org/articles/zollinger-ellison-syndrome }}</ref>=== | ||
* Negative contrast may be used to distend the stomach | * Negative contrast may be used to distend the stomach | ||
* Thickened rugal folds | * Thickened rugal folds | ||
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===Insulinoma<ref name=Radiopaedia032015>{{cite web | title = Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/insulinoma }}</ref>=== | ===Insulinoma<ref name=Radiopaedia032015>{{cite web | title = Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/insulinoma }}</ref>=== | ||
* They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection 6-7. Some may show calcification. | * They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection 6-7. Some may show calcification. | ||
===Pancreatic Islet Cell Tumors<ref name= | ===Pancreatic Islet Cell Tumors<ref name=Radiopaedia032015>{{cite web | title = Radiopedia2015 Endocrine tumours of the pancreas [Dr Yuranga Weerakkody and Radswiki]| url = http://radiopaedia.org/articles/gastrinoma }}</ref>=== | ||
* Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. Tumours tend to be smaller and hypervascular and may be calcified, and may be cystic. | * Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. Tumours tend to be smaller and hypervascular and may be calcified, and may be cystic. | ||
===Gastrinoma<ref name= | ===Gastrinoma<ref name=Radiopaedia042015>{{cite web | title = Radiopedia2015 Gastrinoma [Dr Frank Gaillard]| url = http://radiopaedia.org/articles/gastrinoma }}</ref>=== | ||
* 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. | * 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. | ||
* Tumor size is variable, but pancreatic lesions average 3-4 cm. | * Tumor size is variable, but pancreatic lesions average 3-4 cm. | ||
* The lesions are often hypervascular, so they may be visible on arterial phase CT and angiography. | * The lesions are often hypervascular, so they may be visible on arterial phase CT and angiography. | ||
===Glucagonoma<ref name= | ===Glucagonoma<ref name=Radiopaedia052015>{{cite web | title = Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/glucagonoma }}</ref>=== | ||
* Tumor size is variable, but most are large and have metastasized at the time of diagnosis. Most are located in the distal pancreas and are vascular. | * Tumor size is variable, but most are large and have metastasized at the time of diagnosis. Most are located in the distal pancreas and are vascular. | ||
* Tumors may be solid or contain central low-attenuation areas on CT. | * Tumors may be solid or contain central low-attenuation areas on CT. | ||
==Reference== | ==Reference== | ||
{{Reflist}} | {{Reflist}} |
Revision as of 20:45, 9 September 2015
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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
CT
Gastrointestinal Neuroendocrine Tumors[1]
- Used for suspected gastric, enteric and pancreatic NETS pre and post IV iodinated contrast.
- Bowel distension with fluid, either by oral intake (CT enterography) or via an Nasojejunal tube (CT enteroclysis) improves detection of primary GI NETS .
Zollinger-Ellison Syndrome[2]
- Negative contrast may be used to distend the stomach
- Thickened rugal folds
- Multiple gastric nodules/masses[3][4]
Insulinoma[5]
- They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection 6-7. Some may show calcification.
Pancreatic Islet Cell Tumors[5]
- Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. Tumours tend to be smaller and hypervascular and may be calcified, and may be cystic.
Gastrinoma[6]
- 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.
- Tumor size is variable, but pancreatic lesions average 3-4 cm.
- The lesions are often hypervascular, so they may be visible on arterial phase CT and angiography.
Glucagonoma[7]
- Tumor size is variable, but most are large and have metastasized at the time of diagnosis. Most are located in the distal pancreas and are vascular.
- Tumors may be solid or contain central low-attenuation areas on CT.
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.
- ↑ 5.0 5.1 "Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".
- ↑ "Radiopedia2015 Gastrinoma [Dr Frank Gaillard]".
- ↑ "Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".