Multiple endocrine neoplasia type 1 CT: Difference between revisions

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==CT==
==CT==
===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>===
===Gastrointestinal Neuroendocrine Tumors===
* [[CT]] is used for suspected gastric, enteric and pancreatic [[neuroendocrine tumor]]s with pre and post IV iodinated contrast.
* Common CT findings of gastrointestinal tumors include the following:<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>
* [[Bowel]] distension with [[fluid]], either by [[oral]] intake (CT enterography) or via an nasojejunal tube (CT [[enteroclysis]]), improves detection of primary gastrointestinal [[neuroendocrine tumor]]s.
:* [[CT]] is used for suspected gastric, enteric and pancreatic [[neuroendocrine tumor]]s with pre and post IV iodinated contrast.
===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>===
:* [[Bowel]] distension with [[fluid]], either by [[oral]] intake (CT enterography) or via an nasojejunal tube (CT [[enteroclysis]]), improves detection of primary gastrointestinal [[neuroendocrine tumor]]s.
* Negative contrast may be used to distend the [[stomach]]
===Zollinger-Ellison Syndrome===
* Thickened rugal folds
* Common CT findings of Zollinger-Ellison syndrome include the following:<ref name=Radiopaedia022015>{{cite web | title = Radiopedia2015 Zollinger-Ellison syndrome [Dr Henry Knipe]| url = http://radiopaedia.org/articles/zollinger-ellison-syndrome }}</ref>
* Multiple gastric nodules/masses<ref name="pmid9534694">{{cite journal| author=King AD, Ko GT, Yeung VT, Chow CC, Griffith J, Cockram CS| title=Dual phase spiral CT in the detection of small insulinomas of the pancreas. | journal=Br J Radiol | year= 1998 | volume= 71 | issue= 841 | pages= 20-3 | pmid=9534694 | doi=10.1259/bjr.71.841.9534694 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9534694  }} </ref><ref name="pmid12933480">{{cite journal| author=Fidler JL, Fletcher JG, Reading CC, Andrews JC, Thompson GB, Grant CS et al.| title=Preoperative detection of pancreatic insulinomas on multiphasic helical CT. | journal=AJR Am J Roentgenol | year= 2003 | volume= 181 | issue= 3 | pages= 775-80 | pmid=12933480 | doi=10.2214/ajr.181.3.1810775 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12933480  }} </ref>
:* Negative contrast may be used to distend the [[stomach]]
===Insulinoma<ref name=Radiopaedia032015>{{cite web | title = Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/insulinoma }}</ref>===
:* Thickened rugal folds
* They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection. Some may show [[calcification]].
:* Multiple gastric nodules/masses<ref name="pmid9534694">{{cite journal| author=King AD, Ko GT, Yeung VT, Chow CC, Griffith J, Cockram CS| title=Dual phase spiral CT in the detection of small insulinomas of the pancreas. | journal=Br J Radiol | year= 1998 | volume= 71 | issue= 841 | pages= 20-3 | pmid=9534694 | doi=10.1259/bjr.71.841.9534694 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9534694  }} </ref><ref name="pmid12933480">{{cite journal| author=Fidler JL, Fletcher JG, Reading CC, Andrews JC, Thompson GB, Grant CS et al.| title=Preoperative detection of pancreatic insulinomas on multiphasic helical CT. | journal=AJR Am J Roentgenol | year= 2003 | volume= 181 | issue= 3 | pages= 775-80 | pmid=12933480 | doi=10.2214/ajr.181.3.1810775 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12933480  }} </ref>
===Pancreatic Islet Cell Tumors<ref name=Radiopaedia042015>{{cite web | title = Radiopedia2015 Endocrine tumours of the pancreas [Dr Yuranga Weerakkody and Radswiki]| url = http://radiopaedia.org/articles/gastrinoma }}</ref>===
===Insulinoma===
* Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. [[Tumor]]s tend to be smaller, hypervascular and may be calcified or cystic.
* Common CT findings of insulinoma include the following:<ref name=Radiopaedia032015>{{cite web | title = Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/insulinoma }}</ref>
===Gastrinoma<ref name=Radiopaedia052015>{{cite web | title = Radiopedia2015 Gastrinoma [Dr Frank Gaillard]| url = http://radiopaedia.org/articles/gastrinoma }}</ref>===
:* They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection. Some may show [[calcification]].
===Pancreatic Islet Cell Tumors===
* Common CT findings of pancreatic islet cell tumors include the following:<ref name=Radiopaedia042015>{{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. [[Tumor]]s tend to be smaller, hypervascular and may be calcified or cystic.
===Gastrinoma===
* Common CT findings of gastrinoma include the following:<ref name=Radiopaedia052015>{{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 the size of pancreatic lesions varies from 3-4 cm.
* [[Tumor]] size is variable, but the size of pancreatic lesions varies from 3-4 cm.
* The [[lesion]]s are often hypervascular, so they may be visible on arterial phase [[CT]] and [[angiography]].
* The [[lesion]]s are often hypervascular, so they may be visible on arterial phase [[CT]] and [[angiography]].
===Glucagonoma<ref name=Radiopaedia062015>{{cite web | title = Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/glucagonoma }}</ref>===
===Glucagonoma===
* [[Tumor]] size is variable, but most of them are large and have metastasized at the time of diagnosis. Most of them are located in the distal [[pancreas]] and are [[vascular]].
* Common CT findings of gastrinoma include the following:<ref name=Radiopaedia062015>{{cite web | title = Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/glucagonoma }}</ref>
* [[Tumor]]s may be solid or contain central low-attenuation areas on [[CT]].
:* [[Tumor]] size is variable, but most of them are large and have metastasized at the time of diagnosis. Most of them are located in the distal [[pancreas]] and are [[vascular]].
:* [[Tumor]]s may be solid or contain central low-attenuation areas on [[CT]].
 
==Reference==
==Reference==
{{reflist|2}}
{{reflist|2}}


[[Category:Hereditary cancers]]
[[Category:Hereditary cancers]]

Revision as of 19:00, 18 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

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

  • Common CT findings of gastrointestinal tumors include the following:[1]

Zollinger-Ellison Syndrome

  • Common CT findings of Zollinger-Ellison syndrome include the following:[2]
  • Negative contrast may be used to distend the stomach
  • Thickened rugal folds
  • Multiple gastric nodules/masses[3][4]

Insulinoma

  • Common CT findings of insulinoma include the following:[5]
  • They tend to be hyper-attenuating on arterial phase so arterial or pancreatic phased imaging may aid in better detection. Some may show calcification.

Pancreatic Islet Cell Tumors

  • Common CT findings of pancreatic islet cell tumors include the following:[6]
  • Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. Tumors tend to be smaller, hypervascular and may be calcified or cystic.

Gastrinoma

  • Common CT findings of gastrinoma include the following:[7]
  • 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 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]
  • Tumor size is variable, but most of them are large and have metastasized at the time of diagnosis. Most of them are located in the distal pancreas and are vascular.
  • Tumors may be solid or contain central low-attenuation areas on CT.

Reference

  1. "Radiopedia2015 Gastrointestinal neuroendocrine tumours [Dr Dalia Ibrahim and Dr Jan Smith]".
  2. "Radiopedia2015 Zollinger-Ellison syndrome [Dr Henry Knipe]".
  3. 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.
  4. 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. "Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".
  6. "Radiopedia2015 Endocrine tumours of the pancreas [Dr Yuranga Weerakkody and Radswiki]".
  7. "Radiopedia2015 Gastrinoma [Dr Frank Gaillard]".
  8. "Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".