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{{Multiple endocrine neoplasia type 1}}
{{Multiple endocrine neoplasia type 1}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Ammu}}
==Overview==
==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 [[nodule]]s and calcified or cystic [[pancreatic tumor]]s.
Abdominal [[CT]] scan may be helpful in the [[diagnosing]] pancreatic involvement of multiple endocrine neoplasia type 1. Findings on [[CT]] scan suggestive of pancreatic involvement of multiple endocrine neoplasia type 1 include thickened [[stomach]] rugal folds, multiple gastric [[nodule]]s and calcified or cystic [[pancreatic tumor]]s.


==CT==
==CT==
===Gastrointestinal Neuroendocrine Tumors===
* [[CT]] is used for suspected gastric, enteric and pancreatic [[neuroendocrine tumor]]s with pre and post IV iodinated contrast.<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>
* [[CT]] is used for suspected gastric, enteric and pancreatic [[neuroendocrine tumor]]s with pre and post IV iodinated contrast.<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.
* [[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.
 
{| class="wikitable"
===Zollinger-Ellison Syndrome===
!Condition
* 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>
!CT Findings
:* Negative contrast may be used to distend the [[stomach]]
|-
:* Thickened rugal folds
|Zollinger-Ellison Syndrome
:* 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>
|
===Insulinoma===
* Thickened rugal folds
* 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>
* 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>
:* 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===
|Insulinoma
* 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.
* Hyper-attenuating on arterial phase<ref name="Radiopaedia052015">{{cite web | title = Radiopedia2015 Gastrinoma [Dr Frank Gaillard]| url = http://radiopaedia.org/articles/gastrinoma }}</ref>
:* [[Tumor]]s tend to be smaller, hypervascular and may be calcified or cystic.
* [[calcification|Calcifications]]<ref name="Radiopaedia032015">{{cite web | title = Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/insulinoma }}</ref>
 
|-
===Gastrinoma===
|Pancreatic Islet Cell Tumors
* 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.
* [[Tumor]]s tend to be smaller, hypervascular and may be calcified or cystic<ref name="Radiopaedia042015">{{cite web | title = Radiopedia2015 Endocrine tumours of the pancreas [Dr Yuranga Weerakkody and Radswiki]| url = http://radiopaedia.org/articles/gastrinoma }}</ref>
|-
|Gastrinoma
|
* [[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.
===Glucagonoma===
|-
* 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>
|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]].
|
:* [[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]].:<ref name="Radiopaedia062015">{{cite web | title = Radiopedia2015 Glucagonoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/glucagonoma }}</ref>
|}


==Reference==
==References==
{{reflist|2}}
{{reflist|2}}


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Latest revision as of 02:44, 27 November 2017

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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 diagnosing pancreatic involvement of multiple endocrine neoplasia type 1. Findings on CT scan suggestive of pancreatic involvement of multiple endocrine neoplasia type 1 include thickened stomach rugal folds, multiple gastric nodules and calcified or cystic pancreatic tumors.

CT

Condition CT Findings
Zollinger-Ellison Syndrome
  • Thickened rugal folds
  • Multiple gastric nodules/masses[2][3]
Insulinoma
Pancreatic Islet Cell Tumors
  • Tumors tend to be smaller, hypervascular and may be calcified or cystic[6]
Gastrinoma
  • Tumor size is variable, but the size of pancreatic lesions varies from 3-4 cm.
  • The lesions are often hypervascular.
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.
  • Tumors may be solid or contain central low-attenuation areas on CT.:[7]

References

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

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