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]

CT

Gastrointestinal Neuroendocrine Tumors

• 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

• Negative contrast may be used to distend the stomach
• Thickened rugal folds
• Multiple gastric nodules/masses

Insulinoma

• 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

• 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

• 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

• 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.