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.

CT

Gastrointestinal Neuroendocrine Tumors[1]

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. Some may show calcification.

Pancreatic Islet Cell Tumors[6]

  • Multiphase contrast enhanced thin slice cross-sectional imaging is ideal. Tumors tend to be smaller, hypervascular and may be calcified or cystic.

Gastrinoma[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[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]".