Multiple endocrine neoplasia type 1 MRI: Difference between revisions

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{{Multiple endocrine neoplasia type 1}}
{{Multiple endocrine neoplasia type 1}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Ammu}}
==Overview==
==Overview==
[[MRI]] may be helpful in the [[diagnosis]] of multiple endocrine neoplasia type 1.
[[MRI]] may be helpful in the [[diagnosis]] of multiple endocrine neoplasia type 1. Findings on MRI suggestive of multiple endocrine neoplasia type 1 include diffuse heterogenous enhancement of T1 C+ (Gd), low T1 signal and high T2 signal.
 
==MRI==
==MRI==
===Gastrointestinal Neuroendocrine Tumors===
===Gastrointestinal Neuroendocrine Tumors===
* [[MRI]] is used for suspected hepatic, pancreatic or retroperitoneal [[neuroendocrine tumor]]s, often with [[gadolinium]] 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>
* [[MRI]] is used for suspected [[hepatic]], [[pancreatic]] or [[retroperitoneal]] [[neuroendocrine tumor]]s, often with [[gadolinium]] 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> <ref name="pmid24213321">{{cite journal| author=Tonelli F, Giudici F, Giusti F, Brandi ML| title=Gastroenteropancreatic neuroendocrine tumors in multiple endocrine neoplasia type 1. | journal=Cancers (Basel) | year= 2012 | volume= 4 | issue= 2 | pages= 504-22 | pmid=24213321 | doi=10.3390/cancers4020504 | pmc=3712700 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24213321  }} </ref> <ref name="pmid9298884">{{cite journal| author=Bordi C, Falchetti A, Azzoni C, D'Adda T, Canavese G, Guariglia A et al.| title=Aggressive forms of gastric neuroendocrine tumors in multiple endocrine neoplasia type I. | journal=Am J Surg Pathol | year= 1997 | volume= 21 | issue= 9 | pages= 1075-82 | pmid=9298884 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9298884  }} </ref>
* [[MRI]] enterography is also possible
* [[MRI]] enterography is also possible


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* Dynamic [[MRI]] with fast gradient echo sequences following [[bolus]] [[injection]] of [[contrast]] medium may aid the detection of these [[tumor]]s<ref name="pmid11675319">{{cite journal| author=Owen NJ, Sohaib SA, Peppercorn PD, Monson JP, Grossman AB, Besser GM et al.| title=MRI of pancreatic neuroendocrine tumours. | journal=Br J Radiol | year= 2001 | volume= 74 | issue= 886 | pages= 968-73 | pmid=11675319 | doi=10.1259/bjr.74.886.740968 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11675319  }} </ref>
* Dynamic [[MRI]] with fast gradient echo sequences following [[bolus]] [[injection]] of [[contrast]] medium may aid the detection of these [[tumor]]s<ref name="pmid11675319">{{cite journal| author=Owen NJ, Sohaib SA, Peppercorn PD, Monson JP, Grossman AB, Besser GM et al.| title=MRI of pancreatic neuroendocrine tumours. | journal=Br J Radiol | year= 2001 | volume= 74 | issue= 886 | pages= 968-73 | pmid=11675319 | doi=10.1259/bjr.74.886.740968 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11675319  }} </ref>
* MRI 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>
* MRI 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>
:* '''T1 C+ (Gd)''': typically shows enhancement, although [[contrast]] enhancement may not improve [[tumor]] visualisation compared with non-[[contrast]] images
:* '''T1 C+ (Gd)''': typically shows enhancement, although [[contrast]] enhancement may not improve [[tumor]] visualisation compared with non-[[contrast]] images. <ref name="pmid23569534">{{cite journal| author=Li J, Zeng L, Yang Y, Zhan Y, Tao J, Wu B| title=Multiple endocrine neoplasia type 1- presenting multiple lipomas and hypoglycemia onset. | journal=Am J Case Rep | year= 2012 | volume= 13 | issue=  | pages= 224-9 | pmid=23569534 | doi=10.12659/AJCR.883383 | pmc=3616096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23569534  }} </ref> <ref name="pmid1684067">{{cite journal| author=Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH| title=Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach. | journal=Surgery | year= 1991 | volume= 110 | issue= 6 | pages= 998-1004; discussion 1004-5 | pmid=1684067 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1684067  }} </ref>


===Somatostatinoma===
===Somatostatinoma===
* Smaller [[lesion]]s may be difficult to [[diagnose]].
* Smaller [[lesion]]s may be difficult to [[diagnose]].
* Signal characteristics of larger lesion include:<ref name=Radiopaedia072015>{{cite web | title = Radiopedia2015 Somatostatinoma [Dr Yuranga Weerakkody]| url = http://radiopaedia.org/articles/somatostatinoma }}</ref>
* Signal characteristics of larger lesion include:<ref name=Radiopaedia072015>{{cite web | title = Radiopedia2015 Somatostatinoma [Dr Yuranga Weerakkody]| url = http://radiopaedia.org/articles/somatostatinoma }}</ref>
:* '''T1''': low signal 1,8
:* '''T1''': low signal  
:* '''T2''': high signal 1,8
:* '''T2''': high signal  
:* '''T1 (C+) Gd''': most show early diffuse heterogenous enhancement
:* '''T1 (C+) Gd''': most show early diffuse heterogenous enhancement


==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

MRI may be helpful in the diagnosis of multiple endocrine neoplasia type 1. Findings on MRI suggestive of multiple endocrine neoplasia type 1 include diffuse heterogenous enhancement of T1 C+ (Gd), low T1 signal and high T2 signal.

MRI

Gastrointestinal Neuroendocrine Tumors

Insulinoma

  • T1 C+ (Gd): typically shows enhancement, although contrast enhancement may not improve tumor visualisation compared with non-contrast images. [6] [7]

Somatostatinoma

  • Smaller lesions may be difficult to diagnose.
  • Signal characteristics of larger lesion include:[8]
  • T1: low signal
  • T2: high signal
  • T1 (C+) Gd: most show early diffuse heterogenous enhancement

References

  1. "Radiopedia2015 Gastrointestinal neuroendocrine tumours [Dr Dalia Ibrahim and Dr Jan Smith]".
  2. Tonelli F, Giudici F, Giusti F, Brandi ML (2012). "Gastroenteropancreatic neuroendocrine tumors in multiple endocrine neoplasia type 1". Cancers (Basel). 4 (2): 504–22. doi:10.3390/cancers4020504. PMC 3712700. PMID 24213321.
  3. Bordi C, Falchetti A, Azzoni C, D'Adda T, Canavese G, Guariglia A; et al. (1997). "Aggressive forms of gastric neuroendocrine tumors in multiple endocrine neoplasia type I." Am J Surg Pathol. 21 (9): 1075–82. PMID 9298884.
  4. Owen NJ, Sohaib SA, Peppercorn PD, Monson JP, Grossman AB, Besser GM; et al. (2001). "MRI of pancreatic neuroendocrine tumours". Br J Radiol. 74 (886): 968–73. doi:10.1259/bjr.74.886.740968. PMID 11675319.
  5. "Radiopedia2015 Insulinoma [Dr Yuranga Weerakkody and Dr Frank Gaillard]".
  6. Li J, Zeng L, Yang Y, Zhan Y, Tao J, Wu B (2012). "Multiple endocrine neoplasia type 1- presenting multiple lipomas and hypoglycemia onset". Am J Case Rep. 13: 224–9. doi:10.12659/AJCR.883383. PMC 3616096. PMID 23569534.
  7. Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH (1991). "Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach". Surgery. 110 (6): 998–1004, discussion 1004-5. PMID 1684067.
  8. "Radiopedia2015 Somatostatinoma [Dr Yuranga Weerakkody]".

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