超选择血管造影CT在胰岛细胞瘤术前诊断中的价值  

The clinical value of super- selective CT angiography in making preoperative diagnosis of insulinoma

作　　者：付金鑫 王茂强[1] 段峰[1] 陈现现 刘凤永[1] 

机构地区：[1]解放军总医院介入放射科,北京100853

出　　处：《介入放射学杂志》2016年第5期396-399,共4页Journal of Interventional Radiology

摘　　要：目的探究超选择血管造影CT(SSCTA)在胰岛细胞瘤术前诊断中的价值。方法 2013年至2015年收治的54例术后病理确诊为胰岛细胞瘤患者,所有患者均进行SSCTA检查,对其术前不同影像学检查方法的资料进行回顾性分析,行经腹部超声(TAUS)检查42例;超声内镜(EUS)检查48例;超声造影(CEUS)检查51例;增强CT检查30例;增强MRI检查48例;血管造影(SAG)检查54例,分析各检查方法的定位灵敏度及准确率,以指导更好地选择术前诊断方法。结果各种检查方法的诊断的定位灵敏度及准确率:经腹部超声为21.4%,14.3%;超声造影为82.4%,58.8%;EUS为87.5%,68.8%;增强CT为70.0%,60.0%;增强MRI为87.5%,81.3%;血管造影为72.2%,44.4%;SSCTA为94.4%,88.9%。SSCTA定位诊断胰岛细胞瘤的灵敏度及准确率明显高于其它诊断方法(P<0.05),54例患者行SSCTA检查后均未出现任何严重并发症。结论 SSCTA对胰岛细胞瘤的术前诊断具有重要价值,且安全可靠。Objective To investigate the clinical value of super-selective CT angiography （SSCTA） in making preoperative diagnosis of insulinoma. Methods A total of 54 patients with pathologically- proved insulinoma, who were admitted to authors＇ hospital during the period from 2013 to 2015, were enrolled in this study. SSCTA was performed in all the patients, the preoperative materials of various imaging examinations, including transabdominal ultrasound （TAUS, n=42）, endoscopic ultrasound （EUS, n=48）, contrast-enhanced ultrasound （CEUS, n=51 ）, enhanced CT （ECT, n=30）, enhanced MRI （EMRI, n=48） and selective angiography （SAG, n=54） were retrospectively analyzed. The localization sensitivity and accuracy rate of various examinations for insulinoma were calculated. The selection of optimal preoperative examination method was discussed. Results The localization sensitivities of TAUS, CEUS, EUS, ECT, EMRI, SAG and SSCTA were 21.4%, 82.4%, 87.5 %, 70.0%, 87.5%, 72.2% and 94.4% respectively, and the localization accuracy rates of TAUS, CEUS, EUS, ECT, EMRI, SAG and SSCTA were 14.3%, 58.8%, 68.8%, 60.0%, 81.3%, 44.4% and 88.9% respectively. The localization sensitivity and the localization accuracy of SSCTA were significantly higher than those of all the other examination methods （P〈0.05）. No serious complications occurred after SSCTA in all patients. Conclusion SSCTA is of great important value in making preoperative diagnosis of insulinoma. Besides, this technique is safe and reliable.

关 键 词：胰岛细胞瘤 血管造影CT 影像检查:定位 

分 类 号：R736.7[医药卫生—肿瘤]