Hypoglycemia echocardiography or ultrasound: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hypoglycemia}} | {{Hypoglycemia}} | ||
{{CMG}} {{AE}} {{MAD}} | {{CMG}} {{AE}} {{ADS}} {{MAD}} | ||
==Overview== | ==Overview== | ||
Transabdominal ultrasound has low sensitivity varying between 0-66% in detecting insulinoma. The sensitivity increases with the use of more invasive endoscopic ultrasound (93%) and intraoperative ultrasound (86%). | [[Ultrasound|Transabdominal ultrasound]] has low [[sensitivity]] varying between 0-66% in detecting [[insulinoma]]. The sensitivity increases with the use of more invasive [[endoscopic ultrasound]] (93%) and intraoperative ultrasound (86%). Hypoechoic lesion and hypervascular mass are ultrasonographic findings. | ||
== Transabdominal Ultrasound== | == Transabdominal Ultrasound== | ||
*Ultrasound may be helpful in the diagnosis of [[insulinoma]]. The | *Ultrasound may be helpful in the diagnosis of [[insulinoma]]. The sensitivity varies from 0-66%. The smaller tumor is difficult to detect especially those on [[pancreas]] tail. Findings on a transabdominal [[ultrasound]] suggestive of [[insulinoma]] include<ref name="McAuleyDelaney2005">{{cite journal|last1=McAuley|first1=G.|last2=Delaney|first2=H.|last3=Colville|first3=J.|last4=Lyburn|first4=I.|last5=Worsley|first5=D.|last6=Govender|first6=P.|last7=Torreggiani|first7=W.C.|title=Multimodality preoperative imaging of pancreatic insulinomas|journal=Clinical Radiology|volume=60|issue=10|year=2005|pages=1039–1050|issn=00099260|doi=10.1016/j.crad.2005.06.005}}</ref>: | ||
** Low [[echogenicity]] | ** Low [[echogenicity]] | ||
** Hypervascularity on the [[Doppler ultrasound|Doppler]] | ** Hypervascularity on the [[Doppler ultrasound|Doppler]] | ||
*An ultrasound | *An [[ultrasound]] may be helpful in the diagnosis of complications of [[malignant]] [[insulinoma]], which include liver [[metastasis]]. | ||
==Invasive Ultrasound== | ==Invasive Ultrasound== | ||
===Endoscopic Ultrasound=== | ===Endoscopic Ultrasound=== | ||
This is an invasive ultrasound which can be done pre-operatively. | This is an invasive [[ultrasound]] which can be done pre-operatively. Its use has been increased with improve in its sensitivity. Endoscopic ultrasound is more accurate for pancreatic head [[Insulinoma|insulinomas.]] It is the primary diagnostic modality for the diagnosis of pancreatic [[neuroendocrine tumors]] (which includes [[insulinoma]]).<ref name="McAuleyDelaney2005">{{cite journal|last1=McAuley|first1=G.|last2=Delaney|first2=H.|last3=Colville|first3=J.|last4=Lyburn|first4=I.|last5=Worsley|first5=D.|last6=Govender|first6=P.|last7=Torreggiani|first7=W.C.|title=Multimodality preoperative imaging of pancreatic insulinomas|journal=Clinical Radiology|volume=60|issue=10|year=2005|pages=1039–1050|issn=00099260|doi=10.1016/j.crad.2005.06.005}}</ref><ref name="pmid17906369">{{cite journal| author=Sotoudehmanesh R, Hedayat A, Shirazian N, Shahraeeni S, Ainechi S, Zeinali F et al.| title=Endoscopic ultrasonography (EUS) in the localization of insulinoma. | journal=Endocrine | year= 2007 | volume= 31 | issue= 3 | pages= 238-41 | pmid=17906369 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17906369 }} </ref><ref name="pmid11007228">{{cite journal| author=Anderson MA, Carpenter S, Thompson NW, Nostrant TT, Elta GH, Scheiman JM| title=Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. | journal=Am J Gastroenterol | year= 2000 | volume= 95 | issue= 9 | pages= 2271-7 | pmid=11007228 | doi=10.1111/j.1572-0241.2000.02480.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11007228 }} </ref> | ||
<ref name="pmid17906369">{{cite journal| author=Sotoudehmanesh R, Hedayat A, Shirazian N, Shahraeeni S, Ainechi S, Zeinali F et al.| title=Endoscopic ultrasonography (EUS) in the localization of insulinoma. | journal=Endocrine | year= 2007 | volume= 31 | issue= 3 | pages= 238-41 | pmid=17906369 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17906369 }} </ref><ref name="pmid11007228">{{cite journal| author=Anderson MA, Carpenter S, Thompson NW, Nostrant TT, Elta GH, Scheiman JM| title=Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. | journal=Am J Gastroenterol | year= 2000 | volume= 95 | issue= 9 | pages= 2271-7 | pmid=11007228 | doi=10.1111/j.1572-0241.2000.02480.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11007228 }} </ref> | |||
* It enables visualization of smaller tumors (2 mm) | The advantages are: | ||
* It enables visualization of smaller [[Tumor|tumors]] (2 mm) | |||
* Local metastasis and invasion can be detected | * Local metastasis and invasion can be detected | ||
* Higher | * Higher resolutions | ||
The disadvantages are | The disadvantages are invasiveness, high cost, availability, and expertise. | ||
{{#ev:youtube|TF1phjhRZLg}} | {{#ev:youtube|TF1phjhRZLg}} | ||
===Intra-operative Ultrasound=== | ===Intra-operative Ultrasound=== | ||
It was introduced in 1981 and used to localize non-palpable lesions and those who are in close proximity to [[pancreas]] and [[bile ducts]]. This method can localize tumors in 86% of cases when performed during an open or [[Laparoscopic surgery|laparoscopic surgery.]]<ref name="pmid9426437">{{cite journal| author=Brown CK, Bartlett DL, Doppman JL, Gorden P, Libutti SK, Fraker DL et al.| title=Intraarterial calcium stimulation and intraoperative ultrasonography in the localization and resection of insulinomas. | journal=Surgery | year= 1997 | volume= 122 | issue= 6 | pages= 1189-93; discussion 1193-4 | pmid=9426437 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9426437 }} </ref><ref name="pmid16360384">{{cite journal| author=Grover AC, Skarulis M, Alexander HR, Pingpank JF, Javor ED, Chang R et al.| title=A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas. | journal=Surgery | year= 2005 | volume= 138 | issue= 6 | pages= 1003-8; discussion 1008 | pmid=16360384 | doi=10.1016/j.surg.2005.09.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16360384 }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 19:00, 16 November 2017
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American Roentgen Ray Society Images of Hypoglycemia echocardiography or ultrasound |
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Risk calculators and risk factors for Hypoglycemia echocardiography or ultrasound |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2] Mohammed Abdelwahed M.D[3]
Overview
Transabdominal ultrasound has low sensitivity varying between 0-66% in detecting insulinoma. The sensitivity increases with the use of more invasive endoscopic ultrasound (93%) and intraoperative ultrasound (86%). Hypoechoic lesion and hypervascular mass are ultrasonographic findings.
Transabdominal Ultrasound
- Ultrasound may be helpful in the diagnosis of insulinoma. The sensitivity varies from 0-66%. The smaller tumor is difficult to detect especially those on pancreas tail. Findings on a transabdominal ultrasound suggestive of insulinoma include[1]:
- Low echogenicity
- Hypervascularity on the Doppler
- An ultrasound may be helpful in the diagnosis of complications of malignant insulinoma, which include liver metastasis.
Invasive Ultrasound
Endoscopic Ultrasound
This is an invasive ultrasound which can be done pre-operatively. Its use has been increased with improve in its sensitivity. Endoscopic ultrasound is more accurate for pancreatic head insulinomas. It is the primary diagnostic modality for the diagnosis of pancreatic neuroendocrine tumors (which includes insulinoma).[1][2][3]
The advantages are:
- It enables visualization of smaller tumors (2 mm)
- Local metastasis and invasion can be detected
- Higher resolutions
The disadvantages are invasiveness, high cost, availability, and expertise. {{#ev:youtube|TF1phjhRZLg}}
Intra-operative Ultrasound
It was introduced in 1981 and used to localize non-palpable lesions and those who are in close proximity to pancreas and bile ducts. This method can localize tumors in 86% of cases when performed during an open or laparoscopic surgery.[4][5]
References
- ↑ 1.0 1.1 McAuley, G.; Delaney, H.; Colville, J.; Lyburn, I.; Worsley, D.; Govender, P.; Torreggiani, W.C. (2005). "Multimodality preoperative imaging of pancreatic insulinomas". Clinical Radiology. 60 (10): 1039–1050. doi:10.1016/j.crad.2005.06.005. ISSN 0009-9260.
- ↑ Sotoudehmanesh R, Hedayat A, Shirazian N, Shahraeeni S, Ainechi S, Zeinali F; et al. (2007). "Endoscopic ultrasonography (EUS) in the localization of insulinoma". Endocrine. 31 (3): 238–41. PMID 17906369.
- ↑ Anderson MA, Carpenter S, Thompson NW, Nostrant TT, Elta GH, Scheiman JM (2000). "Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas". Am J Gastroenterol. 95 (9): 2271–7. doi:10.1111/j.1572-0241.2000.02480.x. PMID 11007228.
- ↑ Brown CK, Bartlett DL, Doppman JL, Gorden P, Libutti SK, Fraker DL; et al. (1997). "Intraarterial calcium stimulation and intraoperative ultrasonography in the localization and resection of insulinomas". Surgery. 122 (6): 1189–93, discussion 1193-4. PMID 9426437.
- ↑ Grover AC, Skarulis M, Alexander HR, Pingpank JF, Javor ED, Chang R; et al. (2005). "A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas". Surgery. 138 (6): 1003–8, discussion 1008. doi:10.1016/j.surg.2005.09.017. PMID 16360384.