Hypoglycemia MRI
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American Roentgen Ray Society Images of Hypoglycemia MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];{AE}} Mohammed Abdelwahed M.D[2]
Overview
MRI scan is helpful in the diagnosis of insulinoma in the case of failed CT. It shows enhancement.
MRI
- MRI scan is helpful in the diagnosis of insulinoma in the case of failed CT.
- T1 C typically shows enhancement, although contrast enhancement may not improve tumor visualization.[1]
MRI is superior in detecting insulinoma in that it has greater sensitivity currently ~85%. In a study of 21 insulinomas by Owen et al,the sensitivity was noted to be 94%.(19/21 cases). The 2 cases were of 5 and 7 mm size and in pancreatic tail.[1][2] T1 and T2 relaxation times for islet cell tumor like insulinoma has lower protein and proton concentration time.[3] Abdominal MRI may be helpful in the diagnosis of insulinoma. Findings on MRI suggestive of Insulinoma include[4][3]: Low in signal intensity on fat suppressed T1-weighted images High on intensity on fat suppressed T2-weighted images independent of lesion size Enhancement patterns are due to hypervascularity. Homogeneous enhancement is exhibited commonly in insulinoma, ring enhancement if they are larger than 2 cm. same pattern can be seen in metastatic lymph node as of the primary; homogeneous when small and ring enhancement if the tumor is more than 2 cm. Modern MRI has rapid tri-phasic, breath held T1 rapid gadolinium- enhanced sequences which help to reduce artifacts produced by motion.[1][3] MRI enables accurate location of the tumor in terms of resectability and involvement of vessels.[1][3]
References
- ↑ Pongprasobchai S, Lertwattanarak R, Pausawasdi N, Prachayakul V (2013). "Diagnosis and localization of insulinoma in Thai patients: performance of endoscopic ultrasonography compared to computed tomography and magnetic resonance imaging". J Med Assoc Thai. 96 Suppl 2: S187–93. PMID 23590041.