Chigot V, De Lonlay P, Nassogne M C, Laborde K, Delagne V, Fournet J C, Nihoul-Fékété C, Saudubray J M, Brunelle F
Department of Radiology, Hôpital des Enfants Malades, 149 rue de Sèvres, 75 015 Paris, France.
Pediatr Radiol. 2001 Sep;31(9):650-5. doi: 10.1007/s002470100522.
Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is often resistant to medical therapy. Surgery is therefore necessary. It is due to focal adenomatous islet-cell hyperplasia treatable by partial pancreatectomy, or diffuse beta-cell hyperfunction, which requires near-total pancreatectomy. Pancreatic venous sampling (PVS) is the reference technique for the preoperative diagnosis and localization of focal forms of PHHI in the pancreas. However, hypoglycaemia is necessary to analyse the results and PVS is technically challenging. Pancreatic arterial calcium stimulation (PACS) is technically easier and does not require hypoglycaemia.
To study the accuracy in the diagnosis and localization of PHHI.
PACS was performed in 12 patients and correlated with histology.
The accuracy of PACS is poor in diffuse lesions since only two of six cases were correctly identified by this test. Five of six focal lesions were correctly recognized and located.
PACS is less accurate than PVS in PHHI. Currently, it should be performed only when PVS fails.
婴儿持续性高胰岛素血症性低血糖症（PHHI）通常对药物治疗耐药。因此手术是必要的。它是由局灶性腺瘤样胰岛细胞增生引起的，可通过部分胰腺切除术治疗，或者是弥漫性β细胞功能亢进，这需要近乎全胰腺切除术。胰腺静脉采血（PVS）是术前诊断和定位胰腺局灶性PHHI的参考技术。然而，分析结果需要低血糖状态，且PVS在技术上具有挑战性。胰腺动脉钙刺激试验（PACS）在技术上更容易，且不需要低血糖状态。
研究PACS在PHHI诊断和定位中的准确性。
对12例患者进行了PACS检查，并与组织学结果进行关联。
PACS在弥漫性病变中的准确性较差，因为该检查仅正确识别了6例中的2例。6例局灶性病变中有5例被正确识别和定位。
在PHHI中，PACS的准确性低于PVS。目前，仅在PVS失败时才应进行PACS。
