Dipartimento di Scienze Bio-Morfologiche e Funzionali, Sez. di Diagnostica per Immagini e Radioterapia (Ed. 10), Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131, Napoli, Italy.
Radiol Med. 2011 Jun;116(4):595-606. doi: 10.1007/s11547-011-0636-2. Epub 2011 Feb 1.
The authors compared multidetector-row computed tomography (MDCT) and endoscopic ultrasound (EUS) in the identification of pancreaticoduodenal endocrine tumours (PETs) in patients with multiple endocrine neoplasia type 1 (MEN 1).
Fourteen consecutive patients (eight men and six women, aged 26-54 years) with MEN 1 underwent MDCT performed with a 4- (n=5) or 64- (n=9) detector-row system and EUS done with a radial transducer (7.5-20 MHz) within 7-28 days of each other. Prior to MDCT examination, patients were given 750 cc of water and asked to lie down in the right lateral decubitus for 15 min. Multiphase MDCT images were acquired both before and after the injection of nonionic iodinated contrast material (2 cc/kg) at an injection rate of 4 ml/s, with technical parameters and scan delay varying in relation to the system used. Images were all reconstructed at 3-mm intervals for the three phases (arterial, pancreatic and portal) and evaluated on a dedicated workstation.
MDCT detected a total of 25 PETs (3-18 mm) in nine patients. Of these lesions, nine were situated within the duodenal wall and 16 in either the pancreatic head (n=3), body (n=7), or tail (n=6). Three additional lesions were detected retrospectively after EUS imaging. Most (18/22, 81%) were hypervascular nodules, and four appeared as either hypoattenuating or cystic lesions. EUS detected a total of 32 PETs (2-18 mm) in 11 patients. Most lesions (29/32, 90%) appeared hypoechoic and were situated in the duodenal wall (n=15) or in either the pancreatic head (n=10), body (n=6) or tail (n=1).
Our preliminary data indicate that MDCT is complementary to EUS in the identification of PETs in MEN-1 patients.
作者比较了多层螺旋 CT（MDCT）和内镜超声（EUS）在 14 例多发性内分泌肿瘤 1 型（MEN 1）患者胰腺十二指肠内分泌肿瘤（PETs）中的诊断价值。
14 例 MEN 1 患者（8 名男性，6 名女性，年龄 26-54 岁），先后在 7-28 天内行 MDCT 检查（4 排 MDCT：5 例；64 排 MDCT：9 例）和 EUS 检查（采用径向探头，7.5-20MHz）。MDCT 检查前，患者饮用 750ml 水，取右侧卧位 15min。采用 4ml/s 的速度团注非离子型碘对比剂（2cc/kg），根据使用的系统不同调整技术参数和扫描延迟时间，分别进行动脉期、胰腺期和门静脉期扫描。将原始数据传至专用工作站，以 3mm 间隔进行多平面重建，用于评价。
MDCT 在 9 例患者中发现 25 个 PETs（3-18mm）。这些病灶中，9 个位于十二指肠壁内，16 个位于胰头部（3 个）、体部（7 个）或尾部（6 个）。EUS 检查后，3 个病灶为回顾性发现。大多数病灶（18/22，81%）为富血供结节，4 个为低衰减或囊性病变。EUS 在 11 例患者中发现 32 个 PETs（2-18mm）。大多数病灶（29/32，90%）呈低回声，位于十二指肠壁内（15 个）或胰头部（10 个）、体部（6 个）或尾部（1 个）。
初步数据表明，MDCT 与 EUS 联合应用可提高 MEN 1 患者胰腺内分泌肿瘤的检出率。
