Breuer T G K, Breuer H L, Menge B A, Giese A, Uhl W, Schmidt W E, Tannapfel A, Wild D, Nauck M A, Meier J J
Abteilung für Diabetologie, Medizinische Klinik I, St. Josef-Hospital, Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland.
Klinik für Allgemein- und Viszeralchirurgie, St. Josef-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland.
Internist (Berl). 2016 Apr;57(4):385-9. doi: 10.1007/s00108-016-0020-3.
A 64-year-old woman presented with a history of recurrent hypoglycemia. A prolonged fasting test revealed an increased "amended" insulin-glucose ratio. Transabdominal ultrasound (US), computed tomography (CT) scan, and magnetic resonance imaging (MRI) did not show abnormal results. An insulinoma was suspected based on a contrast-enhanced endoscopic US examination as well as a (68)gallium-DOTA-exendin-4 positron-emission tomography (PET)/CT. The diagnosis of an insulinoma was confirmed histologically after surgical removal of the tumor. Hypoglycemia did not occur during the postoperative period. The prolonged fasting test is the gold standard for the diagnosis of an insulinoma. Novel imaging procedures, such as contrast-enhanced endoscopic US or (68)gallium-DOTA-exendin-4 PET/CT are valuable additions to the diagnostic workup.
一名64岁女性有反复低血糖病史。延长禁食试验显示“修正”胰岛素-葡萄糖比值升高。经腹超声（US）、计算机断层扫描（CT）和磁共振成像（MRI）均未显示异常结果。基于对比增强内镜超声检查以及（68）镓-多胺基多乙酸-艾塞那肽-4正电子发射断层扫描（PET）/CT怀疑为胰岛素瘤。手术切除肿瘤后，组织学确诊为胰岛素瘤。术后未再发生低血糖。延长禁食试验是诊断胰岛素瘤的金标准。新型成像检查，如对比增强内镜超声或（68）镓-多胺基多乙酸-艾塞那肽-4 PET/CT，是诊断检查中有价值的补充手段。
