a Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands.
b Department of Diagnostic Imaging, College of Veterinary Medicine , University of Florida , Gainesville , FL , USA.
Vet Q. 2018 Dec;38(1):53-62. doi: 10.1080/01652176.2018.1481545. Epub 2018 Jun 5.
To determine 1) the sensitivity of contrast-enhanced CT (CECT) for detection of primary canine insulinomas and metastases 2) the sensitivity of CECT to locate canine insulinomas within the pancreas and 3) the CECT attenuation pattern of canine insulinomas and post-contrast phase in which insulinomas have the best visibility.
A retrospective review was performed of the medical records of 27 canine insulinoma patients. Simultaneous occurrence of blood glucose < 3.5 mmol/L (reference interval: 4.2-5.8 mmol/L) and plasma insulin > 10 mIU/L (reference interval: 1.4-24.5 mIU/L) were considered diagnostic for insulinoma. The dogs had a mean age of 9.0 ± 1.7 (SD) years and comprised 11 males and 17 females.
Using CECT-scans, 26/27 insulinomas were successfully detected. However, CECT-scans predicted the correct location of insulinomas within the pancreas in only 14/27 dogs. In 9/13 inaccurately located insulinoma cases, the location error was major. There was no significant difference between triple, double and single-phase CECT-scans with location accuracies of 54%, 50% and 50%, respectively. Also, there was no specific post-contrast phase in which insulinomas could be visualised best. Detection of lymph node metastases with CECT-scans had a sensitivity of 67% (10/15 lymph node metastases). Detection of liver metastases had a sensitivity of 75% (6/8 liver metastases). This study highlights that major location errors mainly occurred if single- or double-phase CECT-scans were used (6/9 cases).
It is suggested that triple-phase CECT-scans have superior outcome over single- or double-phase CECT-scans in pre-operative imaging of canine insulinomas.
确定 1）增强 CT（CECT）检测犬胰岛素瘤和转移的敏感性 2）CECT 定位胰腺内犬胰岛素瘤的敏感性 3）犬胰岛素瘤的 CECT 衰减模式和增强后相，在此相下胰岛素瘤的可视性最佳。
对 27 例犬胰岛素瘤患者的病历进行了回顾性分析。血糖 <3.5mmol/L（参考区间：4.2-5.8mmol/L）和血浆胰岛素 >10mIU/L（参考区间：1.4-24.5mIU/L）同时发生被认为是胰岛素瘤的诊断标准。这些狗的平均年龄为 9.0±1.7（SD）岁，包括 11 只雄性和 17 只雌性。
使用 CECT 扫描，成功检测到 26/27 例胰岛素瘤。然而，CECT 扫描仅能正确预测 27 只狗中 14 只胰岛素瘤的胰腺内位置。在 9/13 例定位不准确的胰岛素瘤病例中，定位误差较大。三相、双相和单相 CECT 扫描的定位准确率分别为 54%、50%和 50%，无显著差异。此外，没有特定的增强后相可以最佳地观察到胰岛素瘤。CECT 扫描检测淋巴结转移的敏感性为 67%（10/15 个淋巴结转移）。检测肝转移的敏感性为 75%（6/8 个肝转移）。本研究表明，如果仅使用单相或双相 CECT 扫描，则主要会出现较大的定位误差（6/9 例）。
建议在犬胰岛素瘤的术前成像中，使用三相 CECT 扫描优于单相或双相 CECT 扫描。
