Walczak Raelyn, Paek Matthew, Uzzle Matthew, Taylor Jim, Specchi Swan
Diagnostic Imaging, Gulf Coast Veterinary Specialists, Houston, TX, 77027.
Department of Radiology, Synergy Veterinary Imaging Partners, Columbia, MD, 20129.
Vet Radiol Ultrasound. 2019 May;60(3):330-337. doi: 10.1111/vru.12715. Epub 2019 Jan 17.
Clinical and imaging diagnosis of canine insulinomas has proven difficult due to nonspecific clinical signs and the small size of these tumors. The aim of this retrospective case series study was to describe MRI findings in a group of dogs with pancreatic insulinomas. Included dogs were presented for suspected pancreatic insulinoma, MRI was used to assist with localization of the primary lesion, and the diagnosis was confirmed with surgical exploratory laparotomy and histopathology. The MRI studies for each dog were retrieved and the following data were recorded: T1-weighted and T2-weighted signal intensities, type of contrast enhancement, size and location of the primary lesion, and characteristics of metastatic lesions (if present). A total of four dogs were sampled. In all patients, the insulinoma displayed high-intensity signal on T2-weighted fat saturation images, similar to human studies. On postcontrast T1-weighted fat saturation images, the tumors were primarily isointense to normal pancreatic tissue, in contrast to human studies where a low-intensity signal is typically identified. Abnormal islet tissue was detected with MRI in all four dogs and metastases were identified in three dogs. Variations in the MRI appearance of primary and metastatic lesions were identified and could have been related to the variation of tissue composition, including the presence of neoplastic cells, hemorrhage, and fibrovascular stroma, and to the transformation of this tissue throughout the disease process.
由于临床症状不具特异性且犬胰岛素瘤体积较小,犬胰岛素瘤的临床诊断和影像学诊断颇具难度。本回顾性病例系列研究旨在描述一组患有胰腺胰岛素瘤的犬的MRI表现。纳入的犬因疑似胰腺胰岛素瘤就诊,使用MRI辅助定位原发性病变,并通过手术探查性剖腹术和组织病理学确诊。检索每只犬的MRI研究资料并记录以下数据:T1加权和T2加权信号强度、对比增强类型、原发性病变的大小和位置以及转移病变的特征(如有)。总共对四只犬进行了采样。在所有患者中,胰岛素瘤在T2加权脂肪饱和图像上显示为高强度信号,这与人体研究结果相似。在对比增强T1加权脂肪饱和图像上,肿瘤主要与正常胰腺组织等信号,这与人体研究中通常识别出低强度信号不同。在所有四只犬中,MRI均检测到异常胰岛组织,三只犬发现有转移。原发性和转移性病变的MRI表现存在差异,这可能与组织成分的变化有关,包括肿瘤细胞、出血和纤维血管基质的存在,以及该组织在整个疾病过程中的转变。