Graf Anneke, Sarlos Stella, Farrell Stephen G, MacIsaac Richard J, Inder Warrick J, Sachithanandan Nirupa
Department of Diabetes and Endocrinology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Department of Endocrinology, Monash Health, Clayton, Victoria, Australia.
ANZ J Surg. 2020 Dec;90(12):E172-E176. doi: 10.1111/ans.15913. Epub 2020 May 1.
Insulinomas are rare tumours of the pancreas and the most common cause of hypoglycaemia in non-diabetic adults. They can be cured by surgery but require precise localization. The aim of this study was to assess the utility of the selective intra-arterial calcium stimulation test (SIACST) in patients with an insulinoma to correctly localize the tumour.
Medical records of patients with a diagnosis of insulinoma or who underwent an SIACST were retrospectively reviewed. Localization of lesions by SIACST was compared to endoscopic ultrasound and radionuclide imaging studies and verified against findings at surgery.
A total of 24 patients (mean age 58 years, 16 females, 20 with insulinoma) underwent SIACST. The SIACST correctly localized the insulinoma in 17 of 20 patients (85%). Localization rate for computed tomography was 55% and 75% for endoscopic ultrasound and glucagon-like peptide-1 receptor scan.
SIACST provided incremental diagnostic information in patients with insulinoma who had equivocal non-invasive imaging preoperatively. This technique remains an essential diagnostic tool when a lesion is not localized by other methods.
胰岛素瘤是胰腺的罕见肿瘤，是非糖尿病成年人低血糖最常见的病因。手术可治愈胰岛素瘤，但需要精确的定位。本研究的目的是评估选择性动脉内钙刺激试验（SIACST）在胰岛素瘤患者中正确定位肿瘤的效用。
回顾性分析诊断为胰岛素瘤或接受SIACST患者的病历。将SIACST对病变的定位与内镜超声和放射性核素成像研究进行比较，并与手术结果进行对照核实。
共有24例患者（平均年龄58岁，16例女性，20例患有胰岛素瘤）接受了SIACST。SIACST在20例患者中的17例（85%）中正确定位了胰岛素瘤。计算机断层扫描的定位率为55%，内镜超声和胰高血糖素样肽-1受体扫描的定位率为75%。
SIACST为术前非侵入性成像不明确的胰岛素瘤患者提供了额外的诊断信息。当病变不能通过其他方法定位时，该技术仍然是一种重要的诊断工具。
