Schumacher B, Lübke H J, Frieling T, Strohmeyer G, Starke A A
Dept. of Gastroenterology, Hepatology, and Infectious Diseases, Heinrich-Heine-University, Düsseldorf, Germany.
Endoscopy. 1996 Mar;28(3):273-6. doi: 10.1055/s-2007-1005452.
The correct localization of insulinomas using endoscopic ultrasonography (EUS) has been reported to be as high as 80% in multicenter patient cohorts.
Over 24 months, we prospectively investigated 14 patients (11 women, three men) with a definite biochemical diagnosis of endogenous hyperinsulinism prior to surgical exploration and removal of an insulinoma. The endoscopic investigator was not aware of any other imaging results if they had been performed in referring hospitals.
The overall sensitivity of EUS in the detection of pancreatic insulinomas was 57% (eight of 14 tumors); the sensitivity for insulinomas in the head of the pancreas was 83% (five of six); and 37% (three of eight) for tumors in the tail of the pancreas. The actual median diameter of undetected tumors was 11 x 9.5 mm, the median volume 0.66 ml (range 0.13 - 2.6 ml). The median diameter of correctly detected tumors was 16 x 11 mm, the median volume 1.37 ml (range 0.7 - 6.3 ml), the differences not being significantly different. In two patients, false-positive results were caused by peripancreatic lymph nodes.
The sensitivity of EUS in the detection of pancreatic insulinomas depends on the location of the tumor, and possibly on the size of the tumors. Tumors not detected by EUS were likely to be smaller than detected tumors, and were likely to be located in the tail of the pancreas.
据报道，在多中心患者队列中，使用内镜超声检查（EUS）对胰岛素瘤进行正确定位的比例高达80%。
在24个月的时间里，我们前瞻性地研究了14例患者（11名女性，3名男性），这些患者在手术探查并切除胰岛素瘤之前，已通过生化检查明确诊断为内源性高胰岛素血症。内镜检查人员不知道在转诊医院是否进行过其他影像学检查。
EUS检测胰腺胰岛素瘤的总体敏感性为57%（14个肿瘤中的8个）；胰腺头部胰岛素瘤的敏感性为83%（6个中的5个）；胰腺尾部肿瘤的敏感性为37%（8个中的3个）。未检测到的肿瘤实际中位直径为11×9.5毫米，中位体积为0.66毫升（范围0.13 - 2.6毫升）。正确检测到的肿瘤中位直径为16×11毫米，中位体积为1.37毫升（范围0.7 - 6.3毫升），差异无统计学意义。在两名患者中，胰腺周围淋巴结导致了假阳性结果。
EUS检测胰腺胰岛素瘤的敏感性取决于肿瘤的位置，可能还取决于肿瘤的大小。EUS未检测到的肿瘤可能比检测到的肿瘤小，且可能位于胰腺尾部。
