中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (09): 751-754.

• 专题笔谈 • 上一篇    下一篇

胰岛素瘤定位及定性诊断

张太平，徐建威，赵玉沛   

  1. 中国医学科学院 北京协和医院外科，北京 100730
  • 出版日期:2010-09-01 发布日期:2010-09-01

  • Online:2010-09-01 Published:2010-09-01

PDF

1055

摘要：

胰岛素瘤是最常见的胰腺内分泌肿瘤，手术治疗是惟一的根治性治疗手段。胰岛素瘤定性诊断主要依据Whipple三联征和血清胰岛素与血糖比值，必要时可进行72h饥饿试验；定位诊断首选无创伤性检查手段，北京协和医院采用改良多层螺旋CT胰腺双期增强扫描准确率可达95%以上，术中超声检查联合术中探查定位准确率最高，可达100%。数字减影血管造影（DSA）、经皮经肝门静脉采血测定胰岛素（PTPC）和选择性动脉钙刺激静脉采血测定胰岛素（ASVS）等有创检查已基本不用。

关键词: 胰岛素瘤, 定位诊断, 定性诊断

Abstract:

Actuality of diagnosis and localization of insulinoma              ZHANG Tai-ping，XU Jian-wei，ZHAO Yu-pei. Department of  Surgery, Peking Union Medical College Hospital , Peking Union Medical College , Chinese Academy of Medical Science , Beijing 100730 , China
Corresponding author:ZHAO Yu-pei,E-mail:zhao8028@263.net
Abstract    Insulinoma is one of the most common pancreatic endocrine tumors. Surgical treatment is the only curative method. Whipple triad and the ratio of insulin to glucose are the key points for diagnosis of insulinoma.We can do the process of 72h fasting test if it is necessary.Non-invasive diagnostic methods are the first choice for localization of the tumors. In our hospital the improved MSCT has a high accuracy up to 95.1%. Combination IOUS and exploration has the highest accuracy up to 100%.Invasive diagnostic methods like DSA,PTPC and ASVS have seldom been used.This paper makes a evaluation and overview of the localization of insulinoma and is also as a reference for clinic work.

Key words: insulinoma, localization, diagnosis