目的 对比分析胰岛素瘤动态三期增强CT与18F-FDG PET/CT的影像学表现.方法 选择浙江省立同德医院和中国人民解放军第一一七医院2010年5月～2012年5月期间12例经手术或病理诊断证实为胰岛素瘤的患者做为研究对象,对比18F-FDG PET/CT与MSCT动态三期增强影像学表现.结果 12例患者中均伴有不同程度的低血糖和惠普尔三联征,于空腹与发作时血糖均＜2.8mmol/L,胰岛素指数＞0.3,4例病灶于胰头,5例位于胰体,3例于胰尾,病灶平均大小为1.6cm × 1.7cm.CT平扫胰岛素肿瘤多呈低密度或等密度,CT值为32～ 49HU(平均值41HU)；动脉期肿瘤CT值112 ～ 152HU(平均值132HU)；静脉期、延迟期CT肿瘤的强化程度降低,动脉期强化最为显著.应用动脉三期CT扫描检出瘤灶9例(75％),18F-FDG检出瘤灶5例(41.7％),卡方检验两组比较差异有显著性意义.结论 MSCT动态三期增强扫描可以提高对胰岛素瘤的检出率,可以更为清晰的显示肿瘤的形态及位置,将其与18F-FDG PET/CT结合提高对胰岛素肿瘤诊断的准确性.%Objective To compare the 3 phase dynamic enhancing CT of insulinoma with I8F - FDG PET/CT. Methods A total of 12 cases of insulinoma confirmed by surgery or pathology were collected. The image data of 18F - FDG PET/CT and 3 phase dynamic enhancing MSCT were compared. Results Four cases of the insulinoma located in the pancreatic head, 5 in pancreatic body and 3 in pancreatic tail. The average size of lesions was 1.6 cm x 1.7 cm. The tumor on precontrast CT was low density or isodensity with CT value of 32 -49 Hu (average 41 Hu). On postcontrst CT, the tumor enhancement was remarkable in arterial phase with CT value of 112 - 152 Hu (average 132 Hu) , and decreased in venous and delayed phase. Nine insulinomas were detected with 3 phase dynamic enhancing CT and 5 with F - FDG, and there was significant difference between two modalities. Conclusion Three phase dynamic enhancing CT can improve the detection rate of insulinoma, show the form and position of tumor more clearly, and improve the diagnostic accuracy by combining with the 18F - FDG PET/CT.
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