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目的 探讨胰岛素瘤各种定位方法的优缺点 ,以提高胰岛素瘤的定位准确性。方法 对 1990年 4月～ 1999年 4月经手术和病理证实的 2 8例胰岛素瘤患者行术前B超、CT、MRI、DSA、术中扪诊、术中超声 (IOUS)和胰岛素测定 (PVS)检查 ,并对手术结果进行分析。结果 US、CT、MRI和DSA的定位率分别为 2 8 6 % (8/ 2 8)、32 .2 % (9/2 8)、41.7% (5 / 12 )和 5 0 0 % (5 / 10 ) ,而术中扪诊、IOUS和PVS的定位率分别为 82 1% (2 3/ 2 8)、92 3 % (12 / 13)和92 3% (2 4/ 2 6 ) ,术中定位率比术前明显提高。结论 胰岛素瘤的术前定位率较低 ,不必强调多种影像学重复检查 ,而术中定位诊断极其重要 ,IOUS不但能提高肿瘤的定位敏感性 ,还可减少术后并发症。
Objective To explore the advantages and disadvantages of various localization methods for insulinoma to improve the accuracy of insulinoma localization. Methods Preoperative B-ultrasonography, CT, MRI, DSA, intraoperative percussion, intraoperative ultrasound (IOUS) and insulin measurement (PVS) were performed on 28 patients with insulinoma confirmed by surgery and pathology from April 1990 to April 1999. ) Check and analyze the results of the surgery. Results The positioning rates of US, CT, MRI, and DSA were 2 8 6 % (8/8 8), 32.2% (9/2 8), 41.7% (5 / 12), and 50% (5 / 5) respectively. 10) The intraoperative percussion, IOUS, and PVS positioning rates were 82 1% (23/28), 92 3% (12/13), and 92 3% (24/26), respectively. The positioning rate was significantly higher than before surgery. Conclusions The preoperative localization rate of insulinoma is low. It is not necessary to emphasize multiple imaging repeats. Intraoperative positioning diagnosis is extremely important. IOUS can not only improve the localization sensitivity but also reduce postoperative complications.