Localization of insulinomas to regions of the pancreas by intraarterial calcium stimulation: the NIH experience.

摘要: Context: Selective intraarterial calcium injection of the major pancreatic arteries with hepatic venous sampling [calcium arterial stimulation (CaStim)] has been used as a localizing tool for insulinomas at National Institutes Health (NIH) since 1989. The accuracy this technique was reported all cases until 1996. Objectives: aim study to assess and track record CaStim over time in context evolving technology review issues related result interpretation procedure complications. only invasive preoperative localization modality our center. Endoscopic ultrasound (US) not studied. Design Setting: We conducted retrospective case referral center. Patients: Twenty-nine women 16 men (mean age, 47 yr; range, 13–78) were diagnosed an insulinoma from 1996–2008. Intervention: A supervised fast confirm diagnosis insulinoma. US, computed tomography (CT), magnetic resonance imaging (MRI), studies. Localization predicted by each test compared surgical accuracy. Main Outcome: measured CT, MRI, preoperatively. Results: All 45 patients had surgically proven insulinomas. Thirty-eight (84%) localized correct anatomical region CaStim. In five (11%) patients, falsely negative. Two (4%) false-positive localizations. Conclusion: remained vastly superior abdominal or MRI utility purpose setting is thus validated.