What is the role of ultrasonography in the diagnosis of insulinoma?

Updated: May 31, 2020
  • Author: Zonera Ashraf Ali, MBBS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Endoscopic ultrasonography detects 77% of insulinomas in the pancreas. [3, 4, 5] The yield can be higher if it is done in combination with CT scan. A majority of sporadic insulinomas will be detected and localized by a combination of these two investigative means. Note the following:

  • Real-time transabdominal high-resolution ultrasonography has 50% sensitivity.

  • Intraoperative transabdominal high-resolution ultrasonography with the transducer wrapped in a sterile rubber glove and passed over the exposed pancreatic surface detects more than 90% of insulinomas.

  • Performing a preoperative study to localize the tumor followed by intraoperative ultrasonography and a physical examination is not unreasonable.

See the image below.

Endoscopic ultrasonography in a patient with an in Endoscopic ultrasonography in a patient with an insulinoma. The hypoechoic neoplasm (arrows) is seen in the body of the pancreas anterior to the splenic vein (SV) (Rosch, 1992).

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