What is the role of imaging studies in the evaluation of pediatric hypoglycemia?

Updated: Feb 19, 2018
  • Author: Robert P Hoffman, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

Persistent hyperinsulinemic hypoglycemia of infancy can be focal or diffuse. Routine abdominal ultrasonography, computed tomography (CT) scanning, and MRI are of little use in distinguishing between the forms. Positron emission tomography (PET) scanning with [18F] dihydroxyphenylalanine (DOPA) has been shown to effectively distinguish focal from diffuse disease. This study is easier to perform than invasive radiologic techniques such as transhepatic venous sampling or intra-arterial calcium stimulation with hepatic venous sampling. PET scanning is also helpful in locating insulin-producing tumors in older children with acquired hyperinsulinism, which is rare.

Hypopituitarism

Perform head MRI to identify pituitary or hypothalamic neoplasms or congenital abnormalities.


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