Selective intra arterial calcium stimulated venous sampling for the localization of pancreatic insulinomas
- VernacularTitle:选择性动脉钙刺激静脉采血检测胰岛素定位胰岛素瘤的临床研究
- Author:
Xi CHEN
;
Zengbin WU
;
Yonggang HE
;
Weiyao CAI
;
Weiping YANG
;
Hongwei LI
- Publication Type:Journal Article
- Keywords:
Insulinoma;
Insulin;
Diagnosis
- From:
Chinese Journal of General Surgery
1994;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of selective intra arterial calcium stimulated venous sampling (ASVS) for the localization of pancreatic insulinoma. Methods Ten consecutive patients with clinically proved insulinoma were enrolled. Gastroduodenal artery, superior mensenteric artery, proximal and distal splenic artery were selectively cathererized for stimulating by rapid injection of 0.3g calcium gluconate. Blood was sampled through hepatic vein prior to and 30, 60, 90, 120, 150 s after stimulation for detecting insulin level. The peak insulin level after stimulation was divided by baseline level, and the highest one was named as peak ratio. The tumor was considered locating at the domain supplied by the artery of peak ratio. Results Accurate rate of ASVS was 90%, and ASVS was higher than that of B US (30%), EUS (43%), CT (70%), MRI (78%) and SAG (20%). Only 2 patients complained slight dizzy and chest distress. Conclusions ASVS has higher accuracy than conventional image studies by focusing the secreting function of insulinoma. It is suitable for some difficult cases. Injecting low dose calcium rapidly can effectively stimulate insulinoma secreting insulin. To separate the proximal splenic artery from the distal one by arteria pancreatic magna and to inject stimulator respectively is helpful for localizing the tumor in pancreas tail.
