Improved detection and localization of insulinoma using small field-of-view diffusion-weighted MRI: A case report

Q4 Medicine

Radiology Case Reports Pub Date : 2025-05-12 DOI:10.1016/j.radcr.2025.04.059

Quang Trung Nguyen BSc , Van Diep Pham BSc, Quoc Dat Tran BSc, Quang Long Le BSc, Ngoc Cuong Nguyen PhD, Tuan Linh Le PhD

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引用次数: 0

Abstract

Insulinoma is a rare but challenging-to-diagnose pancreatic neuroendocrine tumor, often presenting with recurrent spontaneous hypoglycemia. Surgical resection remains the definitive treatment; however, accurate preoperative localization is critical for optimizing surgical outcomes and avoiding unnecessary extensive pancreatic resection. We report a case of a 57-year-old female with recurrent hypoglycemia, whose lesion was undetectable using conventional ultrasound, computed tomography (CT), and standard magnetic resonance imaging (MRI). However, small field-of-view diffusion-weighted imaging (sFOV DWI) successfully identified a 13 × 10 mm pancreatic lesion between the body and tail, with imaging characteristics consistent with a pancreatic neuroendocrine tumor. The patient underwent successful surgical resection, with histopathological confirmation of insulinoma, leading to complete resolution of symptoms postoperatively. This case highlights the utility of sFOV DWI in detecting small pancreatic lesions that may be missed by conventional imaging techniques. Its application in challenging cases could significantly improve diagnostic accuracy and guide surgical planning.

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利用小视场扩散加权MRI改进胰岛素瘤的检测和定位：1例报告

胰岛素瘤是一种罕见但难以诊断的胰腺神经内分泌肿瘤，常表现为复发性自发性低血糖。手术切除仍然是最终的治疗方法；然而，准确的术前定位对于优化手术效果和避免不必要的广泛胰腺切除术至关重要。我们报告一例57岁女性复发性低血糖，其病变未检测常规超声，计算机断层扫描（CT）和标准磁共振成像（MRI）。然而，小视场扩散加权成像（sFOV DWI）成功地识别了身体和尾巴之间13 × 10 mm的胰腺病变，其成像特征与胰腺神经内分泌肿瘤一致。患者手术切除成功，组织病理学证实为胰岛素瘤，术后症状完全缓解。本病例强调了sFOV DWI在检测常规成像技术可能遗漏的胰腺小病变方面的应用。应用于疑难病例，可显著提高诊断准确性，指导手术计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.