ABSTRACT
Objective: To determine the efficacy of MRI pulse sequences with SENSE coil for depicting insulinoma. Methods: Thirteen patients with clinically suspected insulinoma, documented by pathologic examination of resected specimens, underwent MRI examination. An investigator determined the following data for each tumor: size, location, margination, signal intensity, and contrast enhancement pattern. In addition, the evidence of metastases was assessed. Results: Masses were located throughout the pancreas (head, n=2; neck, n=1; body, n=2; tail, n=6, and uncinate process, n=2). The mean maximal diameter was 13.7 mm (range, from 6 mm. to 30 mm.). The sensitivity of detecting tumor on different MR techniques were 30.7% on in-phase T1-weighted images, 61.5% on T2-weight images with fat suppression technique, 76.9% on pre-contrast 3D-GRE T1-weighted images, and 46.1% on dynamic 3D-GRE Gd images. The tumor detection rate obtained by both T2-weight images with fat suppression technique and pre-contrast 3D-GRE T1-weighted images were highest one (91.7%) with the same sensitivity of detecting tumor by the complete set of MR images. Two patients had metastatic liver disease at presentation. Conclusion: Recent advanced MR imaging is one of the sensitive imaging modalities for detecting the presence of insulinoma and metastatic disease. Combined pre-contrast 3D GRE sequence and T2-weighted images with fat suppression are the essential recent MR protocol.