RESUMO
The authors analyzed the data of contrast-enhanced multislice spiral computed tomography (MSCT) angiography versus those of volumetric dynamic computed tomography, percutaneous and endoscopic ultrasonography, selective angiography, and arterial stimulation blood sampling in the diagnosis of sporadic insulinomas depending on the size and site of the tumor. Forty-five patients (25 women and 20 men) aged 20 to 55 years (mean age, 43.4 +/- 2.8 years) with characteristic clinical symptoms and Whipple's triad, were examined. These were found to have 45 sporadic insulinomas that were located in the head and isthmus (n = 13 (28.9%)), body (n = 19 (42.2%)), and tail (n = 13 (28.9%)). The insulinomas measured 4.0 to 10.0 mm (mean size, 6.5 +/- 2.1 mm) (n = 9), 11.0 to 20.0 mm (mean size, 13.2 +/- 2.5 mm) (n = 23), and 21.0 to 25.0 mm (mean size, 22.6 +/- 2.8 mm) (n = 13). Volumetric dynamic CT angiography increases detection rates for tumors less than 1.0 cm in size to 77.8%. It enabled insulinomas to be localized in 82.2% of cases.
