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目的分析2例以Whipple三联征为首发症状的多发性内分泌腺瘤1型(MEN1)的CT及MRI表现,以期提高对该病的认识。方法 2例MEN1型病例均采用实验室检查、超声、CT及MRI检查,行手术探查和胰岛素瘤病灶切除,并与病理结果对照。结果术中发现2例患者共11个胰岛素瘤病灶,CT检出4个(36%),MRI检出6个(55%),未检出的病灶直径均低于0.5 cm。病变发生于胰头、胰体、胰尾部分别为2、4、5个。1例合并垂体微腺瘤,1例合并单侧肾上腺瘤及双侧甲状旁腺增生。结论 CT及MRI有助于检出MEN1型患者的多个胰岛素瘤病灶,但对于微小病灶的检出仍有困难。
Objective To analyze the CT and MRI findings of two cases of multiple endocrine neoplasia type 1 (MEN1) with Whipple triad as the first symptom, in order to improve their understanding of the disease. Methods 2 cases of MEN1 cases were examined by laboratory, ultrasound, CT and MRI, surgical exploration and excision of insulinoma lesions, and pathological findings. Results A total of 11 insulinoma lesions were found in 2 patients. There were 4 (36%) CTs and 6 (55%) MRIs. The diameter of undetected lesions was less than 0.5 cm. Lesions occurred in the head of pancreas, pancreatic body, pancreatic tail were 2,4,5. 1 case complicated with pituitary adenoma, 1 case with unilateral adrenal tumor and bilateral hyperparathyroidism. Conclusion CT and MRI are helpful to detect multiple insulinoma lesions in MEN1 patients, but it is still difficult to detect small lesions.