The clinical value of super-selective CT angiography in making preoperative diagnosis of insulinoma

Objective: To investigate the clinical value of super-selective CT angiography (SSCTA) in making preoperative diagnosis of insulinoma. Methods: A total of 54 patients with pathologically-proved insulinoma, who were admitted to authors' hospital during the period from 2013 to 2015, were enrolled in this study. SSCTA was performed in all the patients, the preoperative materials of various imaging examinations, including transabdominal ultrasound (TAUS, n = 42), endoscopic ultrasound (EUS, n = 48), contrast-enhanced ultrasound (CEUS, n = 51), enhanced CT (ECT, n = 30), enhanced MRI (EMRI, n = 48) and selective angiography (SAG, n = 54) were retrospectively analyzed. The localization sensitivity and accuracy rate of various examinations for insulinoma were calculated. The selection of optimal preoperative examination method was discussed. Results: The localization sensitivities of TAUS, CEUS, EUS, ECT, EMRI, SAG and SSCTA were 21.4%, 82.4%, 87.5 %, 70.0%, 87.5%, 72.2% and 94.4% respectively, and the localization accuracy rates of TAUS, CEUS, EUS, ECT, EMRI, SAG and SSCTA were 14.3%, 58.8%, 68.8%, 60.0%, 81.3%, 44.4% and 88.9% respectively. The localization sensitivity and the localization accuracy of SSCTA were significantly higher than those of all the other examination methods (P < 0.05). No serious complications occurred after SSCTA in all patients. Conclusion: SSCTA is of great important value in making preoperative diagnosis of insulinoma. Besides, this technique is safe and reliable. (authors)