Metode dijagnostike inzulinoma

master's thesis

• Title (english): Diagnostic evaluation of suspected insulinoma - comparison of different diagnostic methods
• Author: Petra Vuica
• Mentor: Tina Dušek (mentor)
• Committee member: Darko Kaštelan (predsjednik povjerenstva)
• Committee member: Nikola Đaković (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Inzulinomi pripadaju neuroendokrinim tumorima te potječu od β stanica gušterače. Ovi rijetki tumori su hormonski aktivni te pojačano luče inzulin. Zbog hiperinzulinemije, javljaju se simptomi hipoglikemije, kao što su kao vrtoglavica, dvoslike, zamagljen vid, konfuznost ili gubitak svijesti. Inzulinomi su u većini slučajeva benigne naravi, te se nakon kirurškog odstranjenja očekuje potpuno izlječenje. U ovom radu analizirana je medicinska dokumentacija devet pacijenata koji su bili liječeni na KBC-u Zagreb od 2010.-2015. godine. Kod svih ispitanika dijagnoza inzulinoma je postavljena biokemijskim testovima gdje je dokazana endogena hiperinzulinemija. Ispitanici su nakon toga prošli radiološku dijagnostiku radi predoperativnog utvrđivanja lokalizacije tvorbe. Cilj rada bio je utvrditi uspješnost pojedinih slikovnih metoda u lokalizaciji inzulinoma te usporediti dobivene podatke s podacima iz literature. Rezultati su pokazali kako je najmanju osjetljivost imao abdominalni ultrazvuk, nakon njega endoskopski ultrazvuk s osjetljivošću od 33 %. Nešto bolju osjetljivost koja iznosi 62,5 % imala je kompjuterizirana tomografija. Sljedeća po uspješnosti bila je magnetska rezonancija, a najboljom se pokazala selektivna arterijska stimulacija kalcijem. Podaci su odgovarali podacima nađenim u literaturi. Uzevši u obzir ograničenja rada, od kojih je najvažniji mali broj ispitanika došli smo do zaključka da kod kliničke sumnje na inzulinom možemo kao prvu metodu odabrati CT ili MR, ovisno o dostupnosti, a nakon toga napraviti nešto invazivniju pretragu kao što je selektivna arterijska stimulacija kalcijem.

Abstract (english)

Insulinoma is a neuroendocrine tumor derived from pancreatic β cells. This rare tumor is hormonally active and produces extra insulin. Symptoms of hypoglycemia occur because of hyperinsulinemia. These symptoms include vertigo, diplopia, blurred vision, confusion and loss of consciousness. Insulinomas are usually benign tumors, and after surgical removal, total recovery is expected. In this paper we analyzed medical documentation of nine patients who were treated at the Clinical hospital center Zagreb from 2010 – 2015. All of the participants were diagnosed with insulinoma by biochemical findings which proved endogenus hyperinsulinemia. The patients then underwent a radiological examination in order to determine the preoperative localization of the tumor. The aim of this paper was to determine the success rate of different diagnostic methods and compare them with the information from the existing literature. The results showed that the abdominal ultrasound had the least sensitivity rate, followed by endoscopic ultrasound with sensitivity rate of 33 %. CT showed greater sensitivity of 62, 5 %, followed by MRI. Selective arterial calcium stimulation was found to be the most successful. The success rate data was similar to those found in literature. Considering the limitations of this paper, such as small number of participants, we came to the conclusion that after clinical suspicion of insulinoma, CT or MRI can be performed, depending on availability, followed by more invasive procedures, such as selective arterial calcium stimulation.

• Keywords: inzulinom; hiperinzulinemija; hipoglikemija; metode dijagnostike; osjetljivost
• Keywords (english): insulinoma; hyperinsulinemia; hypoglycemia; diagnostic methods; sensitivity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:511905
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-07-10 11:56:22