INSULINOMA ASSOCIATED WITH LIVER-LESIONS - VALUE OF MR-IMAGING

We report on a middle-aged woman who presented with clinical and bioch emical findings of insulinoma, Preoperative evaluation by ultrasound, CT, and angiography located the pancreatic lesion but also revealed tw o focal liver lesions. The latter were interpreted as metastases, MR i maging with injection of superparamagnetic iron oxide particles not on ly localized the insulinoma but proved to be the only noninvasive tech nique capable to exclude presence of liver metastases preoperatively, This reversed management to minimal laparascopic surgery. Recent liter ature of preoperative imaging evaluation of insulinoma and focal liver lesions is discussed. (Am J Gastroenterol 1998;93:1559-1562, (C) 1998 by Am. Coll. of Gastroenterology).