Poorly enhanced areas of pancreatic adenocarcinomas on late-phase dynamic computed tomography: comparison with pathological findings.
OBJECTIVE
The aim of the study was to retrospectively compare image findings of poorly enhanced areas (PEAs) of pancreatic adenocarcinomas that show almost no enhancement or obviously hypoattenuating area relative to the surrounding carcinoma on late-phase dynamic computed tomography (CT) with pathological findings.


METHODS
Thirty-nine patients with pancreatic adenocarcinoma underwent dynamic CT and surgery. Poorly enhanced areas were classified according to their size, attenuation value, position, and border on CT imaging and signal intensity on magnetic resonance imaging.


RESULTS
Of the 33 PEAs, 12 showed neoplastic duct-like structure that contained both large tumor gland and dilated pancreatic duct with atypia, 11 showed necrosis, 4 showed retention cyst, 2 showed dilated pancreatic duct without atypia or with limited invasion, 1 showed mucin, and 3 showed no remarkable differences in characteristics compared with surrounding tissue. Neoplastic duct-like structures tended to be well defined (P < 0.01). Necrotic portions tended to show a high attenuation value (P < 0.01) and central position (P < 0.01) and were ill defined (P < 0.01). Retention cysts tended to show a peripheral position (P < 0.01).


CONCLUSIONS
Poorly enhanced areas corresponded to cystic, necrotic, and mucinous components. Image findings demonstrated these characteristics. Necrotic component can be visualized and distinguished with other components and can be a prognostic factor.
Hattori
Yuki
Y
Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. hattori-ht2ryk@nifty.com
Gabata
Toshifumi
T
Zen
Yoh
Y
Mochizuki
Kentaro
K
Kitagawa
Hirohisa
H
Matsui
Osamu
O
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology* / Q000601:surgery; D010181:Pancreatic Cyst / Q000175:diagnosis; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*