title: Poorly enhanced areas of pancreatic adenocarcinomas on late-phase dynamic computed tomography: comparison with pathological findings.
abstract: 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.
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. hattori-ht2ryk@nifty.com
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hattori
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mochizuki
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
mesh_terms: 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*