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CT and MR imaging features of pancreatic adenosquamous carcinoma and their correlation with prognosis

  • Pancreas
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Abstract

Purpose

To retrospectively investigate the computed tomography (CT) and magnetic resonance (MR) imaging features of pancreatic adenosquamous carcinoma (PASC) and the association between imaging findings and prognosis.

Materials and methods

CT, MR images of 26 patients with PASC were analyzed. Clinical symptoms, tumor markers, and patients’ survival were recorded. Tumor attenuation, enhancement pattern and degree, vessel involvement, adjacent tissue invasion and metastasis were evaluated. The association between imaging features and overall survival (OS) were also assessed using Cox proportional hazards ratio model.

Results

Fourteen masses were found in the head of the pancreas and 12 in the body/tail. The mean tumor size was 4.47 ± 1.76 cm. PASC usually showed ill-defined (96.2%), lobulated (76.9%) and predominantly solid mass (92.3%). Ring enhancement in the peripheral area of the tumor was commonly seen (76.9%). Vessel invasion was seen in 17 cases (65.4%), encasement of adjacent arteries in 7 cases (26.9%), upstream main pancreatic duct (MPD) dilatation in 16 cases (61.5%) and double duct sign in 9 cases (34.6%). Multivariate Cox proportional hazards model demonstrated that patients with vessel invasion may predict a poor prognosis (p = 0.037).

Conclusion

PASC tends to be an ill-defined solid mass with peripheral ring enhancement, and relatively poor enhancement in the central area. PASC may also show vessel invasion, vessel encasement and upstream MPD dilatation. Vessel invasion may indicate a poor prognosis.

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Acknowledgements

Thanks for all the authors’ contributions to patient’s data collection, imaging analysis, statistical analysis, and valuable suggestions.

Funding

This work was supported by the National Natural Science Foundation of China (81771899) and the Key Program of Research and Development of Jiangsu Province (BE2017772).

Author information

Authors and Affiliations

  1. Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China

    Rui Zhao, Xiao Chen, Shuai Ren, Wenjing Cui, Shaojuan Wang, Jianhua Wang, Yong Zhu, Xiaowen Tang & Zhongqiu Wang

  2. Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

    Zhenyu Jia

  3. Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao, Nanjing, 210009, China

    Deng-ling Zhao

  4. Department of Pathology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

    Tao Li

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Zhao, R., Jia, Z., Chen, X. et al. CT and MR imaging features of pancreatic adenosquamous carcinoma and their correlation with prognosis. Abdom Radiol 44, 2822–2834 (2019). https://doi.org/10.1007/s00261-019-02060-w

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