Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Medical Imaging, Institute, Shanghai 200032, People's Republic of China; Department of Medical Imaging, Shanghai Medical School of Fudan University, Shanghai, 200032, People's Republic of China.
Clin Imaging. 2013 Nov-Dec;37(6):1054-60. doi: 10.1016/j.clinimag.2013.08.002. Epub 2013 Sep 10.
The objective was to retrospectively study computed tomography (CT) and magnetic resonance imaging (MRI) findings of adenosquamous carcinoma of the pancreas (PASC).
Twelve patients (six women and six men; mean age, 61.3 years; range, 47-78 years) who presented with PASC as documented by pathologic examination underwent CT (n=10) or both CT and MRI (n=2) examination. Two radiologists evaluated the images and determined the location, size, margin, internal attenuation or signal intensity, contrast enhancement, and pattern for each tumor. Additionally, the presence of poorly enhanced areas, upstream main pancreatic duct (MPD) dilatation, pancreatic atrophy, and peripancreatic tissue metastasis were evaluated. Images were cross-referenced to surgical and pathologic findings.
Masses were distributed throughout the pancreas (head, n=6; body, n=1; and tail, n=5). The tumor size ranged from 2.4 to 5.5 cm with an average size of 3.7 cm. Eight (66.7%) masses were ill defined, and seven (58.3%) were partially exophytic. Twelve (100%) masses showed heterogeneous and poorly enhanced areas. The lesions showed weak (n=5), moderate (n=5), or intense (n=2) progressive enhancement. The diameter of MPD in six patients ranged from 3.0 to 5.0 mm with an average of 3.7 mm. Pancreatic atrophy was not found. In 10 patients (83.3%), masses invaded the peripancreatic tissues. Two patients had metastatic liver disease at presentation.
PASC typically presented as an ill-defined, hypovascular mass with a poorly enhanced area, exophytic tendency, and peripancreatic tissue invasion. Lack of pancreatic atrophy and mild MPD dilatation were also distinct from common duct pancreatic adenocarcinoma.
本研究旨在回顾性分析胰腺腺鳞癌（PASC）的计算机断层扫描（CT）和磁共振成像（MRI）表现。
经病理检查证实为 PASC 的 12 例患者（6 例女性，6 例男性；平均年龄 61.3 岁；范围 47-78 岁）分别接受 CT（n=10）或 CT 和 MRI（n=2）检查。两名放射科医生评估图像并确定每个肿瘤的位置、大小、边界、内部衰减或信号强度、对比增强和模式。此外，还评估了增强程度差的区域、上游主胰管（MPD）扩张、胰腺萎缩和胰周组织转移的存在情况。图像与手术和病理结果进行了交叉参考。
肿块分布于整个胰腺（头部，n=6；体部，n=1；尾部，n=5）。肿瘤大小范围为 2.4-5.5cm，平均大小为 3.7cm。8 个（66.7%）肿块边界不清，7 个（58.3%）肿块部分外生。12 个（100%）肿块显示不均匀和增强程度差的区域。病变呈弱（n=5）、中（n=5）或强（n=2）渐进性增强。6 例患者 MPD 直径为 3.0-5.0mm，平均直径为 3.7mm。未发现胰腺萎缩。10 例患者（83.3%）肿块侵犯胰周组织。2 例患者在就诊时已发生肝转移。
PASC 通常表现为边界不清、少血管的肿块，伴有增强程度差的区域、外生性倾向和胰周组织侵犯。缺乏胰腺萎缩和轻度 MPD 扩张也是与胆总管胰腺腺癌不同的特征。
