Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Abdom Radiol (NY). 2020 Mar;45(3):774-781. doi: 10.1007/s00261-019-02365-w.
To determine imaging findings of pancreatic adenocarcinomas incidentally detected on contrast-enhanced multiphasic dynamic computed tomography (CT) obtained during the follow-up for other diseases.
From January 2007 to December 2018, 14 patients with pancreatic adenocarcinomas incidentally detected on CT obtained during the follow-up for other diseases (incidental group) and 105 patients with pancreatic adenocarcinomas symptomatically detected on ultrasound or CT (non-incidental group) were included. Imaging characteristics of the tumor were compared between the two groups. Additionally, imaging findings prior to the detection of a tumor on previous CT images in the incidental group were also assessed.
In cancers of the pancreas body/tail, there was a significantly smaller tumor size (median, 17 mm vs. 42 mm, p < 0.001), a significantly lower incidence of loss of fatty marbling (p = 0.025), vascular involvement (p < 0.001), lymph node metastasis (p = 0.046) and distant metastasis (p = 0.017), and a significantly higher incidence of preserved lobulation (p < 0.001) in the incidental group than in the non-incidental group. Regarding the cancers of the pancreas head, there were no significant differences in the radiological findings between the two groups. On previous CT images, small pancreatic nodules, secondary signs, and loss of fatty marbling tended to be the preceding findings of incidental pancreatic adenocarcinomas.
Incidentally detected pancreatic adenocarcinomas in the pancreas body/tail were characterized by an earlier tumor stage than in cases of symptomatically detected pancreatic adenocarcinoma. Several CT findings prior to the detection of a tumor may be useful for the early detection of pancreatic adenocarcinoma during the follow-up for other diseases.
确定在其他疾病随访期间进行的增强多期动态 CT 扫描中偶然发现的胰腺腺癌的影像学表现。
2007 年 1 月至 2018 年 12 月，纳入了 14 例在其他疾病随访中 CT 偶然发现的胰腺腺癌患者（偶然组）和 105 例因症状性超声或 CT 发现胰腺腺癌的患者（非偶然组）。比较两组肿瘤的影像学特征。此外，还评估了偶然组中 CT 图像上肿瘤前的影像学表现。
在胰体/尾部癌中，偶然组肿瘤的直径明显更小（中位数，17mm 比 42mm，p<0.001），脂肪纹理丧失（p=0.025）、血管侵犯（p<0.001）、淋巴结转移（p=0.046）和远处转移（p=0.017）的发生率较低，保留分叶的发生率较高（p<0.001）。胰头部癌两组间影像学表现无显著差异。在之前的 CT 图像上，胰腺小结节、次要征象和脂肪纹理丧失可能是偶然发现的胰腺腺癌的前期表现。
偶然发现的胰体/尾部腺癌的肿瘤分期早于症状性发现的胰腺腺癌。在其他疾病随访期间，肿瘤前的一些 CT 表现可能有助于早期发现胰腺腺癌。
