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

  • Rui Zhao
  • Zhenyu Jia
  • Xiao Chen
  • Shuai Ren
  • Wenjing Cui
  • Deng-ling Zhao
  • Shaojuan Wang
  • Jianhua Wang
  • Tao Li
  • Yong Zhu
  • Xiaowen Tang
  • Zhongqiu WangEmail author



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.


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).


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.


Pancreatic neoplasm Carcinoma, adenosquamous Multidetector computed tomography Magnetic resonance imaging 



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


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).

Compliance with ethical standards

Conflict of interest

The authors of this manuscript declare that they have no conflict of interest.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Supplementary material

261_2019_2060_MOESM1_ESM.pdf (424 kb)
Supplementary material 1 (PDF 423 kb)


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologyThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjingChina
  2. 2.Department of Interventional RadiologyThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina
  3. 3.Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
  4. 4.Department of PathologyThe First Affiliated Hospital with Nanjing Medical UniversityNanjingChina

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