Late contrast-enhanced CT for small pancreatic carcinoma: Delayed enhanced area on CT with histopathological correlation

Purpose: To determine the appearance of pancreatic adenocarcinoma on delayed contrast enhanced computed tomography (CT) and verify the diagnostic significance. Patients and Methods: Twenty-two surgically resected lesions of pancreatic adenocarcinoma were studied with dynamic CT and findings were compared with those on histopathology. Results: Ten 45% of 22 pancreatic adenocarcinoma demonstrated masses on unenhanced CT, while 21 (95%) demonstrated on early contrast-enhanced CT (early CT), and 15 (68%) demonstrated masses on delayed contrast-enhanced CT (late CT). Pancreatic mass was demonstrated as a low-density area on unenhanced and early CT, but mass density varied on late CT. Delayed enhancement of the mass was predominantly observed in small lesions; 3 (75%) of 4 lesions 2 cm or smaller were detected as high-density areas. Histologically, delayed enhanced lesions showed severe or moderate degrees of fibrosis. Conclusion: Late CT is useful for the detection of pancreatic adenocarcinoma with fibrosis as a high-density area, especially in small lesions.