World journal of radiology最新文献

{"title":"Characterization of endometriosis in patients with Mullerian anomalies using the Enzian classification: A retrospective cohort study.","authors":"Ishan Kumar, Shweta Kumari, Ritu Ojha, Rupam Kumari, Kajal Kushwaha, Pramod Kumar Singh, Ashish Verma","doi":"10.4329/wjr.v18.i3.118143","DOIUrl":"https://doi.org/10.4329/wjr.v18.i3.118143","url":null,"abstract":"<p><strong>Background: </strong>Mullerian anomalies are frequently associated with endometriosis, particularly in the presence of genital tract obstruction; however, the anatomical distribution and determinants of disease in this population remain incompletely characterized. Most existing data are derived from surgical series, with limited use of standardized imaging-based classification systems.</p><p><strong>Aim: </strong>To characterize the prevalence and distribution of endometriosis in patients with Mullerian anomalies using pelvic magnetic resonance imaging (MRI) and the Enzian classification.</p><p><strong>Methods: </strong>This retrospective observational study included pelvic MRI examinations performed over a 15-month period. Patients whose MRI reports described Mullerian anomalies were identified, and imaging datasets were re-evaluated. Mullerian anomalies were classified using the Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy system. Endometriosis was assessed on MRI and mapped using the Enzian classification, including ovarian (O), peritoneal (P), and deep infiltrating tissue (T) involvement across pelvic compartments. The presence of genital tract obstruction was determined based on MRI evidence of hemorrhagic collections.</p><p><strong>Results: </strong>Seventy-five patients with Mullerian anomalies were included. MRI findings consistent with endometriosis were identified in 22 patients (29.3%). Ovarian endometriomas were the most common manifestation, present in 16 patients (21.3%), while tubo-ovarian involvement corresponding to Enzian T2-T3 disease was seen in 11 patients (14.7%). Endometriosis was more frequently observed in complex uterine configurations, particularly bicorporeal septate uterus (U3c), aplastic uterus with a functional rudimentary cavity (U5a), and in patients classified as U0 with associated cervicovaginal anomalies. Vaginal aplasia (V4) was associated with a significantly lower prevalence of endometriosis compared with normal vaginal anatomy (<i>P</i> = 0.019). Genital tract obstruction showed a strong association with endometriosis, with affected patients demonstrating nearly threefold higher prevalence compared with non-obstructive anomalies (61.5% <i>vs</i> 22.6%, <i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>Endometriosis in patients with Mullerian anomalies demonstrates variable distribution on MRI, with higher prevalence in complex and obstructive uterine configurations. MRI combined with standardized Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy and Enzian classifications provides a structured, anatomy-driven approach for evaluating disease patterns in this heterogeneous population.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 3","pages":"118143"},"PeriodicalIF":1.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Evidence for a two-step species-level pulmonary nocardiosis diagnostic approach.","authors":"John Halphen, Mohadese Ahmadzade, Babith Mankidy, Ashkan Berenji, Mohammad Ghasemi-Rad","doi":"10.4329/wjr.v18.i3.118126","DOIUrl":"https://doi.org/10.4329/wjr.v18.i3.118126","url":null,"abstract":"<p><p>Pulmonary nocardiosis, a rare and diagnostically challenging infection, usually presents with heterogeneous radiographic findings, compounded by the low sensitivity of traditional confirmatory cultures. In their most recent work, Wang <i>et al</i> analyzed 102 patients with pulmonary nocardiosis to address these concerns, investigating species-characteristic imaging patterns, pathological associations, and the role of metagenomic next-generation sequencing (mNGS) in the diagnostic approach. High-resolution computed tomography (CT) in adult patients with pulmonary infections caused by <i>Nocardia wallacei</i> was demonstrated to have a sensitive (85.71%) and specific (83.34%) presentation of bronchopneumonia in relation to the five <i>Nocardia</i> species in the sample with CT data. The authors also compared traditional cultures to mNGS, finding that traditional cultures and mNGS were concordantly positive in only 3.3% of cases. This letter supports a combined radiologic and molecular diagnostic approach, enabling earlier and more accurate species identification in pulmonary nocardiosis, thereby informing treatment decisions, and enhancing epidemiologic understanding.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 3","pages":"118126"},"PeriodicalIF":1.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic profiles and hepatic steatosis assessed by controlled attenuation parameter and elastography during Ramadan fasting in San Antonio, United States.","authors":"Jazza Jamil, Sabahat Ali, Arif Ahmad, Mohammed Al-Zakwani, Anum Gul, Pir A Shah, Suhaib Haq, Eric Lawitz","doi":"10.4329/wjr.v18.i3.117162","DOIUrl":"https://doi.org/10.4329/wjr.v18.i3.117162","url":null,"abstract":"<p><strong>Background: </strong>Ramadan fasting (RF) is a form of time-restricted feeding, where individuals abstain from eating and drinking from dawn to sunset. RF has been shown to have positive effects on weight loss, as well as vascular and metabolic disorders. We evaluated the effects of RF on the metabolic profiles of a cohort of Muslims in San Antonio. FibroScan (vibration-controlled transient elastography + controlled attenuation parameter) was used to assess liver stiffness and steatosis before and after RF.</p><p><strong>Aim: </strong>To evaluate the effects of RF on metabolic and liver profiles, including body mass index (BMI), metabolic syndrome (MS), and hepatic steatosis, in a cohort of Muslims residing in San Antonio.</p><p><strong>Methods: </strong>A total of 41 subjects residing in San Antonio, TX, who fasted for 14-15 hours daily for 30 consecutive days during Ramadan, were included in this study. Subjects with any alcohol intake, chronic hepatitis (B and C), pregnancy, or use of hepatotoxic/steatotic agents were excluded. All subjects completed two visits (within 1-2 weeks before and after Ramadan). Each visit involved measurements of BMI, blood pressure, metabolic markers (fasting lipid panel and glucose), liver tests [gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, bilirubin (total and indirect), albumin], and FibroScan measurements.</p><p><strong>Results: </strong>Prior to RF, 29% had MS and 37% had BMI ≥ 30. MS was present in 11% with BMI < 30 and 60% with BMI ≥ 30 (<i>P</i> = 0.01). Hepatic steatosis was more prevalent in the BMI ≥ 30 group (66% <i>vs</i> 30%, <i>P</i> = 0.02) and correlated with BMI (<i>r</i> = 0.54, <i>P</i> = 0.0003). Most participants had mild fibrosis (F0-1 or F2), with advanced fibrosis in 8% (BMI < 30) and 14% (BMI ≥ 30). Liver enzymes were largely normal at baseline. After 30 days of RF, body weight and BMI significantly decreased (<i>P</i> < 0.0001), while MS prevalence remained unchanged. Controlled attenuation parameter scores improved significantly overall (278.6 dB/m to 264.4 dB/m, <i>P</i> < 0.0001) and within both BMI groups, with no major changes in glucose, lipids, or aminotransferases.</p><p><strong>Conclusion: </strong>In this South Asian Muslim cohort, MS prevalence was high, especially in males with BMI ≥ 30. Higher BMI correlated with steatosis; 30-day RF reduced weight and improved steatosis.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 3","pages":"117162"},"PeriodicalIF":1.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infrared thermography as adjunctive imaging in spine surgery: Evaluating thermal asymmetry for predicting symptomatic level and recovery.","authors":"Sathish Muthu, Kavya Priyadharshini Natarajan, Vibhu Krishnan Viswanathan, Dhibin Vikash Kolarpatti Ponnusamy, Rajappan Chandra Satish Kumar, Khan Sharun, Hyun Jun Jang","doi":"10.4329/wjr.v18.i3.116736","DOIUrl":"https://doi.org/10.4329/wjr.v18.i3.116736","url":null,"abstract":"<p><strong>Background: </strong>Objective assessment of pain relief and adequacy of decompression following spine surgery remains challenging. Infrared thermography (IRT) offers a non-invasive, radiation-free modality to visualize physiological changes in regional blood flow and inflammation.</p><p><strong>Aim: </strong>To evaluate diagnostic concurrence and postoperative normalization of IRT in patients undergoing spine surgery, and to identify clinical predictors of recovery in thermal patterns.</p><p><strong>Methods: </strong>This retrospective study included 35 adult patients who underwent lumbar decompression or fusion procedures for spinal pathologies such as degenerative conditions, deformity, tumors and adjacent segment disease. The pre-operative and post-operative IRT scans were analyzed to quantify the focal temperature asymmetry corresponding to the symptomatic spinal levels. Two blinded reviewers independently evaluated the concurrence and postoperative normalization of the values.</p><p><strong>Results: </strong>The mean age of the cohort was 66.3 ± 10.7 years (males: 63.6%). Multilevel disease was present in 63.6% of patients. While the preoperative thermographic concurrence with the symptomatic level was observed in 78.8% of patients, postoperative normalization was demonstrable in 63.6%. The normalization rates were the highest for transforaminal lumbar interbody fusion (80%) and decompression-only procedures (66.7%). Logistic regression analysis identified female sex, diagnosis of single-level spinal stenosis and transforaminal lumbar interbody fusion surgery as the positive predictors for post-operative normalization. In contrast, multilevel disease was recognized as a negative predictor. Model performance showed moderate discriminative accuracy (area under curve: 0.64, 95% confidence interval: 0.52-0.76).</p><p><strong>Conclusion: </strong>IRT demonstrated correlation with symptomatic spinal levels preoperatively and showed moderate association with postoperative thermal normalization following spine surgery. These preliminary findings suggest that IRT may provide additional, non-invasive information to complement standard imaging in the assessment of neural decompression and recovery. Larger, prospective studies are warranted to confirm its clinical utility and define its role in routine postoperative monitoring.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 3","pages":"116736"},"PeriodicalIF":1.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of metal artifact reduction software in computed tomography angiography of lower limb metallic prosthesis: A retrospective study.","authors":"Ahmad M Mounir, Ali H Elmokadem, Gehad A H Saleh, Ahmed El-Morsy, Ghada H Abd El-Raouf","doi":"10.4329/wjr.v18.i3.118119","DOIUrl":"https://doi.org/10.4329/wjr.v18.i3.118119","url":null,"abstract":"<p><strong>Background: </strong>Metal artifacts significantly limit the diagnostic quality of computed tomography (CT) algorithm in patients with lower limb metallic prostheses. Single-energy metal artifact reduction (SEMAR) algorithms have been developed to address this limitation.</p><p><strong>Aim: </strong>To evaluate the effects of SEMAR algorithm on image quality characteristics of lower limb CT algorithm (CTA) (artifact reduction, signal-to-noise ratio [SNR] and inter-observer agreement) in patients with metallic prostheses.</p><p><strong>Methods: </strong>Twenty-two patients (14 males, 8 females; median age 54 years) with unilateral or bilateral metal lower limb prostheses or screws underwent lower limb CTA on a 128-slice multi-detector CT scanner. Images were reconstructed with and without SEMAR algorithm. Three radiologists independently assessed subjective image quality using standardized scoring systems. Quantitative analysis included measurement of SNR and contrast-to-noise ratio in arterial and soft tissue regions of interest.</p><p><strong>Results: </strong>Application of SEMAR significantly improved SNR in two of three observers (<i>P</i> = 0.009 and <i>P</i> = 0.004), with values approaching those in the contralateral reference limb. Overall artifact reduction was statistically significant (median difference 1.5 Hounsfield unit, <i>P</i> < 0.001), as was improvement in overall image quality (median difference 1 Hounsfield unit, <i>P</i> < 0.001). Good inter-observer agreement (intraclass correlation coefficient > 0.75) was demonstrated for SNR and contrast-to-noise ratio assessment with metal artifact reduction (MAR) and reference images, while poor agreement (intraclass correlation coefficient < 0.5) was noted for non-MAR images. Kendall's <i>W</i> demonstrated significant concordance among observers (<i>W</i> = 0.899, <i>P</i> < 0.001 for study quality with MAR).</p><p><strong>Conclusion: </strong>SEMAR algorithm significantly reduces metal artifacts from lower limb fixation prostheses without compromising vessel contrast, improving visualization of periprosthetic vascular structures and enhancing diagnostic capability of CTA examinations.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 3","pages":"118119"},"PeriodicalIF":1.5,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When anatomy becomes pathology: Rethinking carotid-hyoid contact in cerebrovascular events.","authors":"Si-Yu Jiang, Rui Li","doi":"10.4329/wjr.v18.i2.116873","DOIUrl":"https://doi.org/10.4329/wjr.v18.i2.116873","url":null,"abstract":"<p><p>In this letter, we comment on the recent article by Karangeli <i>et al</i>, which systematically examined the spatial relationship between the hyoid bone and the carotid arteries using computed tomography angiography. The authors revealed significant anatomical variability in the 224 patients in their study, with type VI (external carotid artery lateral to the hyoid) and type VIII (both carotid arteries lateral to the hyoid) being the most common non-null configurations. Notably, sex-based differences were identified, suggesting possible morphometric or biomechanical influences. These findings have important implications for radiologists and surgeons, as non-null variants - particularly types VIII and XI - might predispose to dynamic carotid compression, transient ischemic events, or intraoperative vascular injury. Recognizing these patterns during preoperative imaging can enhance surgical safety and improve the diagnostic evaluation of unexplained cerebrovascular symptoms. The study by Karangeli <i>et al</i> underscores the clinical importance of translating detailed anatomical mapping into preventive strategies that bridge imaging precision and vascular protection.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 2","pages":"116873"},"PeriodicalIF":1.5,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of the clinical application of dual-layer spectral computed tomography in gastrointestinal malignancies.","authors":"Hong-Yu Yan, Bing Zhang, Zhao-Guo Han, Jia-Zhong Ren, Yan-Qing Liu","doi":"10.4329/wjr.v18.i2.115610","DOIUrl":"https://doi.org/10.4329/wjr.v18.i2.115610","url":null,"abstract":"<p><p>Gastrointestinal malignancies were the leading causes of cancer-related deaths worldwide in 2022. Owing to the absence of typical clinical symptoms at an early stage, most patients are diagnosed at an advanced stage when the disease has usually progressed to distant metastasis. Biological agents, immune checkpoint inhibitors, and precision radiotherapy have enhanced the efficacy of systemic treatment for locally advanced and metastatic gastrointestinal malignancies. Monitoring tumor malignancy, performing molecular testing of tumors, formulating precise treatment strategies, and evaluating patient prognosis have emerged as key focus areas of research on gastrointestinal malignancies. Dual-layer spectral computed tomography (DLCT) can be used not only to assess tumor histological features but also to quantify them, providing information regarding changes in the tumor microenvironment. Spectral computed tomography is a crucial tool for the initial diagnosis, staging, response evaluation, and follow-up management of patients with gastrointestinal malignancies. This review summarizes the research progress of the clinical application of DLCT in some types of gastrointestinal malignancies, such as esophageal, gastric, and colorectal cancers.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 2","pages":"115610"},"PeriodicalIF":1.5,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography-based nutritional associated nomogram on machine learning predicts survival outcomes in patients with resectable soft-tissue sarcoma.","authors":"Yu-Han Yang","doi":"10.4329/wjr.v18.i2.116462","DOIUrl":"https://doi.org/10.4329/wjr.v18.i2.116462","url":null,"abstract":"<p><strong>Background: </strong>Soft-tissue sarcomas (STS) are heterogeneous mesenchymal malignancies for which surgery remains the mainstay of curative treatment, yet recurrence and mortality rates remain substantial. Nutritional status and body composition measured <i>via</i> routine blood tests and computed tomography-derived metrics such as skeletal muscle and adipose tissue areas have emerged as important determinants of outcomes in cancer. Advanced machine-learning methods can integrate high-dimensional nutritional and radiologic variables to improve individualized survival prediction.</p><p><strong>Aim: </strong>To identify prognostic value of nutrition-associated factors for patients with STS treated with excision and to construct a predictive model for nutritional assessment by traditional survival analysis and a random forest machine learning method.</p><p><strong>Methods: </strong>We retrospectively included 638 patients who were diagnosed with STS and underwent surgical excision from January 2009 to June 2018. Nutrition-associated indicators from peripheral blood tests and routine computed tomography were collected. The primary outcome was overall survival (OS). The secondary outcomes were progression-free survival and length of postoperative hospital stay. The random survival forest (RSF) analysis selected important variables for re progression-free survival and OS, and the random forest analysis selected important variables for length of hospitalization. Nomograms were constructed by the prognostic features to predict survival probabilities.</p><p><strong>Results: </strong>The RSF analysis identified stage, hospital duration, subtype, body mass index, and tumour size as important variables for OS. The RSF-based nomogram on nutritional indexes for various clinical outcomes showed consistent calibration capacities on calibration plots and great discriminative abilities on the C-index and Brier score.</p><p><strong>Conclusion: </strong>Our study implicated the prognostic value of multiple nutritional assessment indexes for prediction of clinical outcomes in STS, and patients' nutrition status need long-term surveillance and management.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 2","pages":"116462"},"PeriodicalIF":1.5,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of cerebral blood flow changes in post-transjugular intrahepatic portosystemic shunts hepatic encephalopathy.","authors":"Wan-Li Zhuang, Shang-Wen Xu, Jian Fang, Zhi-Qiang Zhang, Shi-An Zhang, Jie-Long Wang, Jiao-Long Zheng, Xiao-Yang Wang, Dong-Liang Li","doi":"10.4329/wjr.v18.i2.116973","DOIUrl":"https://doi.org/10.4329/wjr.v18.i2.116973","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatic encephalopathy (HE) is the most common serious complication after transjugular intrahepatic portosystemic shunts (TIPS) surgery, the pathogenesis of which is not well understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore the mechanisms of HE after TIPS from a cerebral hemodynamic perspective and provide a theoretical basis for clinical treatment, three-dimensional arterial spin labeling and resting-state functional magnetic resonance imaging were applied in patients with portal hypertension post-TIPS to analyze dynamic changes in cerebral blood flow (CBF) and spontaneous brain activity, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who meet the inclusion criteria were selected as the case group, and 18 healthy volunteers were assigned as the control group. The differences in amplitude of low-frequency fluctuation (ALFF) and CBF between the case group and the control group before TIPS surgery and the differences in ALFF and CBF between the case group at each detection time point were compared and analyzed, and analyze the correlation between the changes in ALFF and CBF in the case group and the changes in clinical data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the healthy control group, the CBF values of patients with cirrhosis and portal hypertension who were treated with TIPS were reduced in the area centered on the right orbitofrontal gyrus and the left superior temporal gyrus. ALFF scores decreased in the area centered on the left superior temporal gyrus, the left inferior frontal gyrus of the operculum and the right precuneus. Compared with preoperatively, CBF in the TIPS group increased in the area centered on the left fusiform gyrus at 1 month after surgery and the difference in CBF in this area was negatively correlated with the difference in the Child-Pugh liver function score. ALFF values increased in the area centered on the left superior temporal gyrus and the ALFF difference in this area was positively correlated with the portal vein pressure difference. There was no significant difference in CBF 3 months after TIPS in comparison to pre-TIPS. ALFF scores increased in the area centered on the left orbitofrontal gyrus and the left precuneus 3 months after TIPS surgery and the difference in ALFF in the left orbitofrontal gyrus was negatively correlated with the difference in the Digit Symbol Substitution Test score. Compared to 1 month after TIPS surgery, CBF values decreased in the area centered on the right fusiform gyrus and increased in the area centered on the left angular gyrus 3 months after TIPS surgery. The difference in CBF in the right fusiform gyrus was positively correlated with the difference in the Number Connection Test Part A score. ALFF values decreased in the area centered on the right insula and in the cerebellum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;TIPS surgery has a certain effect on spontaneous brain activity in patients with portal hypertension and cirrhosis for th","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 2","pages":"116973"},"PeriodicalIF":1.5,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining the diagnostic pathway for pulmonary nocardiosis: The imperative for early metagenomic sequencing.","authors":"Tarun Kumar Suvvari, Ruchita Kodakandla, Venkataramana Kandi","doi":"10.4329/wjr.v18.i2.119080","DOIUrl":"https://doi.org/10.4329/wjr.v18.i2.119080","url":null,"abstract":"<p><p>In this article, we comment on the pivotal article by Wang <i>et al</i>. We focus on the critical intersection of advanced imaging and molecular diagnostics highlighted by their findings. The study delineates specific high-risk computed tomography patterns, notably consolidation with nodules/cavities, particularly in immunocompromised hosts or patients with bronchiectasis, that should serve as immediate red flags for pulmonary nocardiosis. Traditionally, diagnosis has relied on slow-growing cultures, leading to dangerous therapeutic delays. This editorial argues that the presence of these defined radiologic signatures may represent an important step toward refining the diagnostic pathway for pulmonary nocardiosis. Rather than a confirmatory last resort, metagenomic next-generation sequencing should be deployed as a first-line investigative tool following high-suspicion imaging. We propose a concrete, integrated diagnostic algorithm where imaging triage triggers parallel processing with metagenomic next-generation sequencing and conventional microbiology. This synergy of morphology and metagenomics promises to expedite species-specific diagnosis, guide timely targeted therapy, and ultimately improve outcomes for patients with this challenging and often elusive infection.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"18 2","pages":"119080"},"PeriodicalIF":1.5,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}