World journal of radiology最新文献

{"title":"Enhancing back pain and sciatica diagnosis: Coronal short tau inversion recovery's role in routine lumbar magnetic resonance imaging protocols.","authors":"Somaya Al Kiswani, Maysoon Nasser, Abdulla Alzibdeh, Elias Eq Lahham","doi":"10.4329/wjr.v17.i6.107164","DOIUrl":"10.4329/wjr.v17.i6.107164","url":null,"abstract":"<p><strong>Background: </strong>Back pain and sciatica are common complaints that often require imaging for accurate diagnosis and management. Conventional lumbar magnetic resonance imaging (MRI) protocols typically include sagittal and axial T1 and T2 sequences; however, these may miss certain pathologies. The addition of coronal short tau inversion recovery (STIR) sequences offers the potential to enhance the detection of both spinal and extra-spinal abnormalities, thereby improving clinical decision-making and patient outcomes.</p><p><strong>Aim: </strong>To evaluate the impact of adding coronal STIR sequences to routine lumbar MRI in diagnosing back pain and sciatica.</p><p><strong>Methods: </strong>We prospectively analyzed data from patients aged 6 and older presenting with back pain or sciatica who underwent lumbar spine MRI at our institution. The standardized MRI protocol utilized included sagittal and axial T1 and T2 sequences, complemented by a coronal STIR sequence. Data on structural abnormalities were collected, reviewed, and analyzed using counts, percentages, and Fisher's exact test for categorical variables.</p><p><strong>Results: </strong>Our cohort comprised 274 patients (115 males, 159 females; mean age 44.91 years). Notably, 39 patients exhibited abnormalities across all sequences, while 72.63% showed normal findings on the coronal STIR sequence. Importantly, 30.29% of cases were diagnosed as normal without the coronal STIR, and 36 patients with normal T1 and T2 sequences presented abnormalities on the coronal STIR. The coronal STIR sequence successfully identified 26 spinal and 10 non-spinal pathologies, including 17 cases of sacroiliitis, with a significant association (<i>P</i> < 0.0001) between sacroiliitis diagnosis and abnormalities visible solely on this sequence.</p><p><strong>Conclusion: </strong>Integrating coronal STIR into routine lumbar MRI enhances detection of hidden spinal and extra-spinal pathologies, improves patient management, and offers a cost-effective, practical upgrade with significant diagnostic and clinical value.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 6","pages":"107164"},"PeriodicalIF":1.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555100","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":"Factors affecting disease control after pituitary tumor resection in acromegaly: What is the current evidence?","authors":"Cornelius J Fernandez, Vijaya Lakshmi, Abul Bashar M Kamrul-Hasan, Joseph M Pappachan","doi":"10.4329/wjr.v17.i6.106438","DOIUrl":"10.4329/wjr.v17.i6.106438","url":null,"abstract":"<p><p>Acromegaly, characterized by persistent hypersecretion of growth hormone (GH), is most often caused by a pituitary neuroendocrine tumor (PitNET), though, less often, ectopic GH or GH-releasing hormone secretion from various neoplasms outside the pituitary gland could cause it. Nearly 70% of somatotroph PitNETs are macroadenomas at diagnosis. Transsphenoidal surgery, the most effective treatment modality for acromegaly, could achieve remission in 73%. However, the remission rates could reach 87% if surgery is followed by medical therapy. Due to variable therapeutic responses to surgical and medical therapy, pre-treatment awareness regarding the best therapeutic modality based on clinical, biochemical, radiological, histopathological and genetic parameters would help in accurate pretreatment decision-making. Earlier studies have identified poor prognosis markers like tumor size, tumor invasion, T2-weighted hyperintensity, granulation, and pretreatment GH and/or insulin-like growth factor 1 levels. In a recent study, published by Alvarez <i>et al</i> identified that preoperative PitNET volume is a good predictor of control of acromegaly following surgical treatment and the likelihood of requiring more aggressive additional therapies after surgery. They found that PitNET volume exceeding 3697 mm³ was associated with poorer disease control in patients with somatotroph PitNETs.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 6","pages":"106438"},"PeriodicalIF":1.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555101","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 assessment of pericoronary adipose tissue in cardiovascular diseases: Diagnostic and prognostic implications.","authors":"Ling-Li Wang, Yuan-Bo Xiong, Xin-Yi Feng, Ya-Yudie Liu, Kai-Xiang Su, Si-Yu Jiang, Si-Yu Wang, Ling Zhou, Shao-Ke Li, Dan-Dan Guo, Rui Li","doi":"10.4329/wjr.v17.i6.107281","DOIUrl":"10.4329/wjr.v17.i6.107281","url":null,"abstract":"<p><p>Pericoronary adipose tissue (PCAT) plays an important role in the pathogenesis and progression of cardiovascular diseases due to its bidirectional communication with the coronary artery wall. In recent years, PCAT parameters measured using coronary computed tomography have emerged as potential noninvasive imaging biomarkers for quantifying coronary artery inflammation, with significant clinical value in the early detection, disease progression assessment, treatment efficacy evaluation, and prognosis prediction of cardiovascular diseases. Furthermore, new technologies such as PCAT radiomics analysis have broadened its potential applications in evaluating coronary plaque vulnerability, predicting cardiovascular events, and improving risk stratification. This review discusses recent advances in PCAT research, focusing on its role in coronary artery disease risk identification and inflammation monitoring, and aims to offer imaging-based insights to support its future clinical use in cardiovascular disease management.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 6","pages":"107281"},"PeriodicalIF":1.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555098","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":"Non-contrast computed tomography radiomics model to predict benign and malignant thyroid nodules with lobe segmentation: A dual-center study.","authors":"Hao Wang, Xuan Wang, Yu-Sheng Du, You Wang, Zhuo-Jie Bai, Di Wu, Wu-Liang Tang, Han-Ling Zeng, Jing Tao, Jian He","doi":"10.4329/wjr.v17.i6.106682","DOIUrl":"10.4329/wjr.v17.i6.106682","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative differentiation of benign and malignant thyroid nodules is critical for optimal patient management. However, conventional imaging modalities present inherent diagnostic limitations.</p><p><strong>Aim: </strong>To develop a non-contrast computed tomography-based machine learning model integrating radiomics and clinical features for preoperative thyroid nodule classification.</p><p><strong>Methods: </strong>This multicenter retrospective study enrolled 272 patients with thyroid nodules (376 thyroid lobes) from center A (May 2021-April 2024), using histopathological findings as the reference standard. The dataset was stratified into a training cohort (264 lobes) and an internal validation cohort (112 lobes). Additional prospective temporal (97 lobes, May-August 2024, center A) and external multicenter (81 lobes, center B) test cohorts were incorporated to enhance generalizability. Thyroid lobes were segmented along the isthmus midline, with segmentation reliability confirmed by an intraclass correlation coefficient (≥ 0.80). Radiomics feature extraction was performed using Pearson correlation analysis followed by least absolute shrinkage and selection operator regression with 10-fold cross-validation. Seven machine learning algorithms were systematically evaluated, with model performance quantified through the area under the receiver operating characteristic curve (AUC), Brier score, decision curve analysis, and DeLong test for comparison with radiologists interpretations. Model interpretability was elucidated using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>The extreme gradient boosting model demonstrated robust diagnostic performance across all datasets, achieving AUCs of 0.899 [95% confidence interval (CI): 0.845-0.932] in the training cohort, 0.803 (95%CI: 0.715-0.890) in internal validation, 0.855 (95%CI: 0.775-0.935) in temporal testing, and 0.802 (95%CI: 0.664-0.939) in external testing. These results were significantly superior to radiologists assessments (AUCs: 0.596, 0.529, 0.558, and 0.538, respectively; <i>P</i> < 0.001 by DeLong test). SHAP analysis identified radiomic score, age, tumor size stratification, calcification status, and cystic components as key predictive features. The model exhibited excellent calibration (Brier scores: 0.125-0.144) and provided significant clinical net benefit at decision thresholds exceeding 20%, as evidenced by decision curve analysis.</p><p><strong>Conclusion: </strong>The non-contrast computed tomography-based radiomics-clinical fusion model enables robust preoperative thyroid nodule classification, with SHAP-driven interpretability enhancing its clinical applicability for personalized decision-making.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 6","pages":"106682"},"PeriodicalIF":1.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555103","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-guided percutaneous biopsy for assessing tumor heterogeneity in neuroendocrine tumor metastases to the liver.","authors":"Lei-Lei Ying, Ke-Ning Li, Wen-Tao Li, Xin-Hong He, Chao Chen","doi":"10.4329/wjr.v17.i5.104808","DOIUrl":"10.4329/wjr.v17.i5.104808","url":null,"abstract":"<p><strong>Background: </strong>Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) frequently metastasize to the liver, with heterogeneity in tumor grade impacting patient prognosis and treatment. The Ki-67 index, a key prognostic marker, often varies between primary and metastatic sites; however, routine liver biopsy remains controversial. Although percutaneous computed tomography-guided core needle biopsy (PCT-CNB) is safe and effective for focal lesions, its role in detecting intertumor grading discrepancies and survival implications in GEP-NETs is underexplored. Conflicting survival associations with grade shifts have been reported in previous studies. We hypothesized that PCT-CNB could identify clinically significant grading heterogeneity in liver metastases, correlating with survival outcomes, thereby refining risk stratification and therapeutic strategies.</p><p><strong>Aim: </strong>To investigate intertumor grading heterogeneity in GEP-NET liver metastases <i>via</i> PCT-CNB.</p><p><strong>Methods: </strong>We retrospectively investigated 92 patients with liver metastases from GEP-NETs <i>via</i> PCT-CNB, 76 patient samples from the liver and primary sites, and 16 from the liver and secondary liver sites. Ki-67 immunohistochemistry was performed for tissue sampling, and grading classifications were determined. Intertumor grading classification heterogeneity and associated changes in patient survival outcomes were also evaluated.</p><p><strong>Results: </strong>No procedure-related mortality was recorded during or after biopsy. In 37/92 patients (40.2%), the grading classifications changed: The grading increased from G1 to G2 in 13 patients, from G1 to G3 in 2, and from G2 to G3 in 14; the grading decreased from G2 to G1 in 5 patients, from G3 to G1 in 1, and from G3 to G2 in 2. Patients with G1 or G2 disease had better progression-free survival and overall survival (OS) outcomes than those with G3 disease did (<i>P</i> = 0.001 and <i>P</i> < 0.001, respectively). The 5-year and 10-year OS rates for stable G2 patients were 67.5% and 26.0%, respectively, decreasing to 46.4% and 23.2%, respectively, among G2 patients whose grade increased (<i>P</i> = 0.016).</p><p><strong>Conclusion: </strong>The PCT-CNB of liver metastases from GEP-NETs differed in grade between the liver tumor and primary site/secondary liver metastases. Additionally, when grading increased from G2, the OS rate significantly decreased.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 5","pages":"104808"},"PeriodicalIF":1.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276125","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":"Diagnostic accuracy of noninvasive steatosis biomarkers with magnetic resonance imaging proton density fat fraction as gold standard.","authors":"Jia-Liang Chen, Shao-Jie Duan, Sheng Xie, Shu-Kun Yao","doi":"10.4329/wjr.v17.i5.104272","DOIUrl":"10.4329/wjr.v17.i5.104272","url":null,"abstract":"<p><strong>Background: </strong>Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The accuracy of noninvasive biomarkers for detecting hepatic steatosis is still limited.</p><p><strong>Aim: </strong>To assess the diagnostic performance of noninvasive steatosis biomarkers in diagnosing NAFLD using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the gold standard.</p><p><strong>Methods: </strong>A total of 131 suspected NAFLD patients (60% male, median age 36 years) undergoing MRI-PDFF were consecutively recruited from a tertiary hospital. Steatosis grades determined by MRI-PDFF were classified as none (< 5%), mild (5%-11%), moderate (11%-17%), and severe (≥ 17%). Six steatosis biomarkers were calculated according to clinical parameters and laboratory tests, including fatty liver index, hepatic steatosis index, ZJU index, Framingham steatosis index, triglycerides and glucose index, and visceral adiposity index. The accuracy of these biomarkers in detecting hepatic steatosis was evaluated using the area under the receiver operating characteristic curves (AUCs). The Youden index was used to determine the optimal cut-off for each biomarker. The linear trend analysis of each biomarker across the steatosis grades was conducted by Mantel-Haenszel <i>χ</i> ² test. Spearman's rank correlation assessed the relationship between steatosis biomarkers and MRI-PDFF.</p><p><strong>Results: </strong>Steatosis grades based on MRI-PDFF prevalence were: None 27%, mild 40%, moderate 15% and severe 18%. Six steatosis biomarkers showed a linear trend across the steatosis grades and a significant positive correlation with MRI-PDFF. The six steatosis biomarkers demonstrated AUCs near 0.90 (range: 0.857-0.912, all <i>P</i> < 0.001) for diagnosing NAFLD by MRI-PDFF ≥ 5%. The optimal cut-offs showed sensitivity between 84.4%-91.7% and specificity between 71.4%-85.7%. The diagnostic performance of these biomarkers in detecting moderate-to-severe and severe steatosis was relatively weaker.</p><p><strong>Conclusion: </strong>These noninvasive steatosis biomarkers accurately diagnosed NAFLD and correlated well with MRI-PDFF for detecting NAFLD, but they did not effectively detect moderate or severe steatosis.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 5","pages":"104272"},"PeriodicalIF":1.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276126","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":"Imaging biomarkers for detection and longitudinal monitoring of ventricular abnormalities from birth to childhood.","authors":"Antonio Navarro-Ballester, Rosa Álvaro-Ballester, Miguel Á Lara-Martínez","doi":"10.4329/wjr.v17.i5.106084","DOIUrl":"10.4329/wjr.v17.i5.106084","url":null,"abstract":"<p><p>This narrative review examines the use of imaging biomarkers for diagnosing and monitoring hydrocephalus from birth through childhood. Early detection and longitudinal follow-up are essential for guiding timely interventions and assessing treatment outcomes. Cranial ultrasound and magnetic resonance imaging (MRI) are the primary imaging modalities, providing critical insights into ventricular size, cerebrospinal fluid dynamics, and neurodevelopmental implications. Key parameters, including Evans' index, Levene's index, and the Cella Media index, as well as volumetric and diffusion-based MRI techniques, have been explored for their diagnostic and prognostic value. Advances in automated image analysis and artificial intelligence have further improved measurement precision and reproducibility. Despite these developments, challenges remain in standardizing imaging protocols and establishing normative reference values across different pediatric populations. This review highlights the strengths and limitations of current imaging approaches, emphasizing the need for consistent methodologies to enhance diagnostic accuracy and optimize patient management in hydrocephalus.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 5","pages":"106084"},"PeriodicalIF":1.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276128","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":"Right-to-left shunt detection in patent foramen ovale: The value of synchronized contrast transcranial Doppler and contrast transthoracic echocardiography.","authors":"Yu-Yin Wang, Lu Xie, Jun-Bang Feng, Yang-Yang Xu, Chuan-Ming Li","doi":"10.4329/wjr.v17.i5.105951","DOIUrl":"10.4329/wjr.v17.i5.105951","url":null,"abstract":"<p><p>Patent foramen ovale (PFO) is a common congenital heart disorder associated with stroke, decompression sickness and migraine. Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiography has important clinical significance and can improve the accuracy of detecting right-left shunts (RLSs) in patients with PFO. In this letter, regarding an original study presented by Yao <i>et al</i>, we present our insights and discuss how to better help clinicians evaluate changes in PFO-related RLS.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 5","pages":"105951"},"PeriodicalIF":1.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276131","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":"Specific imaging features of sellar atypical teratoid/rhabdoid tumor or the lack of thereof.","authors":"Run Yu","doi":"10.4329/wjr.v17.i5.106975","DOIUrl":"10.4329/wjr.v17.i5.106975","url":null,"abstract":"<p><p>Primary sellar atypical teratoid/rhabdoid tumor (AT/RT) is the most aggressive sellar mass. Although rare, sellar AT/RT exhibits a very relentless clinical course and usually results in death within months to a few years after diagnosis. The best clinical evidence suggests that surgical debulking and timely adjuvant chemoradiation are most effective in prolonging survival. A preoperative radiological diagnosis of sellar AT/RT thus is crucial in informing patients and physicians about this devastating disease. This minireview summaries the imaging features of sellar AT/RT. magnetic resonance imaging features of sellar AT/RT and the much more common sellar mass, pituitary macroadenoma, are similar in most aspects: They are both isointense to brain gray matter on T1 and T2 imaging and enhance upon gadolinium administration. Suprasellar extension and cavernous sinus invasion are present in practically all cases of sellar AT/RT, but are also present in 50%-75% of pituitary macroadenomas, especially in large ones, suggesting that suprasellar extension and cavernous sinus invasion disproportionate to the tumor size may favor sellar AT/RT diagnosis. Since sellar AT/RT grows very rapidly and does not allow significant remodeling of perisellar structures, the imaging features of perisellar structures such as optic chiasm and cavernous sinus may be key for imaging diagnosis of sellar AT/RT although they have not been well described in sellar AT/RT. In limited cases of sellar AT/RT, optic chiasm degeneration and thinning, which are very common in pituitary macroadenoma, are not present, giving hope for using features of perisellar structures to diagnose sellar AT/RT by imaging.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 5","pages":"106975"},"PeriodicalIF":1.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276132","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":"Calciphylaxis following liver transplantation in a patient with end-stage renal disease: A case report.","authors":"Xiang-Ling Wei, You-Wen Zhang, Ming Han, Cheng-Jun Sun, Guan-Zhi Lai, Shui-Guo Tang, Rong-Ji Ye, Hao-Qing Xu, Lin-Wei Wu, Wu-Zheng Xia","doi":"10.4329/wjr.v17.i5.105785","DOIUrl":"10.4329/wjr.v17.i5.105785","url":null,"abstract":"<p><strong>Background: </strong>Calciphylaxis, also called calcific uremic arteriolopathy, is characterized by microvascular calcification and occlusion, which is commonly seen in patients with end-stage renal disease (ESRD). Although several studies have demonstrated an association of calciphylaxis with ESRD, reports linking calciphylaxis to LT (LT) are scarce. This report presents a rare case of calciphylaxis in a patient who underwent LT, leading to microvascular occlusion and hyperbilirubinemia.</p><p><strong>Case summary: </strong>A 34-year-old man presented with a 7-day history of jaundice and severe bilateral leg pain. The patient had undergone LT and was put on hemodialysis for one year due to calcineurin inhibitor-induced ESRD. Physical examination revealed jaundice, leathery skin changes, severe muscle pain in both legs, and penile induration. Laboratory tests identified elevated bilirubin levels, gamma-glutamyltransferase, and alkaline phosphatase, while alanine aminotransferase and aspartate aminotransferase concentrations were within normal limits. Computed tomography (CT) revealed extensive calcifications in the subcutaneous tissue. Three-dimensional CT reconstruction indicated significantly reduced blood flow in the hepatic artery, primarily in the small to medium-sized branches. Contrast-enhanced ultrasonography confirmed hepatic ischemia, with no enhancement seen in hepatic artery branches. Liver biopsy specimen revealed no signs of rejection. The patient decided to receive conservative treatment and succumbed to the illness after six months.</p><p><strong>Conclusion: </strong>This case indicates that calciphylaxis should be suspected in patients who have undergone LT with ESRD presenting with hyperbilirubinemia and skin lesions.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"17 5","pages":"105785"},"PeriodicalIF":1.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276124","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}