Andres Antonio Labra, Giancarlo Schiappacasse, Rolando Alfonso Cocio, Jorge Tomás Torres, Fernando Omar González, Joaquin Alberto Cristi, Marcela Schultz
{"title":"Secondary rectal linitis plastica caused by prostatic adenocarcinoma - magnetic resonance imaging findings and dissemination pathways: A case report.","authors":"Andres Antonio Labra, Giancarlo Schiappacasse, Rolando Alfonso Cocio, Jorge Tomás Torres, Fernando Omar González, Joaquin Alberto Cristi, Marcela Schultz","doi":"10.4329/wjr.v16.i9.473","DOIUrl":"10.4329/wjr.v16.i9.473","url":null,"abstract":"<p><strong>Background: </strong>Secondary rectal linitis plastica (RLP) from prostatic adenocarcinoma is a rare and poorly understood form of metastatic spread, characterized by a desmoplastic response and concentric rectal wall infiltration with mucosal preservation. This complicates endoscopic diagnosis and can mimic gastrointestinal malignancies. This case series underscores the critical role of magnetic resonance imaging (MRI) in identifying the distinct imaging features of RLP and highlights the importance of considering this condition in the differential diagnosis of patients with a history of prostate cancer.</p><p><strong>Case summary: </strong>Three patients with secondary RLP due to prostatic adenocarcinoma presented with varied clinical features. The first patient, a 76-year-old man with advanced prostate cancer, had rectal pain and incontinence. MRI showed diffuse prostatic invasion and significant rectal wall thickening with a characteristic \"target sign\" pattern. The second, a 57-year-old asymptomatic man with elevated prostate-specific antigen levels and a history of prostate cancer exhibited rectoprostatic angle involvement and rectal wall thickening on MRI, with positron emission tomography/computed tomography PSMA confirming the prostatic origin of the metastatic spread. The third patient, an 80-year-old post-radical prostatectomy, presented with refractory constipation. MRI revealed a neoplastic mass infiltrating the rectal wall. In all cases, MRI consistently showed stratified thickening, concentric signal changes, restricted diffusion, and contrast enhancement, which were essential for diagnosing secondary RLP. Biopsies confirmed the prostatic origin of the neoplastic involvement in the rectum.</p><p><strong>Conclusion: </strong>Recognizing MRI findings of secondary RLP is essential for accurate diagnosis and management in prostate cancer patients.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 9","pages":"473-481"},"PeriodicalIF":1.4,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362144","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":"Perianal tuberculous ulcer with active pulmonary, intestinal and orificial tuberculosis: A case report.","authors":"Bao Yuan, Chao-Qun Ma","doi":"10.4329/wjr.v16.i8.356","DOIUrl":"10.4329/wjr.v16.i8.356","url":null,"abstract":"<p><strong>Background: </strong>Orificial tuberculosis is a rare type of tuberculosis, which is easy to be misdiagnosed, and can cause great damage to the perianal skin and mucosa. Early diagnosis can avoid further erosion of the perianal muscle tissue by tuberculosis bacteria.</p><p><strong>Case summary: </strong>Here, we report a case of disseminated tuberculosis in a 62-year-old male patient with a perianal tuberculous ulcer and active pulmonary tuberculosis, intestinal tuberculosis and orificial tuberculosis. This is an extremely rare case of cutaneous tuberculosis of the anus, which was misdiagnosed for nearly a year. The patient received conventional treatment in other medical institutions, but specific treatment was delayed. Ultimately, proper diagnosis and treatment with standard anti-tuberculosis drugs for one year led to complete cure.</p><p><strong>Conclusion: </strong>For skin ulcers that do not heal with repeated conventional treatments, consider ulcers caused by rare bacteria, such as <i>Mycobacterium tuberculosis</i>.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"356-361"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141257","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":"Direct visualization of postoperative aortobronchial fistula on computed tomography.","authors":"Nanae Tsuchiya, Hitoshi Inafuku, Satoko Yogi, Yuko Iraha, Gyo Iida, Mizuki Ando, Takaaki Nagano, Shotaro Higa, Tatsuya Maeda, Yuya Kise, Kojiro Furukawa, Koji Yonemoto, Akihiro Nishie","doi":"10.4329/wjr.v16.i8.337","DOIUrl":"10.4329/wjr.v16.i8.337","url":null,"abstract":"<p><strong>Background: </strong>Postoperative aortobronchial fistula (ABF) is a rare complication that can occur in 0.3%-5.0% of patients over an extended period of time after thoracic aortic surgery. Direct visualization of the fistula <i>via</i> imaging is rare.</p><p><strong>Aim: </strong>To investigate the relationship between computed tomography (CT) findings and the clinical signs/symptoms of ABF after thoracic aortic surgery.</p><p><strong>Methods: </strong>Six patients (mean age 71 years, including 4 men and 2 women) with suspected ABF on CT (air around the graft) at our hospital were included in this retrospective study between January 2004 and September 2022. Chest CT findings included direct confirmation of ABF, peri-graft fluid, ring enhancement, dirty fat sign, atelectasis, pulmonary hemorrhage, and bronchodilation, and the clinical course were retrospectively reviewed. The proportion of each type of CT finding was calculated.</p><p><strong>Results: </strong>ABF detection after surgery was found to have a mean and median of 14 and 13 years, respectively. Initial signs and symptoms were asymptomatic in 4 patients, bloody sputum was found in 1 patient, and fever was present in 1 patient. The complications of ABF included graft infection in 2 patients and graft infection with hemoptysis in 2 patients. Of the 6 patients, 3 survived, 2 died, and 1 was lost to follow-up. The locations of the ABFs were as follows: 1 in the ascending aorta; 1 in the aortic arch; 2 in the aortic arch leading to the descending aorta; and 2 in the descending aorta. ABFs were directly confirmed by CT in 4/6 (67%) patients. Peri-graft dirty fat (4/6, 67%) and peri-graft ring enhancement (3/6, 50%) were associated with graft infection, endoleaks and pseudoaneurysms were associated with hemoptysis (2/6, 33%).</p><p><strong>Conclusion: </strong>Asymptomatic ABF after thoracic aortic surgery can be confirmed on chest CT. CT is useful for the diagnosis of ABF and its complications.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"337-347"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141255","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}
Zhu-Qin Li, Wu Liu, Wei-Liang Luo, Su-Qin Chen, Yu-Ping Deng
{"title":"Artificial intelligence software for assessing brain ischemic penumbra/core infarction on computed tomography perfusion: A real-world accuracy study.","authors":"Zhu-Qin Li, Wu Liu, Wei-Liang Luo, Su-Qin Chen, Yu-Ping Deng","doi":"10.4329/wjr.v16.i8.329","DOIUrl":"10.4329/wjr.v16.i8.329","url":null,"abstract":"<p><strong>Background: </strong>With the increasingly extensive application of artificial intelligence (AI) in medical systems, the accuracy of AI in medical diagnosis in the real world deserves attention and objective evaluation.</p><p><strong>Aim: </strong>To investigate the accuracy of AI diagnostic software (Shukun) in assessing ischemic penumbra/core infarction in acute ischemic stroke patients due to large vessel occlusion.</p><p><strong>Methods: </strong>From November 2021 to March 2022, consecutive acute stroke patients with large vessel occlusion who underwent mechanical thrombectomy (MT) post-Shukun AI penumbra assessment were included. Computed tomography angiography (CTA) and perfusion exams were analyzed by AI, reviewed by senior neurointerventional experts. In the case of divergences among the three experts, discussions were held to reach a final conclusion. When the results of AI were inconsistent with the neurointerventional experts' diagnosis, the diagnosis by AI was considered inaccurate.</p><p><strong>Results: </strong>A total of 22 patients were included in the study. The vascular recanalization rate was 90.9%, and 63.6% of patients had modified Rankin scale scores of 0-2 at the 3-month follow-up. The computed tomography (CT) perfusion diagnosis by Shukun (AI) was confirmed to be invalid in 3 patients (inaccuracy rate: 13.6%).</p><p><strong>Conclusion: </strong>AI (Shukun) has limits in assessing ischemic penumbra. Integrating clinical and imaging data (CT, CTA, and even magnetic resonance imaging) is crucial for MT decision-making.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"329-336"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141254","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}
Ran Ma, Yan-Mei Wang, Hua Guan, Li Zhang, Wei Zhang, Ling-Cai Chen
{"title":"Pulmonary abscess caused by <i>Streptococcus pseudopneumoniae</i> in a child: A case report and review of literature.","authors":"Ran Ma, Yan-Mei Wang, Hua Guan, Li Zhang, Wei Zhang, Ling-Cai Chen","doi":"10.4329/wjr.v16.i8.362","DOIUrl":"10.4329/wjr.v16.i8.362","url":null,"abstract":"<p><strong>Background: </strong>Lung abscess found on chest X-ray and computed tomography examinations is rare in infants and young children. Several pathogens can cause lung abscesses, with the most common pathogens being anaerobes, <i>Streptococci</i> and <i>Staphylococcus aureus. Streptococcus pseudopneumoniae</i> (<i>S. pseudopneumoniae</i>) is a member of the <i>Streptococcaceae</i> family, and is mainly isolated from respiratory tract specimens. There are currently no cases of lung abscess caused by <i>S. pseudopneumoniae</i> in the literature.</p><p><strong>Case summary: </strong>A 2-year-old boy was admitted to hospital due to persistent cough and fever. Lung computed tomography examination suggested the formation of a lung abscess. His diagnosis was not confirmed by testing for serum respiratory pathogens (6 items), respiratory pathogen nucleic acid (27 items), and laboratory culture. Finally, metagenomic next-generation sequencing of bronchoalveolar lavage fluid revealed the presence of <i>S. pseudopneumoniae</i>, confirming its role in causing the lung abscess. After receiving antibiotic treatment, reexamination with lung computed tomography showed that the abscess was resorbed and the patient's outcome was good.</p><p><strong>Conclusion: </strong>This is the first report of a lung abscess in a child caused by <i>S. pseudopneumoniae</i> infection. Metagenomic next-generation sequencing of bronchoalveolar lavage fluid is helpful in achieving rapid and accurate pathogen identification.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"362-370"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141259","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}
Woongsoon John Choi, Peggy Lee, Penelope C Thomas, Tanya J Rath, Monique A Mogensen, Roberta W Dalley, Pattana Wangaryattawanich
{"title":"Imaging approach for jaw and maxillofacial bone tumors with updates from the 2022 World Health Organization classification.","authors":"Woongsoon John Choi, Peggy Lee, Penelope C Thomas, Tanya J Rath, Monique A Mogensen, Roberta W Dalley, Pattana Wangaryattawanich","doi":"10.4329/wjr.v16.i8.294","DOIUrl":"10.4329/wjr.v16.i8.294","url":null,"abstract":"<p><p>Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic pathologies. These lesions can arise from various tissues, including bone, cartilage, and soft tissue, each presenting distinct challenges in diagnosis and treatment. While some pathologies exhibit characteristic imaging features that aid in diagnosis, many others are nonspecific. This overlap often necessitates a multimodal imaging approach, combining techniques such as radiographs, computed tomography, and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic considerations. This article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors, including updates on the 2022 World Health Organization classification of these tumors. The relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"294-316"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142319","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}
Zhen-Kun Xiao, Yong-Hong Duan, Xin-Yu Mao, Ri-Chu Liang, Min Zhou, Yong-Mei Yang
{"title":"Traditional craniotomy versus current minimally invasive surgery for spontaneous supratentorial intracerebral haemorrhage: A propensity-matched analysis.","authors":"Zhen-Kun Xiao, Yong-Hong Duan, Xin-Yu Mao, Ri-Chu Liang, Min Zhou, Yong-Mei Yang","doi":"10.4329/wjr.v16.i8.317","DOIUrl":"10.4329/wjr.v16.i8.317","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery (MIS) and craniotomy (CI) are the current treatments for spontaneous supratentorial cerebral haemorrhage (SSTICH).</p><p><strong>Aim: </strong>To compare the efficacy and safety of MIS and CI for the treatment of SSTICH.</p><p><strong>Methods: </strong>Clinical and imaging data of 557 consecutive patients with SSTICH who underwent MIS or CI between January 2017 and December 2022 were retrospectively analysed. The patients were divided into two subgroups: The MIS group and CI group. Propensity score matching was performed to minimise case selection bias. The primary outcome was a dichotomous prognostic (favourable or unfavourable) outcome based on the modified Rankin Scale (mRS) score at 3 months; an mRS score of 0-2 was considered favourable.</p><p><strong>Results: </strong>In both conventional statistical and binary logistic regression analyses, the MIS group had a better outcome. The outcome of propensity score matching was unexpected (odds ratio: 0.582; 95%CI: 0.281-1.204; <i>P</i> = 0.144), which indicated that, after excluding the interference of each confounder, different surgical modalities were more effective, and there was no significant difference in their prognosis.</p><p><strong>Conclusion: </strong>Deciding between MIS and CI should be made based on the individual patient, considering the hematoma size, degree of midline shift, cerebral swelling, and preoperative Glasgow Coma Scale score.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"317-328"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141260","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}
Peng Guo, Wei Sun, Ling-Xie Song, Wen-Yu Cao, Jin-Ping Li
{"title":"Multimodal imaging for the diagnosis of oligodendroglioma associated with arteriovenous malformation: A case report.","authors":"Peng Guo, Wei Sun, Ling-Xie Song, Wen-Yu Cao, Jin-Ping Li","doi":"10.4329/wjr.v16.i8.348","DOIUrl":"10.4329/wjr.v16.i8.348","url":null,"abstract":"<p><strong>Background: </strong>The rare co-occurrence of oligodendroglioma and arteriovenous malformation (AVM) in the same intracranial location.</p><p><strong>Case summary: </strong>In a 61-year-old man presenting with progressive headaches, is described in this case study. Preoperative multimodal imaging techniques (computed tomography, magnetic resonance imaging, magnetic resonance spectroscopy, digital subtraction angiography, and computed tomography angiography) were employed to detect hemorrhage, cystic and solid lesions, and arteriovenous shunting in the right temporal lobe. The patient underwent right temporal craniotomy for lesion removal, and postoperative pathological analysis confirmed the presence of oligodendroglioma (World Health Organization grade II, not otherwise specified) and AVM.</p><p><strong>Conclusion: </strong>The preoperative utilization of multimodal imaging examination can help clinicians reduce the likelihood of misdiagnosis or oversight of these conditions, and provides important information for subsequent treatment. This case supports the feasibility of craniotomy for the removal of glioma with AVM.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"348-355"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141256","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":"Plea to radiologists: Please consider Mahvash disease when encountering an enlarged pancreas.","authors":"Run Yu","doi":"10.4329/wjr.v16.i8.371","DOIUrl":"10.4329/wjr.v16.i8.371","url":null,"abstract":"<p><p>Radiologists play a key role in establishing an early and accurate diagnosis, especially for rare diseases. Mahvash disease (OMIM 619290) is an autosomal recessive hereditary disease caused by inactivating mutations of the glucagon receptor and its main clinical consequences are pancreatic neuroendocrine tumors and in some cases, porto-sinusoidal vascular disease and portal hypertension. Untreated Mahvash disease can be lethal. The diagnosis of Mahvash disease has almost always been delayed in the past due to radiologists' unawareness of or unfamiliarity with the unique imaging features of Mahvash disease which are moderately to enormously enlarge pancreas with preserved pancreas contour and parenchyma without vascular involvement or lymphadenopathy. These features help differentiate Mahvash disease from other etiologies of diffusely enlarged pancreas such as diffuse pancreatic ductal carcinoma, diffuse pancreatic lymphoma, and autoimmune pancreatitis. Invoking Mahvash disease in the differential diagnosis of an enlarged pancreas has recently been shown to facilitate early diagnosis. To prevent missing the diagnosis of this significant disease, I sincerely ask radiologists to consider Mahvash disease in their differential diagnoses of diffusely enlarged pancreas.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 8","pages":"371-374"},"PeriodicalIF":1.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141258","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":"Comparison between solid pseudopapillary neoplasms of the pancreas and pancreatic ductal adenocarcinoma with cystic changes using computed tomography.","authors":"Shuai Ren, Li-Chao Qian, Xiao-Jing Lv, Ying-Ying Cao, Marcus J Daniels, Zhong-Qiu Wang, Li-Na Song, Ying Tian","doi":"10.4329/wjr.v16.i6.211","DOIUrl":"10.4329/wjr.v16.i6.211","url":null,"abstract":"<p><strong>Background: </strong>Solid pseudopapillary neoplasms of the pancreas (SPN) share similar imaging findings with pancreatic ductal adenocarcinoma with cystic changes (PDAC with cystic changes), which may result in unnecessary surgery.</p><p><strong>Aim: </strong>To investigate the value of computed tomography (CT) in differentiation of SPN from PDAC with cystic changes.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical and imaging findings of 32 patients diagnosed with SPN and 14 patients diagnosed with PDAC exhibiting cystic changes, confirmed through pathological diagnosis. Quantitative and qualitative analysis was performed, including assessment of age, sex, tumor size, shape, margin, density, enhancement pattern, CT values of tumors, CT contrast enhancement ratios, \"floating cloud sign,\" calcification, main pancreatic duct dilatation, pancreatic atrophy, and peripancreatic invasion or distal metastasis. Multivariate logistic regression analysis was used to identify relevant features to differentiate between SPN and PDAC with cystic changes, and receiver operating characteristic curves were obtained to evaluate the diagnostic performance of each variable and their combination.</p><p><strong>Results: </strong>When compared to PDAC with cystic changes, SPN had a lower age (32 years <i>vs</i> 64 years, <i>P</i> < 0.05) and a slightly larger size (5.41 cm <i>vs</i> 3.90 cm, <i>P</i> < 0.05). SPN had a higher frequency of \"floating cloud sign\" and peripancreatic invasion or distal metastasis than PDAC with cystic changes (both <i>P</i> < 0.05). No significant difference was found with respect to sex, tumor location, shape, margin, density, main pancreatic duct dilatation, calcification, pancreatic atrophy, enhancement pattern, CT values of tumors, or CT contrast enhancement ratios between the two groups (all <i>P ></i> 0.05). The area under the receiver operating characteristic curve of the combination was 0.833 (95% confidence interval: 0.708-0.957) with 78.6% sensitivity, 81.3% specificity, and 80.4% accuracy in differentiation of SPN from PDAC with cystic changes.</p><p><strong>Conclusion: </strong>A larger tumor size, \"floating cloud sign,\" and peripancreatic invasion or distal metastasis are useful CT imaging features that are more common in SPN and may help discriminate SPN from PDAC with cystic changes.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 6","pages":"211-220"},"PeriodicalIF":1.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564631","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}