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AFP-Negative Hepatocellular Carcinoma: CT Imaging Diagnosis, Differential Diagnosis, AI Applications, and Clinical Management

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  Why Normal Alpha-Fetoprotein Does Not Exclude Liver Cancer: A Comprehensive Radiology and Precision Imaging Guide Clinical Hook "Can liver cancer exist even when AFP is completely normal?" A 48-year-old man underwent a routine abdominal ultrasound during a health screening. He had no abdominal pain, no jaundice, and no constitutional symptoms. Surprisingly, ultrasonography revealed a 2 cm hepatic nodule within a cirrhotic liver . Subsequent contrast-enhanced CT demonstrated arterial phase hyperenhancement (APHE) followed by portal venous washout , highly suggestive of hepatocellular carcinoma (HCC). However, his serum alpha-fetoprotein (AFP) level remained within the normal range (<20 ng/mL) . This clinical scenario illustrates one of the most important diagnostic pitfalls in hepatology: normal AFP does not exclude liver cancer. This case underscores why modern liver cancer diagnosis relies heavily on imaging rather than tumor markers alone. Learning Objectives After...
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Aortocoronary Saphenous Vein Graft Aneurysm: A Rare but Life-Threatening Complication After Coronary Artery Bypass Surgery

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  Comprehensive CT Imaging Diagnosis, Radiology Interpretation, Differential Diagnosis, and Clinical Management A Rare Emergency Hidden for Three Decades Imagine a patient who underwent successful coronary artery bypass grafting (CABG) thirty years ago. For decades she lived without major cardiac problems. Then she suddenly developed progressive dyspnea and fatigue. Her electrocardiogram was unremarkable. Troponin levels were normal. At first glance, acute coronary syndrome seemed unlikely. However, one chest radiograph unexpectedly revealed a large mediastinal mass. What appeared to be a mediastinal tumor ultimately proved to be one of the rarest late complications after coronary bypass surgery: Aortocoronary Saphenous Vein Graft Aneurysm (SVG Aneurysm). This uncommon entity illustrates why medical imaging , especially CT scan diagnosis , plays an indispensable role in radiology interpretation and emergency diagnosis . Clinical Case A 78-year-old woman presented to the emergency...
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