O. Osunde, K. Omeje, A. Efunkoya, I. Amole, Benjamin I. Akhiwu
Background: Any discrepancy between clinical and radiographic information may have dire consequences on the optimal care of patients. Aim: The aim of this study was to determine the correlation between the clinical and radiographic findings in oral and maxillofacial surgery patients. Materials and Methods: This was a retrospective study of all patients with plain radiographic views of the oral and maxillofacial region, seen at a Nigerian Teaching Hospital, over a 3-year study period. The radiographs and patients' case files were retrieved and demographic, clinical as well as radiographic information were obtained. Radiographic information obtained included source and types of the radiographs, patients' bio-data, side and site of the pathology, clinical indication, labeling on the radiograph as well as interpretation errors in form of missed diagnosis other than missed fractures. The data were analyzed using SPSS version 13. Cohen's kappa agreement test was done between clinical and radiographic information.P <0.05 was considered significant. Results: Radiographs from 156 patients aged 8–80 years, mean (standard deviation), 37.9 (19.22) years, were reviewed. There were 102 males and 54 females. Trauma (n = 54; 34.6%) was the most common indication for radiographs. “Transposition” of side of the lesions accounted for 9 (5.8%) of the cases. Radiographic “transposition” was significantly associated with facial fractures, temporomandibular joint ankylosis, and impacted mandibular third molars (likelihood ratio: χ2 = 16.930; df = 10;P = 0.03). There was some disagreement between clinical and radiographic information with regard to side (kappa = 0.788;P = 0.001). Conclusion: Discrepancies in the side of lesions, between clinical and radiographic information, were observed in this study. Adequate care should be taken by clinicians and radiologists to minimize errors in radiographs.
{"title":"Clinico-radiologic correlates of oral and maxillofacial radiographs: A 3-year study of 156 patients in a Nigerian teaching hospital","authors":"O. Osunde, K. Omeje, A. Efunkoya, I. Amole, Benjamin I. Akhiwu","doi":"10.4103/wajr.wajr_1_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_1_18","url":null,"abstract":"Background: Any discrepancy between clinical and radiographic information may have dire consequences on the optimal care of patients. Aim: The aim of this study was to determine the correlation between the clinical and radiographic findings in oral and maxillofacial surgery patients. Materials and Methods: This was a retrospective study of all patients with plain radiographic views of the oral and maxillofacial region, seen at a Nigerian Teaching Hospital, over a 3-year study period. The radiographs and patients' case files were retrieved and demographic, clinical as well as radiographic information were obtained. Radiographic information obtained included source and types of the radiographs, patients' bio-data, side and site of the pathology, clinical indication, labeling on the radiograph as well as interpretation errors in form of missed diagnosis other than missed fractures. The data were analyzed using SPSS version 13. Cohen's kappa agreement test was done between clinical and radiographic information.P <0.05 was considered significant. Results: Radiographs from 156 patients aged 8–80 years, mean (standard deviation), 37.9 (19.22) years, were reviewed. There were 102 males and 54 females. Trauma (n = 54; 34.6%) was the most common indication for radiographs. “Transposition” of side of the lesions accounted for 9 (5.8%) of the cases. Radiographic “transposition” was significantly associated with facial fractures, temporomandibular joint ankylosis, and impacted mandibular third molars (likelihood ratio: χ2 = 16.930; df = 10;P = 0.03). There was some disagreement between clinical and radiographic information with regard to side (kappa = 0.788;P = 0.001). Conclusion: Discrepancies in the side of lesions, between clinical and radiographic information, were observed in this study. Adequate care should be taken by clinicians and radiologists to minimize errors in radiographs.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43253486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Neuroimaging plays an important role in stroke management by providing information to accurately triage patients, expedite clinical decision with regard to treatment, and in improving outcomes in patients presenting with stroke. The aim of this study is to determine the spectrum of computed tomography (CT) findings in patients with stroke with respect to the type of lesion, location, and possible risk factors. Materials and Methods: This was a retrospective study with data compiled from medical files and cranial CT scan images of 148 patients clinically diagnosed with stroke conducted over a period of 36 months from the Department of Radiology, University of Abuja Teaching Hospital. Results: There were 148 patients with complete data who were clinically diagnosed with stroke. From cranial CT findings, 56.1% of patients studied had cerebral infarct, 41.2% hemorrhage, and 2.7% normal findings. The gender distribution of cranial CT findings was not statistically significant (P = 0.09 for males andP = 0.07 for females). The parietal lobe was the most affected site for hemorrhage and infarcts accounting for 31.1% and 49.4%, respectively. The cerebellum was the least affected site. The two most commonly documented risk factors identified in this study were hypertension and diabetes mellitus accounting for 61.9%. Conclusion: Cerebral infarct was the most common computed tomographic finding among patients with stroke, and the parietal lobe was the most common location for infarct and hemorrhage. Hypertension was a major risk factor for stroke. CT is an important imaging modality for diagnosis, differentiating infarct from hemorrhage in stroke management.
{"title":"Cranial computed tomography imaging of patients with stroke in a tertiary facility","authors":"H. kolade-Yunusa, I. Yaro, L. Yusuf","doi":"10.4103/wajr.wajr_2_19","DOIUrl":"https://doi.org/10.4103/wajr.wajr_2_19","url":null,"abstract":"Background: Neuroimaging plays an important role in stroke management by providing information to accurately triage patients, expedite clinical decision with regard to treatment, and in improving outcomes in patients presenting with stroke. The aim of this study is to determine the spectrum of computed tomography (CT) findings in patients with stroke with respect to the type of lesion, location, and possible risk factors. Materials and Methods: This was a retrospective study with data compiled from medical files and cranial CT scan images of 148 patients clinically diagnosed with stroke conducted over a period of 36 months from the Department of Radiology, University of Abuja Teaching Hospital. Results: There were 148 patients with complete data who were clinically diagnosed with stroke. From cranial CT findings, 56.1% of patients studied had cerebral infarct, 41.2% hemorrhage, and 2.7% normal findings. The gender distribution of cranial CT findings was not statistically significant (P = 0.09 for males andP = 0.07 for females). The parietal lobe was the most affected site for hemorrhage and infarcts accounting for 31.1% and 49.4%, respectively. The cerebellum was the least affected site. The two most commonly documented risk factors identified in this study were hypertension and diabetes mellitus accounting for 61.9%. Conclusion: Cerebral infarct was the most common computed tomographic finding among patients with stroke, and the parietal lobe was the most common location for infarct and hemorrhage. Hypertension was a major risk factor for stroke. CT is an important imaging modality for diagnosis, differentiating infarct from hemorrhage in stroke management.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44414766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Intracardiac echogenic focus (ICEF) is defined as a small bright structure within the fetal heart with similar or greater echogenicity to the surrounding bone. The cause of ICEF is unknown, although it is generally believed to be a normal variant. However, several authors have reported a possible association between an ICEF and chromosomal abnormalities, while some others have found an association with structural cardiac anomalies. There are presently no data on this subject in sub-Saharan Africa about the possible correlation with other anomalies. Materials and Methods: This was a prospective, cross-sectional, hospital-based study in a native West African population that spanned 5 years and 5 months. All the pregnant women who presented for routine prenatal ultrasound screening for fetal anomaly between 18 and 22 weeks' gestation age during the study period were included in the study. The prevalence and pattern of ICEF and correlations with cardiac anomalies were determined. Results: In this study, 1.986 fetuses were evaluated for ICEF. The prevalence of ICEF was 2.2%, and more commonly (38.6%) seen in fetuses of mothers aged 30–34 years. Twenty-five percent (25%) occurred in fetuses of mothers that are older than 35 years. Most cases (65.7%) occurred in mothers that had no risk factors for the cardiac anomaly. Majority of the ICEF were solitary and within the left ventricle (95.5% and 93.2%, respectively). About 2.3% of the ICEF were biventricular. Among those that had further echocardiographic evaluation, 15% had major structural cardiac defects. Conclusion: A left ventricular ICEF may not indicate a normal variant in all cases. We propose the addition of detailed fetal echocardiography to rule out structural cardiac anomalies.
{"title":"Intracardiac echogenic focus: Its importance during routine prenatal ultrasound screening in a black African population","authors":"J. Akinmoladun, B. Adebayo, A. Adekanmi","doi":"10.4103/wajr.wajr_25_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_25_18","url":null,"abstract":"Background: Intracardiac echogenic focus (ICEF) is defined as a small bright structure within the fetal heart with similar or greater echogenicity to the surrounding bone. The cause of ICEF is unknown, although it is generally believed to be a normal variant. However, several authors have reported a possible association between an ICEF and chromosomal abnormalities, while some others have found an association with structural cardiac anomalies. There are presently no data on this subject in sub-Saharan Africa about the possible correlation with other anomalies. Materials and Methods: This was a prospective, cross-sectional, hospital-based study in a native West African population that spanned 5 years and 5 months. All the pregnant women who presented for routine prenatal ultrasound screening for fetal anomaly between 18 and 22 weeks' gestation age during the study period were included in the study. The prevalence and pattern of ICEF and correlations with cardiac anomalies were determined. Results: In this study, 1.986 fetuses were evaluated for ICEF. The prevalence of ICEF was 2.2%, and more commonly (38.6%) seen in fetuses of mothers aged 30–34 years. Twenty-five percent (25%) occurred in fetuses of mothers that are older than 35 years. Most cases (65.7%) occurred in mothers that had no risk factors for the cardiac anomaly. Majority of the ICEF were solitary and within the left ventricle (95.5% and 93.2%, respectively). About 2.3% of the ICEF were biventricular. Among those that had further echocardiographic evaluation, 15% had major structural cardiac defects. Conclusion: A left ventricular ICEF may not indicate a normal variant in all cases. We propose the addition of detailed fetal echocardiography to rule out structural cardiac anomalies.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49245149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vascular aneurysms are common in the arteries and rare in the veins. Internal jugular vein (IJV) aneurysm is a relatively rare condition. The patient presented with a painless swelling on the right side of the neck that appears while coughing, straining, and bending. Detection of a soft and compressible swelling in the course of IJV, superficial to the sternocleidomastoid muscle, which resolves on compression and becomes prominent on Valsalva maneuver supports the clinical diagnosis of IJV aneurysm. Imaging diagnosis was done by color Doppler ultrasound, and precise delineation of the lesion was done with multidetector computed tomography. There was no thrombus within aneurysm.
{"title":"A rare case report of internal jugular vein aneurysm","authors":"Shrishail Adke, P. Shaha, K. Sahoo, P. Patil","doi":"10.4103/wajr.wajr_9_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_9_18","url":null,"abstract":"Vascular aneurysms are common in the arteries and rare in the veins. Internal jugular vein (IJV) aneurysm is a relatively rare condition. The patient presented with a painless swelling on the right side of the neck that appears while coughing, straining, and bending. Detection of a soft and compressible swelling in the course of IJV, superficial to the sternocleidomastoid muscle, which resolves on compression and becomes prominent on Valsalva maneuver supports the clinical diagnosis of IJV aneurysm. Imaging diagnosis was done by color Doppler ultrasound, and precise delineation of the lesion was done with multidetector computed tomography. There was no thrombus within aneurysm.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49286290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Radiation dose depends on the total workload (Wtot) which is affected by the number of patients, tube potential, and tube current. Despite the increment in patients visiting the X-ray units under study and X-ray tube revolutions, changes have not been made in the shielding material to suit the current situation. Aims: This study aims to evaluate the thickness of X-ray shielding barriers in two tertiary hospitals in Kano Metropolis using XRAYBAR software. Materials and Methods: This was a prospective, cross-sectional study and was undertaken from March 2017 to October 2017. A purposive sampling technique was employed to select two hospitals out of five. The two were named A and B, respectively. The minimum required thickness in each barrier was determined by XRAYBAR software. Results: The Wtot (workload) for room I, II and III was found to be 199.9, 146, and 149.1 mA-min per week. The shielding barrier thickness required to reduce the unshielded radiation dose to the design dose limit for wall 1, 2, 3, 4, and operating console of the Room I was found to be 17.5, 5.5, 0.2, 0.00, 3.3 cm, that of wall 1, 2, 3, and 4 of room II was found to be 9.1, 3.4, 0.02, 2.3 cm, while for the wall 1, 2, 3, 4, and operating console of room III was found to be 12.3, 4.8, 3.8, 3.2, and 26.5 cm, respectively. Conclusion: The calculated shielding barrier thickness from XRAYBARR code when compared to the design barrier thickness was found to be adequate.
背景：辐射剂量取决于总工作量（Wtot），而总工作量受患者数量、管电位和管电流的影响。尽管访问研究中的X射线装置和X射线管旋转的患者人数有所增加，但屏蔽材料尚未做出改变以适应当前情况。目的：本研究旨在使用XRAYBAR软件评估卡诺大都会两家三级医院的X射线屏蔽屏障厚度。材料和方法：这是一项前瞻性的横断面研究，于2017年3月至2017年10月进行。采用有目的的抽样技术从五家医院中选择两家。这两个分别被命名为A和B。通过XRAYBAR软件确定每个屏障中所需的最小厚度。结果：I、II和III室的Wtot（工作量）分别为199.9、146和149.1 mA min/周。将非屏蔽辐射剂量降低到设计剂量限值所需的屏蔽屏障厚度为17.5、5.5、0.2、0.00、3.3 cm，房间I的墙壁1、2、3和4的厚度为9.1、3.4、0.02、2.3 cm，而房间III的墙壁1，2、3、4和操作台的厚度为12.3、4.8、3.8、3.2，和26.5厘米。结论：与设计屏障厚度相比，XRAYBARR代码计算的屏蔽屏障厚度是足够的。
{"title":"Determination of X-ray shielding thickness in two tertiary hospitals in Kano metropolis, Nigeria","authors":"A. Abubakar, M. Sidi","doi":"10.4103/wajr.wajr_28_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_28_18","url":null,"abstract":"Background: Radiation dose depends on the total workload (Wtot) which is affected by the number of patients, tube potential, and tube current. Despite the increment in patients visiting the X-ray units under study and X-ray tube revolutions, changes have not been made in the shielding material to suit the current situation. Aims: This study aims to evaluate the thickness of X-ray shielding barriers in two tertiary hospitals in Kano Metropolis using XRAYBAR software. Materials and Methods: This was a prospective, cross-sectional study and was undertaken from March 2017 to October 2017. A purposive sampling technique was employed to select two hospitals out of five. The two were named A and B, respectively. The minimum required thickness in each barrier was determined by XRAYBAR software. Results: The Wtot (workload) for room I, II and III was found to be 199.9, 146, and 149.1 mA-min per week. The shielding barrier thickness required to reduce the unshielded radiation dose to the design dose limit for wall 1, 2, 3, 4, and operating console of the Room I was found to be 17.5, 5.5, 0.2, 0.00, 3.3 cm, that of wall 1, 2, 3, and 4 of room II was found to be 9.1, 3.4, 0.02, 2.3 cm, while for the wall 1, 2, 3, 4, and operating console of room III was found to be 12.3, 4.8, 3.8, 3.2, and 26.5 cm, respectively. Conclusion: The calculated shielding barrier thickness from XRAYBARR code when compared to the design barrier thickness was found to be adequate.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45241765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Grace Bayewu, A. Ogunseyinde, O. Atalabi, G. Ogun, A. Adetona
Objective: The aim of the study was to correlate the sonographic (ultrasound [US]) and color flow Doppler findings with the results of US-guided fine-needle aspiration biopsy. Materials and Methods: This is a cross-sectional study conducted in the ultrasound suite of our hospital, South Western, Nigeria. It is a cross-sectional study on 110 adult patients with clinically palpable thyroid nodule(s) in our hospital. Sonographic scans of 110 thyroid nodules in 110 patients were performed, and characteristics of thyroid nodules that were studied included microcalcifications, an irregular or microlobulated margins, marked hypoechogenicity/hypoechogenicity, a shape that was taller than it was wide, and color flow pattern in Color Doppler ultrasound. The presence and absence of characteristics of nodules were classified as having positive or negative findings, respectively. Results: Among 110 solid thyroid nodules, 23 lesions were classified as positive considering the sonographic characteristics and 9 of them were proved to be malignant on histopathology. Of 87 lesions which were classified as negative, none was proved to be malignant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value based on our sonographic classification method were 100%, 86%, 36%, and 100%, respectively. Conclusion: This study showed that ultrasound can be sensitive and specific for thyroid nodules but the PPV is low.
{"title":"Comparison of the diagnostic performance of ultrasonography with fine-needle aspiration cytology in thyroid nodules","authors":"Grace Bayewu, A. Ogunseyinde, O. Atalabi, G. Ogun, A. Adetona","doi":"10.4103/wajr.wajr_30_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_30_18","url":null,"abstract":"Objective: The aim of the study was to correlate the sonographic (ultrasound [US]) and color flow Doppler findings with the results of US-guided fine-needle aspiration biopsy. Materials and Methods: This is a cross-sectional study conducted in the ultrasound suite of our hospital, South Western, Nigeria. It is a cross-sectional study on 110 adult patients with clinically palpable thyroid nodule(s) in our hospital. Sonographic scans of 110 thyroid nodules in 110 patients were performed, and characteristics of thyroid nodules that were studied included microcalcifications, an irregular or microlobulated margins, marked hypoechogenicity/hypoechogenicity, a shape that was taller than it was wide, and color flow pattern in Color Doppler ultrasound. The presence and absence of characteristics of nodules were classified as having positive or negative findings, respectively. Results: Among 110 solid thyroid nodules, 23 lesions were classified as positive considering the sonographic characteristics and 9 of them were proved to be malignant on histopathology. Of 87 lesions which were classified as negative, none was proved to be malignant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value based on our sonographic classification method were 100%, 86%, 36%, and 100%, respectively. Conclusion: This study showed that ultrasound can be sensitive and specific for thyroid nodules but the PPV is low.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42347608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maneet Kaur, Paramdeep Singh, K. Saggar, R. Kaushal, R. Bansal
Background and Aim: There are several unanswered queries related to normal pressure hydrocephalus (NPH) regarding the diagnostic criteria and selection of appropriate patients for shunt surgery. This study aimed to evaluate the utility of cine phase-contrast (CPC) magnetic resonance imaging (MRI) in the management of patients with NPH. Patients and Methods: In this prospective study, MRI analysis was done on 1.5 Tesla scanner in 20 patients who presented with clinical features and routine MRI findings which were suggestive of NPH. CPC MRI and clinical assessment were performed before and after a high-volume cerebrospinal fluid (CSF) tap by lumbar puncture. Out of these twenty participants, ten underwent ventriculoperitoneal (VP) shunting. Clinical assessment was also done after VP shunting. CSF flow through the aqueduct was also evaluated in twenty age- and sex-matched controls. Results: There was a statistically significant difference between aqueductal flow void score in cases and controls. However, no significant difference in flow void was seen after the tap or after the shunt. There was also a statistically significant difference between the values of stroke volume (SV) in cases and controls. Very high SVs (>50 μL) correlated with marked clinical improvement after the tap and after the shunt. Mildly elevated SV did not help in making any interpretation regarding the usefulness of shunt. There was also a statistically significant difference between the values of peak velocity (PV) in cases and controls. Patients with PV >10 cm/s and with a fall of ≥2 cm/s after tap significantly correlated with clinical improvement. Conclusions: CPC MRI is a useful adjunctive technique to support the diagnosis of NPH as well as in predicting a favorable response to shunt surgery in these patients.
{"title":"Role of cine phase-contrast magnetic resonance imaging in the management of normal pressure hydrocephalus","authors":"Maneet Kaur, Paramdeep Singh, K. Saggar, R. Kaushal, R. Bansal","doi":"10.4103/wajr.wajr_2_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_2_18","url":null,"abstract":"Background and Aim: There are several unanswered queries related to normal pressure hydrocephalus (NPH) regarding the diagnostic criteria and selection of appropriate patients for shunt surgery. This study aimed to evaluate the utility of cine phase-contrast (CPC) magnetic resonance imaging (MRI) in the management of patients with NPH. Patients and Methods: In this prospective study, MRI analysis was done on 1.5 Tesla scanner in 20 patients who presented with clinical features and routine MRI findings which were suggestive of NPH. CPC MRI and clinical assessment were performed before and after a high-volume cerebrospinal fluid (CSF) tap by lumbar puncture. Out of these twenty participants, ten underwent ventriculoperitoneal (VP) shunting. Clinical assessment was also done after VP shunting. CSF flow through the aqueduct was also evaluated in twenty age- and sex-matched controls. Results: There was a statistically significant difference between aqueductal flow void score in cases and controls. However, no significant difference in flow void was seen after the tap or after the shunt. There was also a statistically significant difference between the values of stroke volume (SV) in cases and controls. Very high SVs (>50 μL) correlated with marked clinical improvement after the tap and after the shunt. Mildly elevated SV did not help in making any interpretation regarding the usefulness of shunt. There was also a statistically significant difference between the values of peak velocity (PV) in cases and controls. Patients with PV >10 cm/s and with a fall of ≥2 cm/s after tap significantly correlated with clinical improvement. Conclusions: CPC MRI is a useful adjunctive technique to support the diagnosis of NPH as well as in predicting a favorable response to shunt surgery in these patients.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45956443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: This study aims to establish the role of contrast-enhanced ultrasound (CEUS) and diffusion-weighted (DW) magnetic resonance imaging (MRI) in the characterization of solid liver lesions. Settings and Design: An analysis of 22 patients undergoing CEUS and DW MRI following identification of 1 or more solid liver lesions on conventional ultrasonography. Subjects and Methods: The study is carried in a standard Doppler ultrasound machine with contrast ultrasound capabilities and 1.5T MRI machine over a period of 2 years from July 2015 to June 2017. After baseline US examination, a bolus of 1.0–2.4 ml of ultrasound contrast agent was administered intravenously followed by 10 ml of saline flush. CEUS images were obtained during arterial, portal venous, and delayed phases. After CEUS, patient is transferred to MRI scanning room where the DW imaging (DWI) sequence is taken. The CEUS and DW MRI diagnosis were compared to other imaging modalities, histopathology, and/or clinical follow-up after 12 months. Statistical Analysis Used: Sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate and receiver operating characteristic analysis curve was performed using Statistical Package – SPSS ver. 17.0. Statistical evaluation of qualitative analysis between benign and malignant lesions was performed using the Fisher's exact test. Results: CEUS correctly identified malignant liver lesions in 13 out of 14 cases, with the final diagnosis confirmed by histopathology in 6 cases, by other imaging modalities in 7 cases and follow-up in 1 case. Eight patients were correctly identified as benign liver lesions on CEUS imaging, with all these cases confirmed on other imaging modalities and/or follow-up and two cases by histopathology. In the detection of malignancy, the sensitivity is 86.7% and specificity is 100%. On the DW images the Mean apparent diffusion coefficient (ADC) value for benign lesions is 1.5 and mean ADC value for malignant lesions is 0.7. The ADC was significantly higher in benign lesions than in malignant lesions (P < 0.01). Conclusions: In our experience, CEUS and DWI with ADC values are highly accurate in confirming benign lesions, early detection of malignant lesions, and metastases in known primary malignancy patients. Other advantage of CEUS and DW MRI is that it is also cost-effective as compared to simultaneously performing individual investigations and can be performed in renal insufficiency patients. Hence, we conclude that CEUS and DW MRI sequence should be used in routine practice.
{"title":"Roles of contrast-enhanced ultrasound and diffusion-weighted magnetic resonance imaging and their comparison in solid space-occupying lesions of the liver – Microbubbles and micromovements in imaging","authors":"Santosh Rai, T. Reddy, S. Gopal, S. Shenoy","doi":"10.4103/wajr.wajr_18_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_18_18","url":null,"abstract":"Aims: This study aims to establish the role of contrast-enhanced ultrasound (CEUS) and diffusion-weighted (DW) magnetic resonance imaging (MRI) in the characterization of solid liver lesions. Settings and Design: An analysis of 22 patients undergoing CEUS and DW MRI following identification of 1 or more solid liver lesions on conventional ultrasonography. Subjects and Methods: The study is carried in a standard Doppler ultrasound machine with contrast ultrasound capabilities and 1.5T MRI machine over a period of 2 years from July 2015 to June 2017. After baseline US examination, a bolus of 1.0–2.4 ml of ultrasound contrast agent was administered intravenously followed by 10 ml of saline flush. CEUS images were obtained during arterial, portal venous, and delayed phases. After CEUS, patient is transferred to MRI scanning room where the DW imaging (DWI) sequence is taken. The CEUS and DW MRI diagnosis were compared to other imaging modalities, histopathology, and/or clinical follow-up after 12 months. Statistical Analysis Used: Sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate and receiver operating characteristic analysis curve was performed using Statistical Package – SPSS ver. 17.0. Statistical evaluation of qualitative analysis between benign and malignant lesions was performed using the Fisher's exact test. Results: CEUS correctly identified malignant liver lesions in 13 out of 14 cases, with the final diagnosis confirmed by histopathology in 6 cases, by other imaging modalities in 7 cases and follow-up in 1 case. Eight patients were correctly identified as benign liver lesions on CEUS imaging, with all these cases confirmed on other imaging modalities and/or follow-up and two cases by histopathology. In the detection of malignancy, the sensitivity is 86.7% and specificity is 100%. On the DW images the Mean apparent diffusion coefficient (ADC) value for benign lesions is 1.5 and mean ADC value for malignant lesions is 0.7. The ADC was significantly higher in benign lesions than in malignant lesions (P < 0.01). Conclusions: In our experience, CEUS and DWI with ADC values are highly accurate in confirming benign lesions, early detection of malignant lesions, and metastases in known primary malignancy patients. Other advantage of CEUS and DW MRI is that it is also cost-effective as compared to simultaneously performing individual investigations and can be performed in renal insufficiency patients. Hence, we conclude that CEUS and DW MRI sequence should be used in routine practice.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44915188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Induced abortion is a major cause of infertility in our environment, with postabortal complications commonly occurring, especially when done by untrained medical personnel, and in unsafe environments. Imaging plays a very important role in the assessment of tubal factors as a possible cause of infertility; hence, the choice of hysterosalpingography (HSG) as a vital initial tool in the diagnostic evaluation of these patients. The aim of the study was to determine the relationship between induced abortions and HSG tubal findings in the management of females with infertility. Materials and Methods: This was a cross-sectional descriptive study of 87 HSG's of women being managed for infertility in a private specialist hospital over 2 years from November 2015 to October 2017. Results: The overall mean age of the respondents was 34.09 ± 4.82 years. Most of the respondents were between 30 and 39 years (60.9%) of age, 70 (80.5%) respondents were nulliparous, and 71 (81.6%) had a previous history of induced abortion. Tubal findings were found to be normal in over a third of the respondents (35.6%). The most common abnormal findings were tubal blockage and hydrosalpinx (50.6%). The abnormal tubal findings were significantly associated with a history of more than one induced abortion and nulliparity (P < 0.05). Hydrosalpinx (86.4%) was commonly linked with a previous history of induced abortion, although the difference was not statistically significant (P ≥ 0.05). Conclusions: The study demonstrated that abnormal tubal findings in HSG are more common among women with a history of induced abortion; however, the prevalence of tubal damage had mild correlation with the number of induced abortions.
{"title":"Influence of induced abortion on tubal findings in hysterosalpingography among women with infertility in Calabar, Nigeria","authors":"Ofonime N. Ukweh, Chibuike M. Okeke, Afiong Oku","doi":"10.4103/wajr.wajr_37_18","DOIUrl":"https://doi.org/10.4103/wajr.wajr_37_18","url":null,"abstract":"Background/Aim: Induced abortion is a major cause of infertility in our environment, with postabortal complications commonly occurring, especially when done by untrained medical personnel, and in unsafe environments. Imaging plays a very important role in the assessment of tubal factors as a possible cause of infertility; hence, the choice of hysterosalpingography (HSG) as a vital initial tool in the diagnostic evaluation of these patients. The aim of the study was to determine the relationship between induced abortions and HSG tubal findings in the management of females with infertility. Materials and Methods: This was a cross-sectional descriptive study of 87 HSG's of women being managed for infertility in a private specialist hospital over 2 years from November 2015 to October 2017. Results: The overall mean age of the respondents was 34.09 ± 4.82 years. Most of the respondents were between 30 and 39 years (60.9%) of age, 70 (80.5%) respondents were nulliparous, and 71 (81.6%) had a previous history of induced abortion. Tubal findings were found to be normal in over a third of the respondents (35.6%). The most common abnormal findings were tubal blockage and hydrosalpinx (50.6%). The abnormal tubal findings were significantly associated with a history of more than one induced abortion and nulliparity (P < 0.05). Hydrosalpinx (86.4%) was commonly linked with a previous history of induced abortion, although the difference was not statistically significant (P ≥ 0.05). Conclusions: The study demonstrated that abnormal tubal findings in HSG are more common among women with a history of induced abortion; however, the prevalence of tubal damage had mild correlation with the number of induced abortions.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45596207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Aggarwal, Kavitha Yellur, U. Joish, R. George, H. Swami, Sabarigirish Kanjully
Objective: There is an increased prevalence of congenital sensorineural hearing loss (SNHL) among children born out of consanguineous wedlocks, and congenital deafness is associated with increased prevalence of structural inner-ear malformations. This study is done to evaluate whether consanguinity affects the cochlear length, which in turn will influence the type of cochlear implant and depth of electrode insertion during surgery in these patients. Methods: Children presenting with congenital SNHL and born out of consanguineous marriages (Group A) were compared with children presenting with SNHL and born out of nonconsanguineous marriages (Group B). Patients in both groups were evaluated with magnetic resonance imaging as a routine pretreatment workup. A high-resolution three-dimensional T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolution imaging of the inner ears was performed. Curved multiplanar reconstruction module was used to deconvolute the membranous cochlea and measure its length. The cochlear lengths among both the groups were compared using analysis of variance test. Results: A total of seven patients were included in both Groups A and B each. The mean length of membranous cochlea in Group A was 22.6 mm and Group B was 22.5 mm. There was no statistically significant variation in the cochlear lengths of both the groups. Conclusion: Consanguinity is unlikely to produce any significant variation in the length of the cochlea.
目的:先天性感音神经性听力损失(SNHL)在近亲婚姻出生的儿童中患病率增加，先天性耳聋与结构性内耳畸形的患病率增加有关。本研究旨在评估亲属关系是否会影响人工耳蜗长度，进而影响这些患者手术中人工耳蜗的类型和电极插入深度。方法:将近亲婚姻出生的先天性SNHL患儿(A组)与非近亲婚姻出生的先天性SNHL患儿(B组)进行比较。两组患者均采用磁共振成像作为常规预处理工作。利用不同的内耳翻转角度演化成像进行了高分辨率三维t2加权采样完善和应用优化对比度。采用曲面多平面重构模块对耳膜进行反卷积并测量耳膜长度。采用方差分析检验比较两组患者的耳蜗长度。结果:A组和B组各7例。A组耳膜平均长度22.6 mm, B组耳膜平均长度22.5 mm。两组耳蜗长度无统计学差异。结论:血缘关系对耳蜗长度的影响不大。
{"title":"Congenital sensorineural hearing loss in consanguineous marriages – Does the cochlear length vary","authors":"R. Aggarwal, Kavitha Yellur, U. Joish, R. George, H. Swami, Sabarigirish Kanjully","doi":"10.4103/wajr.wajr_40_17","DOIUrl":"https://doi.org/10.4103/wajr.wajr_40_17","url":null,"abstract":"Objective: There is an increased prevalence of congenital sensorineural hearing loss (SNHL) among children born out of consanguineous wedlocks, and congenital deafness is associated with increased prevalence of structural inner-ear malformations. This study is done to evaluate whether consanguinity affects the cochlear length, which in turn will influence the type of cochlear implant and depth of electrode insertion during surgery in these patients. Methods: Children presenting with congenital SNHL and born out of consanguineous marriages (Group A) were compared with children presenting with SNHL and born out of nonconsanguineous marriages (Group B). Patients in both groups were evaluated with magnetic resonance imaging as a routine pretreatment workup. A high-resolution three-dimensional T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolution imaging of the inner ears was performed. Curved multiplanar reconstruction module was used to deconvolute the membranous cochlea and measure its length. The cochlear lengths among both the groups were compared using analysis of variance test. Results: A total of seven patients were included in both Groups A and B each. The mean length of membranous cochlea in Group A was 22.6 mm and Group B was 22.5 mm. There was no statistically significant variation in the cochlear lengths of both the groups. Conclusion: Consanguinity is unlikely to produce any significant variation in the length of the cochlea.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43240486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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