SA Journal of Radiology最新文献

英文中文

Diagnosing rare intraductal biliary neoplasms – Intraductal papillary neoplasm of the bile duct: A case report with typical imaging findings 诊断罕见的胆管内肿瘤-胆管内乳头状肿瘤1例，影像学表现典型

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-04-29 DOI: 10.4102/sajr.v26i1.2387

Saumya Pandey, Nitin Agarwal, V. Gupta, Ashok K Sharma, A. Aggarwal, Sunita Gupta, Ram Krishan

Intraductal papillary neoplasm of the bile duct (IPN-B) is a rare preinvasive intraductal pathology of the biliary tract. It should be differentiated from other more common benign or malignant causes of biliary obstruction and dilatation such as calculi or cholangiocarcinoma because the management and prognosis of this condition differs significantly. This case report describes a case of IPN-B in a 45-year-old female patient who presented with non-specific complaints of chronic abdominal pain without jaundice for three months.

胆管内乳头状肿瘤(IPN-B)是一种罕见的胆管内病变。它应与其他更常见的胆道阻塞和扩张的良性或恶性原因(如结石或胆管癌)区分开来，因为这种情况的处理和预后有很大不同。本病例报告描述了一例45岁女性IPN-B患者，其表现为慢性腹痛无黄疸三个月的非特异性主诉。

引用次数: 0

Sellar spine: A rare Bony variant of the Sella Turcica 鞍骨脊柱:鞍骨的罕见骨变体

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-04-28 DOI: 10.4102/sajr.v26i1.2371

Luke D. Metelo-Liquito, Thandi E. Buthelezi

A sellar spine is a rare osseous projection from the dorsum sellae, resulting in variable compression of sellar and suprasellar structures and varied clinical presentations. CT is the diagnostic modality of choice, while variable signal intensity on MRI may mimic a pituitary microadenoma. A patient presented with hypoprolactinaemia and puerperal alactogenesis due to a sellar spine diagnosed on CT Brain. Neurosurgical and endocrine review and pituitary MRI were recommended with subsequent loss to follow-up.

鞍棘是一种罕见的来自鞍背的骨性突出，导致鞍和鞍上结构的不同压迫和不同的临床表现。CT是诊断方式的选择，而MRI的可变信号强度可能模拟垂体微腺瘤。患者表现为低催乳素血症和产后乳糜泻，由于CT脑诊断鞍椎。建议行神经外科、内分泌检查和垂体MRI检查，但随后缺乏随访。

引用次数: 1

Primary giant cell tumour of the breast with recurrence: A rare case report 乳腺原发性巨细胞瘤复发1例

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-04-20 DOI: 10.4102/sajr.v26i1.2393

F. Suleman, Moipone N. Vilakazi, M. Bida, Richard Edwards

Giant cell tumour (GCT) arising from the soft tissues of the breast is a rare disease with only eight cases previously reported in the literature. We present a case of histologically proven GCT of the breast, which demonstrated recurrence a few months after resection.

巨细胞瘤(GCT)起源于乳腺软组织是一种罕见的疾病，只有8例文献报道。我们提出一例经组织学证实的乳腺GCT，在切除后几个月复发。

引用次数: 0

A digital audit of emergency upper gastrointestinal fluoroscopy workflow in children with bilious vomiting 胆汁性呕吐儿童急诊上消化道透视工作流程的数字审计

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-03-30 DOI: 10.4102/sajr.v26i1.2300

Bradley C. Messiahs, R. Pitcher

Background Bilious vomiting in children requires an urgent evaluation with upper gastrointestinal (UGI) fluoroscopy as it may herald life-threatening midgut malrotation with volvulus (MMWV). There are no published data available on the duration of time-critical UGI workflow steps. Objectives A digital audit of workflow in emergency UGI contrast studies performed on children with bile-stained vomiting at a large South African teaching hospital. Method A retrospective study was conducted from 01 May 2012 – 31 May 2019. A customised search of the institutional radiology information system (RIS) defined all children with bilious vomiting who underwent emergency UGI fluoroscopy. Extracted RIS timestamps were used to calculate the median duration of the ‘approval’, ‘waiting’, ‘study’ and ‘reporting’ times. One-way analysis of variance and Chi-squared tests assessed the association between key parameters and the duration of workflow steps, with 5% significance (p < 0.05). Results Thirty-seven patients (n = 37) with median age 0.8 months were included, of whom 20 (54%) had an abnormal C-loop. The median ‘total time’ from physician request to report distribution was 107 min (interquartile range [IQR]: 67−173). The median ‘approval’ (6 min; IQR: 1–15) and ‘reporting’ (38 min; IQR: 17–91) times were the shortest and longest workflow steps, respectively. Abnormal C-loops (p = 0.04) and consultant referrals (p = 0.03) were associated with shorter ‘approval’ times. The neonatal ‘waiting’ time was significantly longer than that for older patients (p = 0.02). Conclusion The modern RIS is an excellent tool for time-critical workflow analyses, which can inform interventions for improved service delivery.

背景:儿童胆汁性呕吐需要紧急进行上消化道(UGI)透视检查，因为它可能预示着危及生命的中肠旋转不良伴扭转(MMWV)。没有关于时间关键型UGI工作流步骤持续时间的公开数据。目的对南非一家大型教学医院对有胆汁染色呕吐的儿童进行紧急UGI对比研究的工作流程进行数字审计。方法2012年5月1日至2019年5月31日进行回顾性研究。对机构放射学信息系统(RIS)的定制搜索定义了所有接受紧急UGI透视检查的胆汁性呕吐儿童。提取的RIS时间戳用于计算“批准”、“等待”、“研究”和“报告”时间的中位数持续时间。单因素方差分析和卡方检验评估关键参数与工作流程步骤持续时间之间的相关性，显著性为5% (p < 0.05)。结果纳入37例患者(n = 37)，中位年龄0.8个月，其中20例(54%)存在异常c环。从医生请求到报告分发的中位数“总时间”为107分钟(四分位数间距[IQR]: 67−173)。“批准”的中位数(6分钟;IQR: 1-15)和“报告”(38分钟;IQR: 17-91)次分别是最短和最长的工作流步骤。异常的c -loop (p = 0.04)和咨询师推荐(p = 0.03)与较短的“批准”时间相关。新生儿“等待”时间明显长于老年患者(p = 0.02)。结论:现代RIS是时间要求严格的工作流程分析的优秀工具，可以为改善服务提供干预措施提供信息。

{"title":"A digital audit of emergency upper gastrointestinal fluoroscopy workflow in children with bilious vomiting","authors":"Bradley C. Messiahs, R. Pitcher","doi":"10.4102/sajr.v26i1.2300","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2300","url":null,"abstract":"Background Bilious vomiting in children requires an urgent evaluation with upper gastrointestinal (UGI) fluoroscopy as it may herald life-threatening midgut malrotation with volvulus (MMWV). There are no published data available on the duration of time-critical UGI workflow steps. Objectives A digital audit of workflow in emergency UGI contrast studies performed on children with bile-stained vomiting at a large South African teaching hospital. Method A retrospective study was conducted from 01 May 2012 – 31 May 2019. A customised search of the institutional radiology information system (RIS) defined all children with bilious vomiting who underwent emergency UGI fluoroscopy. Extracted RIS timestamps were used to calculate the median duration of the ‘approval’, ‘waiting’, ‘study’ and ‘reporting’ times. One-way analysis of variance and Chi-squared tests assessed the association between key parameters and the duration of workflow steps, with 5% significance (p < 0.05). Results Thirty-seven patients (n = 37) with median age 0.8 months were included, of whom 20 (54%) had an abnormal C-loop. The median ‘total time’ from physician request to report distribution was 107 min (interquartile range [IQR]: 67−173). The median ‘approval’ (6 min; IQR: 1–15) and ‘reporting’ (38 min; IQR: 17–91) times were the shortest and longest workflow steps, respectively. Abnormal C-loops (p = 0.04) and consultant referrals (p = 0.03) were associated with shorter ‘approval’ times. The neonatal ‘waiting’ time was significantly longer than that for older patients (p = 0.02). Conclusion The modern RIS is an excellent tool for time-critical workflow analyses, which can inform interventions for improved service delivery.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72550417","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}

引用次数: 0

Otosyphilis: A rare cause of acute bilateral sensorineural hearing loss in a HIV-negative patient 耳梅毒:一个罕见的原因急性双侧感音神经性听力损失的hiv阴性患者

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-03-29 DOI: 10.4102/sajr.v26i1.2351

Johan Sothmann, S. Adam, G. V. van Tonder, Razaan Davis, L. J. van Rensburg

Bilateral acute hearing loss is rare, and the aetiology is poorly defined. Less common treatable pathologies such as otosyphilis must be part of the differential diagnosis and should be actively excluded. We present a case of a 23-year-old woman who developed acute bilateral hearing loss due to otosyphilis, confirmed on audiometry and laboratory tests. In this article, the CT, MRI and clinical findings are presented and discussed.

双侧急性听力损失是罕见的，病因不明。不常见的可治疗的病理，如耳梅毒，必须是鉴别诊断的一部分，应积极排除。我们提出一个23岁的妇女谁发展急性双侧听力损失，由于耳梅毒，确认听力学和实验室检查。本文就其CT、MRI及临床表现作一介绍和讨论。

引用次数: 0

An audit of the adequacy of contrast enhancement in CT pulmonary angiograms in a South African tertiary academic hospital setting 在南非三级学术医院设置的CT肺血管造影增强的充分性审计

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-03-24 DOI: 10.4102/sajr.v26i1.2350

Derik J. Basson, H. Moodley

Background Undiagnosed pulmonary embolism carries high mortality and morbidity. Computed tomography pulmonary angiogram (CTPA) is the diagnostic method of choice for accurate diagnosis. Inadequate contrast opacification is the second most common cause of indeterminate CTPAs. Objectives Audit the adequacy of CTPA contrast enhancement and determine whether inadequate enhancement is affected by the size and site of the intravenous cannula, flow rate, contrast volume, contrast leakage and day shift versus after hours services. Method Retrospective and prospective audits of the adequacy of contrast enhancement of CTPAs at the Charlotte Maxeke Johannesburg Academic Hospital were conducted using the Royal College of Radiologists guidelines (≤ 11% of studies with < 210 HU). Protocol variables were collected prospectively from questionnaires completed by radiographers performing the CTPAs. Adequate versus inadequate groups were analysed. Results A total of 63 (retrospective) and 130 (prospective) patients were included with inadequate contrast enhancement rates of 19% (12/63) and 20.8% (27/130), respectively. The majority of CTPAs were performed during the day 56.2% (73/130) with a 20G cannula 66.2% (86/130) in the forearm 33.8% (44/130) injecting 100 mL – 120 mL contrast 43.1% (56/130) at 3 mL/s 63.1% (82/130). The median flow rate (3 mL/s) and contrast volume (80 mL) were identical in both adequate and inadequate groups, while the remaining variables showed no statistical difference. Conclusion The rate of inadequately enhanced CTPAs in this study was high. The protocol variables did not have a significant influence on the rate of inadequate enhancement. Further research, particularly using flow rates > 4 mL/s, is required for protocol optimisation.

背景:未确诊的肺栓塞具有很高的死亡率和发病率。计算机断层肺血管造影(CTPA)是准确诊断的首选诊断方法。造影剂混浊不充分是ctpa不确定的第二大常见原因。目的审核CTPA造影增强的充分性，确定造影增强的充分性是否受到静脉插管的大小和位置、流量、造影剂体积、造影剂泄漏以及白班与非工作时间服务的影响。方法采用皇家放射科学院指南对Charlotte Maxeke约翰内斯堡学术医院ctpa造影剂增强的充分性进行回顾性和前瞻性审计(≤11% < 210 HU的研究)。从执行ctpa的放射技师完成的问卷中前瞻性地收集方案变量。分析了适当组和不适当组。结果共纳入63例(回顾性)和130例(前瞻性)患者，增强率分别为19%(12/63)和20.8%(27/130)。大多数ctpa在白天进行56.2% (73/130)，20G插管66.2%(86/130)，前臂33.8%(44/130)，注射100 mL - 120 mL，对比43.1%(56/130)，注射3 mL/s 63.1%(82/130)。充足组和不足组的中位流速(3 mL/s)和造影剂体积(80 mL)相同，其余变量无统计学差异。结论本研究CTPAs增强不充分的发生率较高。方案变量对增强不足率没有显著影响。方案优化需要进一步的研究，特别是使用流量为4ml /s的情况。

{"title":"An audit of the adequacy of contrast enhancement in CT pulmonary angiograms in a South African tertiary academic hospital setting","authors":"Derik J. Basson, H. Moodley","doi":"10.4102/sajr.v26i1.2350","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2350","url":null,"abstract":"Background Undiagnosed pulmonary embolism carries high mortality and morbidity. Computed tomography pulmonary angiogram (CTPA) is the diagnostic method of choice for accurate diagnosis. Inadequate contrast opacification is the second most common cause of indeterminate CTPAs. Objectives Audit the adequacy of CTPA contrast enhancement and determine whether inadequate enhancement is affected by the size and site of the intravenous cannula, flow rate, contrast volume, contrast leakage and day shift versus after hours services. Method Retrospective and prospective audits of the adequacy of contrast enhancement of CTPAs at the Charlotte Maxeke Johannesburg Academic Hospital were conducted using the Royal College of Radiologists guidelines (≤ 11% of studies with < 210 HU). Protocol variables were collected prospectively from questionnaires completed by radiographers performing the CTPAs. Adequate versus inadequate groups were analysed. Results A total of 63 (retrospective) and 130 (prospective) patients were included with inadequate contrast enhancement rates of 19% (12/63) and 20.8% (27/130), respectively. The majority of CTPAs were performed during the day 56.2% (73/130) with a 20G cannula 66.2% (86/130) in the forearm 33.8% (44/130) injecting 100 mL – 120 mL contrast 43.1% (56/130) at 3 mL/s 63.1% (82/130). The median flow rate (3 mL/s) and contrast volume (80 mL) were identical in both adequate and inadequate groups, while the remaining variables showed no statistical difference. Conclusion The rate of inadequately enhanced CTPAs in this study was high. The protocol variables did not have a significant influence on the rate of inadequate enhancement. Further research, particularly using flow rates > 4 mL/s, is required for protocol optimisation.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77765054","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}

引用次数: 1

Concurrent cranial and cervical spine injuries by associated injury mechanisms in traumatic brain injury patients 外伤性脑损伤患者并发颅颈椎损伤的相关损伤机制

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-03-24 DOI: 10.4102/sajr.v26i1.2321

Pilasande Hlwatika, T. Hardcastle

Background The incidence of concurrent traumatic brain injury (TBI) and cervical spine injury (c-spine) is relatively high, with a variety of risk factors. Objectives The purpose of this study was to determine the incidence and related factors associated with combined cranial and c-spine injury in TBI patients by assessing their demographics and clinical profiles. Method A retrospective study of patients attending the Trauma Centre at the Inkosi Albert Luthuli Hospital as post head trauma emergencies and their CT brain and c-spine imaging performed between January 2018 and December 2018. Results A total of 236 patients met the criteria for the study; 30 (12.7%) patients presented with concurrent c-spine injury. Most TBI patients were males (75%) and accounted for 70% of the c-spine injured patients. The most common mechanism of injury with a relationship to c-spine injury was motor vehicle collisions (MVCs) and/or pedestrian vehicle collisions (70%). The risk factors associated with c-spine injury in TBI patients were cerebral contusions (40%), traumatic subarachnoid haematomas (36%) and skull fractures (33.3%). The statistically significant intracranial injury type more likely to have an associated c-spine injury was diffuse axonal injury (p = 0.04). Conclusion The results suggest that concurrent TBI and c-spine injury should be considered in patients presenting with a contusion, traumatic subarachnoid haematoma and skull fracture. The high incidence of c-spinal injury and more than 1% incidence of spinal cord injury suggests that c-spine scanning should be employed as a routine for post MVC patients with cranial injury.

背景外伤性脑损伤(TBI)并发颈椎损伤(c-spine)发生率较高，危险因素多种多样。目的本研究的目的是通过评估TBI患者的人口统计学和临床资料，确定其颅脑和颈椎联合损伤的发生率和相关因素。方法回顾性研究2018年1月至2018年12月在英科西阿尔伯特卢图利医院创伤中心就诊的头部外伤急诊患者及其CT脑和颈椎成像。结果共有236例患者符合研究标准;30例(12.7%)患者并发颈椎损伤。TBI患者以男性居多(75%)，占颈椎损伤患者的70%。与颈椎损伤相关的最常见损伤机制是机动车碰撞(MVCs)和/或行人车辆碰撞(70%)。与TBI患者颈椎损伤相关的危险因素为脑挫伤(40%)、外伤性蛛网膜下腔血肿(36%)和颅骨骨折(33.3%)。弥漫性轴索损伤在颅内损伤类型中更容易合并颈椎损伤(p = 0.04)。结论颅脑挫伤、外伤性蛛网膜下腔血肿和颅骨骨折患者应考虑并发创伤性脑外伤和颈椎损伤。c-脊髓损伤发生率高，脊髓损伤发生率超过1%，提示对MVC后颅脑损伤患者应常规行c-脊柱扫描。

{"title":"Concurrent cranial and cervical spine injuries by associated injury mechanisms in traumatic brain injury patients","authors":"Pilasande Hlwatika, T. Hardcastle","doi":"10.4102/sajr.v26i1.2321","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2321","url":null,"abstract":"Background The incidence of concurrent traumatic brain injury (TBI) and cervical spine injury (c-spine) is relatively high, with a variety of risk factors. Objectives The purpose of this study was to determine the incidence and related factors associated with combined cranial and c-spine injury in TBI patients by assessing their demographics and clinical profiles. Method A retrospective study of patients attending the Trauma Centre at the Inkosi Albert Luthuli Hospital as post head trauma emergencies and their CT brain and c-spine imaging performed between January 2018 and December 2018. Results A total of 236 patients met the criteria for the study; 30 (12.7%) patients presented with concurrent c-spine injury. Most TBI patients were males (75%) and accounted for 70% of the c-spine injured patients. The most common mechanism of injury with a relationship to c-spine injury was motor vehicle collisions (MVCs) and/or pedestrian vehicle collisions (70%). The risk factors associated with c-spine injury in TBI patients were cerebral contusions (40%), traumatic subarachnoid haematomas (36%) and skull fractures (33.3%). The statistically significant intracranial injury type more likely to have an associated c-spine injury was diffuse axonal injury (p = 0.04). Conclusion The results suggest that concurrent TBI and c-spine injury should be considered in patients presenting with a contusion, traumatic subarachnoid haematoma and skull fracture. The high incidence of c-spinal injury and more than 1% incidence of spinal cord injury suggests that c-spine scanning should be employed as a routine for post MVC patients with cranial injury.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86224205","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}

引用次数: 1

A retrospective review of CT pulmonary angiogram confirmed pulmonary emboli in COVID-19 patients admitted to Groote Schuur Hospital, Cape Town 回顾性分析开普敦格鲁特舒尔医院收治的COVID-19患者的CT肺血管造影证实的肺栓塞

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-02-28 DOI: 10.4102/sajr.v26i1.2280

Petri Ahlers, Mariam Q. Said-Hartley

Background A high incidence of thromboembolic phenomena has been widely reported in patients with coronavirus disease 2019 (COVID-19) pneumonia. There is, however, a paucity of data detailing the incidence and characteristics of pulmonary emboli (PE) in COVID-19 patients in the South African setting. Objectives To describe the incidence and characteristics of PE confirmed by CT pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia admitted to a tertiary hospital in the Western Cape, South Africa. Methods This was a retrospective-, descriptive study of all adult patients with COVID-19 pneumonia confirmed by polymerase chain reaction (PCR) undergoing CTPA for suspected PE while admitted to Groote Schuur Hospital. The study period was from 01 April 2020 to 30 September 2020. Results The study cohort consisted of 116 patients, 59% being female, of whom 29% were pregnant or in the postpartum period. The median age for both genders combined was 49.5 years. The overall incidence of PE was 19%, with 20% in our subset of pregnant and postpartum patients. The majority (64%) of PE’s were reported as being segmental in anatomical location. Conclusion The noteworthy cohort included patients with pulmonary tuberculosis (PTB), HIV as well as pregnant and postpartum patients. The overall incidence of PE was 19% with no significant differences in demographics, comorbidities or D-dimer levels between patients with or without PE. The importance of a high clinical index of suspicion together with the role of CTPA in diagnosing PE in hospitalised COVID-19 patients is emphasised.

背景2019冠状病毒病(COVID-19)肺炎患者血栓栓塞现象高发已被广泛报道。然而，缺乏详细说明南非COVID-19患者肺栓塞(PE)发病率和特征的数据。目的探讨南非西开普省某三级医院新冠肺炎CT肺血管造影(CTPA)确诊的PE的发生率及特点。方法回顾性、描述性研究所有经聚合酶链反应(PCR)确诊的成人COVID-19肺炎患者，在grote Schuur医院接受CTPA检查，疑似PE。研究期间为2020年4月1日至2020年9月30日。结果本研究共纳入116例患者，59%为女性，其中29%为孕妇或产后患者。男女的平均年龄加起来是49.5岁。PE的总发生率为19%，其中20%为孕妇和产后患者。据报道，大多数PE(64%)在解剖位置上为节段性。结论值得注意的队列包括肺结核(PTB)患者、艾滋病患者以及孕妇和产后患者。PE的总发病率为19%，在人口统计学、合并症或d -二聚体水平方面，PE患者与非PE患者没有显著差异。强调了高临床怀疑指数的重要性以及CTPA在诊断住院COVID-19患者PE中的作用。

{"title":"A retrospective review of CT pulmonary angiogram confirmed pulmonary emboli in COVID-19 patients admitted to Groote Schuur Hospital, Cape Town","authors":"Petri Ahlers, Mariam Q. Said-Hartley","doi":"10.4102/sajr.v26i1.2280","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2280","url":null,"abstract":"Background A high incidence of thromboembolic phenomena has been widely reported in patients with coronavirus disease 2019 (COVID-19) pneumonia. There is, however, a paucity of data detailing the incidence and characteristics of pulmonary emboli (PE) in COVID-19 patients in the South African setting. Objectives To describe the incidence and characteristics of PE confirmed by CT pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia admitted to a tertiary hospital in the Western Cape, South Africa. Methods This was a retrospective-, descriptive study of all adult patients with COVID-19 pneumonia confirmed by polymerase chain reaction (PCR) undergoing CTPA for suspected PE while admitted to Groote Schuur Hospital. The study period was from 01 April 2020 to 30 September 2020. Results The study cohort consisted of 116 patients, 59% being female, of whom 29% were pregnant or in the postpartum period. The median age for both genders combined was 49.5 years. The overall incidence of PE was 19%, with 20% in our subset of pregnant and postpartum patients. The majority (64%) of PE’s were reported as being segmental in anatomical location. Conclusion The noteworthy cohort included patients with pulmonary tuberculosis (PTB), HIV as well as pregnant and postpartum patients. The overall incidence of PE was 19% with no significant differences in demographics, comorbidities or D-dimer levels between patients with or without PE. The importance of a high clinical index of suspicion together with the role of CTPA in diagnosing PE in hospitalised COVID-19 patients is emphasised.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87232756","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}

引用次数: 0

Fatal non-accidental injury in South Africa: A Gauteng hospital’s perspective on the incidence and fracture types in post-mortem skeletal surveys 南非致命的非意外伤害:豪登省一家医院对死后骨骼调查中骨折类型和发生率的看法

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-02-22 DOI: 10.4102/sajr.v26i1.2311

Robyn M Wessels, H. Moodley

Background In its severest form, non-accidental injury (NAI) in children is fatal. South Africa has been reported to have double the global average of child homicides. Autopsy is the main investigation in fatal NAI with post-mortem skeletal surveys (PMSS) playing an adjunctive role. Whilst fracture patterns associated with NAI in living patients have been established, this has not been investigated in PMSS in South Africa. Objectives To determine the incidence and characteristics of fractures in suspected fatal NAI cases. To calculate the incidence of fractures according to high-, moderate- and low-specificity fracture locations for NAI. Methods A retrospective review of all PMSS performed between 01 January 2012 and 03 December 2018 was conducted at the Charlotte Maxeke Johannesburg Academic Hospital. Results Of the 73 PMSS, 33 (45.2%) demonstrated fractures. No statistical significance in sex was found: 38 (52.1%) were male and 35 (47.9%) were female (p > 0.05). The mean age of those who sustained fractures was 28 months (standard deviation [s.d.]: 21 months). A total of 115 fractures were sustained, of that the top five bones fractured were the ribs 37 (32.2%), parietal bone 13 (11.3%), ulna 13 (11.3%), femur 13 (11.3%), and radius 11 (9.6%). High-specificity fracture locations accounted for 40/133 (30.1%). Conclusion The fracture types in PMSS were similar to those in live skeletal surveys. Our study’s fracture rate was higher in comparison to international studies. The PMSS is a valuable adjunct to autopsy in detecting occult fractures of the limbs. We recommend that PMSS be performed in suspected fatal NAI cases at least in children up to 24 months of age.

在其最严重的形式，非意外伤害(NAI)在儿童是致命的。据报道，南非的儿童谋杀率是全球平均水平的两倍。尸检是致死性NAI的主要调查，死后骨骼调查(PMSS)起辅助作用。虽然在世患者中与NAI相关的骨折模式已经确立，但在南非的PMSS中尚未对此进行调查。目的探讨疑似致死性脑损伤患者骨折的发生率和特点。根据NAI的高、中、低特异性骨折位置计算骨折发生率。方法回顾性分析2012年1月1日至2018年12月3日在Charlotte Maxeke约翰内斯堡学术医院进行的所有PMSS。结果73例PMSS中33例(45.2%)发生骨折。性别差异无统计学意义:男性38例(52.1%)，女性35例(47.9%)(p > 0.05)。骨折患者的平均年龄为28个月(标准差[s.d。]: 21个月)。共发生骨折115例，骨折前5位依次为肋骨37例(32.2%)、顶骨13例(11.3%)、尺骨13例(11.3%)、股骨13例(11.3%)、桡骨11例(9.6%)。高特异性骨折位置占40/133(30.1%)。结论PMSS骨折类型与活骨调查相似。与国际研究相比，我们的研究骨折率更高。PMSS是一种有价值的辅助尸检在检测隐匿性骨折的四肢。我们建议至少在24个月以下的儿童中，对疑似致命的NAI病例进行PMSS。

{"title":"Fatal non-accidental injury in South Africa: A Gauteng hospital’s perspective on the incidence and fracture types in post-mortem skeletal surveys","authors":"Robyn M Wessels, H. Moodley","doi":"10.4102/sajr.v26i1.2311","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2311","url":null,"abstract":"Background In its severest form, non-accidental injury (NAI) in children is fatal. South Africa has been reported to have double the global average of child homicides. Autopsy is the main investigation in fatal NAI with post-mortem skeletal surveys (PMSS) playing an adjunctive role. Whilst fracture patterns associated with NAI in living patients have been established, this has not been investigated in PMSS in South Africa. Objectives To determine the incidence and characteristics of fractures in suspected fatal NAI cases. To calculate the incidence of fractures according to high-, moderate- and low-specificity fracture locations for NAI. Methods A retrospective review of all PMSS performed between 01 January 2012 and 03 December 2018 was conducted at the Charlotte Maxeke Johannesburg Academic Hospital. Results Of the 73 PMSS, 33 (45.2%) demonstrated fractures. No statistical significance in sex was found: 38 (52.1%) were male and 35 (47.9%) were female (p > 0.05). The mean age of those who sustained fractures was 28 months (standard deviation [s.d.]: 21 months). A total of 115 fractures were sustained, of that the top five bones fractured were the ribs 37 (32.2%), parietal bone 13 (11.3%), ulna 13 (11.3%), femur 13 (11.3%), and radius 11 (9.6%). High-specificity fracture locations accounted for 40/133 (30.1%). Conclusion The fracture types in PMSS were similar to those in live skeletal surveys. Our study’s fracture rate was higher in comparison to international studies. The PMSS is a valuable adjunct to autopsy in detecting occult fractures of the limbs. We recommend that PMSS be performed in suspected fatal NAI cases at least in children up to 24 months of age.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86387703","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}

引用次数: 1

CT pulmonary angiography findings in HIV-infected patients referred for suspected pulmonary thrombo-embolic disease. 疑似肺血栓栓塞性疾病的hiv感染患者的CT肺血管造影结果。

IF 0.9 Q3 Medicine

SA Journal of Radiology

Pub Date : 2022-01-31 eCollection Date: 2022-01-01 DOI: 10.4102/sajr.v26i1.2273

Diane Wiese, Leisha Rajkumar, Susan Lucas, David Clopton, Jacob Benfield, Jason DeBerry

Background: South Africa bares a significant burden of HIV and imaging is commonly performed as part of the workup for respiratory distress.

Objectives: The aim of this study was to document the prevalence of pulmonary thrombo-embolic disease (PTED) and other findings in HIV-infected patients referred for CT pulmonary angiography (CTPA) for suspected PTED.

Method: Forty CTPA studies of documented HIV-infected individuals investigated for suspected PTED during a 1-year period were retrieved, anonymised and interpreted by three consultant radiologists. Inter-reader reliability was calculated using Free Marginal multi-rater Kappa.

Results: Fourteen of the forty cases (35%) were positive for PTED. In the pulmonary embolism (PE)-positive group, 57.14% had peripheral disease and 42.86% had both peripheral and central disease. Associated findings in the PE-positive cases were pulmonary infarcts (17.5%), mosaic attenuation (17.5%) and linear atelectasis (7.5%). The most common incidental findings were solid pulmonary nodules (52.5%), non-wedge-shaped consolidation (45%), cardiomegaly (52.5%) and enlarged intra-thoracic lymph nodes (52.5%). Thirty per cent of the study population had findings related directly to the presence of PTED, whilst most cases in the study (77.5%) had pulmonary findings unrelated to PTED. In the PE-negative cases, 55% reported emergent findings that warranted immediate or urgent medical attention.

Conclusion: Computed tomography pulmonary angiography imaging is critical for diagnosing PE. However, further investigation into the judicious application of CTPA in HIV-infected patients with suspected PTED is required, as CTPA findings in most of the cases in this study were unrelated to PE.

背景:南非是HIV感染的重地，影像学检查通常作为呼吸窘迫检查的一部分。目的:本研究的目的是记录肺血栓栓塞性疾病(PTED)的患病率和其他发现在转到CT肺血管造影(CTPA)疑似PTED的hiv感染患者。方法:在1年的时间里，收集了40份CTPA研究中记录的疑似PTED的hiv感染者，并由三名顾问放射科医生进行匿名和解释。使用Free Marginal多重评分Kappa计算读者间信度。结果:PTED阳性14例(35%)。肺栓塞(PE)阳性组57.14%为外周性疾病，42.86%为外周性和中枢性疾病。pe阳性病例的相关表现为肺梗死(17.5%)、马赛克衰减(17.5%)和线状肺不张(7.5%)。最常见的意外发现是肺实性结节(52.5%)、非楔形实变(45%)、心脏肿大(52.5%)和胸内淋巴结肿大(52.5%)。30%的研究人群的发现与PTED的存在直接相关，而研究中的大多数病例(77.5%)的肺部发现与PTED无关。在pe阴性病例中，55%报告了紧急发现，需要立即或紧急医疗护理。结论:计算机体层析肺血管造影对PE的诊断具有重要意义。然而，由于本研究中大多数病例的CTPA发现与PE无关，因此需要进一步调查CTPA在疑似PTED的hiv感染患者中的明智应用。

{"title":"CT pulmonary angiography findings in HIV-infected patients referred for suspected pulmonary thrombo-embolic disease.","authors":"Diane Wiese, Leisha Rajkumar, Susan Lucas, David Clopton, Jacob Benfield, Jason DeBerry","doi":"10.4102/sajr.v26i1.2273","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2273","url":null,"abstract":"Background: South Africa bares a significant burden of HIV and imaging is commonly performed as part of the workup for respiratory distress.Objectives: The aim of this study was to document the prevalence of pulmonary thrombo-embolic disease (PTED) and other findings in HIV-infected patients referred for CT pulmonary angiography (CTPA) for suspected PTED.Method: Forty CTPA studies of documented HIV-infected individuals investigated for suspected PTED during a 1-year period were retrieved, anonymised and interpreted by three consultant radiologists. Inter-reader reliability was calculated using Free Marginal multi-rater Kappa.Results: Fourteen of the forty cases (35%) were positive for PTED. In the pulmonary embolism (PE)-positive group, 57.14% had peripheral disease and 42.86% had both peripheral and central disease. Associated findings in the PE-positive cases were pulmonary infarcts (17.5%), mosaic attenuation (17.5%) and linear atelectasis (7.5%). The most common incidental findings were solid pulmonary nodules (52.5%), non-wedge-shaped consolidation (45%), cardiomegaly (52.5%) and enlarged intra-thoracic lymph nodes (52.5%). Thirty per cent of the study population had findings related directly to the presence of PTED, whilst most cases in the study (77.5%) had pulmonary findings unrelated to PTED. In the PE-negative cases, 55% reported emergent findings that warranted immediate or urgent medical attention.Conclusion: Computed tomography pulmonary angiography imaging is critical for diagnosing PE. However, further investigation into the judicious application of CTPA in HIV-infected patients with suspected PTED is required, as CTPA findings in most of the cases in this study were unrelated to PE.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39927841","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

SA Journal of Radiology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀