SA Journal of Radiology最新文献

{"title":"Ileocaecal region impaction by plum pits in a South African patient: A case report.","authors":"Mobby M Muzamhindo, Pieter B Kotze, Christelle Ackermann","doi":"10.4102/sajr.v30i1.3571","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3571","url":null,"abstract":"<p><p>Multiple plum pit impaction at the ileocaecal junction is an under-recognised cause of right lower quadrant pathology in Africa. A 54-year-old man presented with chronic abdominal pain, haematemesis and peritonism. CT confirmed partial luminal impaction with secondary appendiceal region inflammation. Conservative management was successful. Dietary history, careful plain radiograph review and CT with volumetric reconstruction were key diagnostic steps in this unusual presentation.</p><p><strong>Contribution: </strong>This case documents an uncommon occurrence of ileocaecal impaction from multiple plum pits with secondary appendiceal region inflammation, while highlighting volumetric CT reconstruction as a valuable diagnostic adjunct in confirming pit morphology.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3571"},"PeriodicalIF":1.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116229","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":"Unusual presentations of meningiomas: A case series.","authors":"Tavonga P C S Bayela, Christell Ackermann, Morné D Coetzee, Suzanne O'Hagan","doi":"10.4102/sajr.v30i1.3480","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3480","url":null,"abstract":"<p><p>Meningiomas, the most common primary intracranial tumours (accounting for 36% of central nervous system neoplasms), typically present as well-circumscribed, extra-axial masses with homogeneous enhancement, dural tails and hyperostosis on imaging. However, 15% show atypical features that can mimic gliomas, metastases or abscesses, posing diagnostic challenges. This case series present seven histologically confirmed meningiomas illustrating atypical imaging appearances, identified retrospectively from the institutional teaching archive. The cases include intraventricular, septated cystic, perineural spread, circumscribed low T2 or FLAIR signal, frond-like low T2 or FLAIR signal, peritumoural cystic and radiation-induced meningiomas. All were WHO grade 1, except one radiation-induced grade 2 tumour. Key atypical imaging findings included heterogeneous enhancement, non-suppressing cystic components on FLAIR, brain invasion, absent dural tail and perilesional oedema. Although these features suggested higher-grade behaviour, they did not correlate with the final histological grade. Atypical imaging features in meningiomas may closely mimic more aggressive pathologies and do not reliably predict histological grade. Recognition of these variants is essential for accurate diagnosis and appropriate management.</p><p><strong>Contribution: </strong>This case series expands the recognised imaging spectrum of meningiomas by demonstrating diverse atypical appearances that closely mimic other intracranial pathologies. Importantly, it highlights the discordance between aggressive imaging features and histological grade, reinforcing that atypical morphology should not be equated with higher-grade disease.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3480"},"PeriodicalIF":1.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116261","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":"Asymptomatic penetrating neck injuries: Course and outcome following CT angiography and oesophagography.","authors":"Danie D Krynauw, Hendrick J Lategan, Richard Pitcher, Daniel van Hoving","doi":"10.4102/sajr.v30i1.3529","DOIUrl":"10.4102/sajr.v30i1.3529","url":null,"abstract":"<p><strong>Background: </strong>Penetrating neck injuries (PNIs) are common, yet imaging protocols for asymptomatic patients remain debated in resource-limited settings.</p><p><strong>Objectives: </strong>Describe the clinical course, imaging findings and outcomes of asymptomatic PNI patients who underwent CT angiography and oesophagography (CTA&O) at a tertiary hospital in the Western Cape, South Africa.</p><p><strong>Method: </strong>A retrospective review of asymptomatic PNI patients who underwent CTA&O at Tygerberg Hospital between 01 January 2021 and 30 June 2022. Demographics, mechanism, imaging findings and outcomes were extracted from electronic hospital systems.</p><p><strong>Results: </strong>Ninety-one patients were included (median age 30 years; 88 [97%] males; 84 [92%] stab wounds). Sixty (66%) had a normal CTA&O; 31 (34%) had 40 abnormalities (aerodigestive tract: <i>n</i> = 28 [70%]; vascular: <i>n</i> = 7 [17.5%]; orthopaedic <i>n</i> = 5 [12.5%]). Of these, 18/31 (58%) had no further investigation and 13/31 (42%) had 14 investigations. Most 17/18 (94%) suspected aerodigestive injury investigations were negative. One (3%) required facial artery embolization. There were no complications or deaths.</p><p><strong>Conclusion: </strong>CTA&O identified PNI-related radiological abnormalities in one-third of the asymptomatic PNI patients. Although most did not represent clinically important injuries requiring intervention, CTA&O is valuable for screening. These findings may improve CTA&O interpretation and reduce downstream investigations while ensuring safety.</p><p><strong>Contribution: </strong>This study provides context-specific evidence on CTA&O findings in asymptomatic PNI patients. Distinguishing common PNI-related radiological abnormalities from clinically important findings may improve CTA&O interpretation and improve resource use.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3529"},"PeriodicalIF":1.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging comparisons of cystic echinococcosis in HIV-positive and HIV-negative patients.","authors":"Kate Couzens-Bohlin, Gercois Human, Elsabe Smit, Urda Kotze, Jake Krige, Christo Kloppers, Marc Bernon, Stefano Cacciatore, Eduard Jonas","doi":"10.4102/sajr.v30i1.3493","DOIUrl":"10.4102/sajr.v30i1.3493","url":null,"abstract":"<p><strong>Background: </strong>Radiological imaging is crucial for diagnosing hepatic cystic echinococcosis (HCE) and assessing complications. Case studies suggest HCE with human immunodeficiency virus (HIV) co-infection is associated with larger, more multilocular cysts, increased extrahepatic dissemination, rupture, secondary infection and biliary invasion.</p><p><strong>Objectives: </strong>To compare the radiological presentation of HCE in HIV-positive (HIV+) and HIV-negative (HIV-) patients and determine whether HIV co-infection influences imaging features.</p><p><strong>Method: </strong>Pre-operative imaging (chest X-rays, ultrasound, CT and MRI of HIV+ and HIV-HCE patients at our tertiary facility between 2011 and 2023 was reviewed. Cyst characteristics and disease staging (WHO and Gharbi classifications) were independently assessed by two blinded radiology specialists.</p><p><strong>Results: </strong>Eighty-six patients (45 HIV+, 63 females) were included. Single unilocular cysts predominated (37.8% HIV+ and 36.6% HIV-). Extrahepatic cysts occurred in 40% of HIV+ and 34.1% of HIV- patients. Right hepatic lobe involvement was more common in HIV+ patients (86% vs. 62.5%). Median cyst diameter was 14.2cm in HIV+ vs. 11.3cm in HIV- patients. Rates of biliary communication, bile duct dilatation, intraperitoneal cyst rupture and cyst infection were similar in HIV+ versus HIV- patients (11.1% vs 12.2%, 11.1% vs 17.1%, 20% vs. 26.8% and 8.9% vs. 19.5%, respectively), as was WHO and Gharbi stage distributions.</p><p><strong>Conclusion: </strong>HIV prevalence (52.3%) exceeded the national prevalence (12.7%), supporting hypotheses that HCE may self-limit less frequently in HIV+ patients. However, co-infection was not associated with more advanced or complicated radiological disease.</p><p><strong>Contribution: </strong>Imaging remains central to HCE diagnosis and management, particularly in HIV+ individuals, where serological testing is less reliable.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3493"},"PeriodicalIF":1.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897887","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":"Progressive left cervical mass in an infant diagnosed as neuroglial heterotopia: A case report.","authors":"Alaipreet Kaur, Sameer Vyas, Atul Jain, Hemlata Jangir","doi":"10.4102/sajr.v30i1.3542","DOIUrl":"10.4102/sajr.v30i1.3542","url":null,"abstract":"<p><p>Neuroglial heterotopia is a congenital developmental anomaly characterised by mature glial tissue located outside the cranial cavity or spinal canal, without intracranial communication. A 12-month-old girl presented with an enlarging left cervical mass and worsening respiratory symptoms. MRI demonstrated a trans-spatial, multiseptated cystic lesion in the left parotid and submandibular spaces, extending medially into the parapharyngeal space with upper airway compression. No intracranial communication was identified. The postoperative specimen revealed mature glial tissue interspersed within fibroconnective stroma, confirming neuroglial heterotopia.</p><p><strong>Contribution: </strong>This case highlights the importance of considering neuroglial heterotopia in the differential diagnosis for congenital or progressive cystic neck masses in infants. Although MRI plays a central role in defining the lesion extent, a definitive diagnosis requires histopathological confirmation.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3542"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686096","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":"Supra-hepatic gallbladder in cirrhosis presenting as a mimic of intra-abdominal fat necrosis: Diagnostic pitfalls and clinical implications.","authors":"Siddhi Chawla, Binit Sureka, Mahaveer S Rodha","doi":"10.4102/sajr.v30i1.3484","DOIUrl":"10.4102/sajr.v30i1.3484","url":null,"abstract":"<p><p>Supra-hepatic gallbladder is an exceptionally rare form of ectopic gallbladder. Its identification can be particularly challenging in patients with cirrhosis, where distortion of hepatic architecture obscures expected anatomical relationships. This report describes a case of supra-hepatic gallbladder in a patient with chronic liver disease, in which surrounding inflammatory oedema mimicked intra-abdominal fat necrosis, creating a significant diagnostic dilemma on imaging.</p><p><strong>Contribution: </strong>This case underscores the importance of recognizing unusual gallbladder locations, understanding their embryological basis, and being aware of potential imaging pitfalls and complications associated with ectopic positioning.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3484"},"PeriodicalIF":1.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686098","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":"When two bleeds collide: Pituitary apoplexy masking a ruptured intracranial aneurysm.","authors":"Tavonga P C S Bayela, Suzanne O'Hagan, Christelle Ackermann","doi":"10.4102/sajr.v30i1.3479","DOIUrl":"10.4102/sajr.v30i1.3479","url":null,"abstract":"<p><p>Concurrent pituitary apoplexy and ruptured intracranial aneurysm are rare, but potentially fatal, if unrecognised. A 53-year-old hypertensive woman presented with acute confusion and transient hemiparesis. Brain CT demonstrated a haemorrhagic sellar-suprasellar mass with atypical subarachnoid and intraventricular haemorrhage. CT angiography (CTA) confirmed a ruptured right middle cerebral artery (MCA) aneurysm and two additional unruptured aneurysms. Subsequent endovascular coil embolisation was successful. The pituitary macroadenoma was managed conservatively.</p><p><strong>Contribution: </strong>Early recognition using haemorrhage pattern analysis and CTA is critical to avoid missed dual pathology in pituitary apoplexy and to guide timely management.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3479"},"PeriodicalIF":1.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686052","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":"Candidate-related factors associated with success in the Fellowship of the College of Diagnostic Radiologists South Africa Part 2 examination.","authors":"Thabokgone Muwezwa, Halvani Moodley, Anushka Ajith","doi":"10.4102/sajr.v30i1.3459","DOIUrl":"10.4102/sajr.v30i1.3459","url":null,"abstract":"<p><strong>Background: </strong>The examination of the Fellowship of the College of Diagnostic Radiologists South Africa (FC Rad Diag [SA]), conducted by the Colleges of Medicine of South Africa (CMSA), is the national exit examination for qualification as a radiology specialist. There is limited published evidence on South African pass rates and factors influencing success in the FC Rad Diag (SA) Part 2 examination.</p><p><strong>Objectives: </strong>This study aimed to determine the pass rate and factors associated with success in the FC Rad Diag (SA) Part 2 examination.</p><p><strong>Method: </strong>A descriptive quantitative study was conducted using CMSA examination data from 2015 to 2023. Descriptive and inferential analyses were used to assess associations between candidate characteristics and examination outcomes.</p><p><strong>Results: </strong>A total of 377 candidates sat in the examination, with an overall pass rate of 85.7% (323/377). Candidates who failed were older (median age 42 years old [37-47 years] vs. 35 years old [33-38 years]; <i>p</i> < 0.001). Higher pass rates were observed among candidates in registrar training posts compared with medical officers (80.2% [259/323] vs. 19.8% [64/323]; <i>p</i> < 0.001). Successful candidates had more recently completed their Bachelor of Medicine and Bachelor of Surgery (MBBCh /MBChB) (median 11 [9-13] vs. 14.5 [12-17] years; <i>p</i> < 0.001) and Part 1 examinations (4 years [3-5 years] vs 5 years [4-6 years]; <i>p</i> < 0.001). They also had fewer examination attempts (median 1 [1-2] vs. 3.5 [2-5]; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Success in the FC Rad Diag (SA) Part 2 examination is influenced by multiple candidate-related factors.</p><p><strong>Contribution: </strong>Targeted academic support programmes should focus on candidates at higher risk of failure, particularly those outside formal registrar posts and those with multiple examination attempts, to improve equity and overall specialist throughput nationally.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3459"},"PeriodicalIF":1.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686084","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":"Neuroendocrine neoplasms in uncommon gastrointestinal sites: A case series and literature review.","authors":"Neha Chhabra, Angie Garg","doi":"10.4102/sajr.v30i1.3455","DOIUrl":"10.4102/sajr.v30i1.3455","url":null,"abstract":"<p><p>Neuroendocrine neoplasms (NENs) are rare, heterogeneous tumours arising from neuroendocrine cells located throughout the body. The gastrointestinal (GI) tract is the most frequent site of origin, but lesions in unusual locations such as the duodenum, gallbladder and rectum are diagnostically challenging because of their atypical presentation and radiological appearance. This series describes three patients with NENs at uncommon GI sites, highlighting imaging findings, histopathological features and management tailored to the tumour site and grade.</p><p><strong>Contribution: </strong>Although rare, NENs at uncommon GI sites should be included in the differential diagnosis of hypervascular lesions. Accurate diagnosis requires integration of cross-sectional imaging, somatostatin-receptor PET and immunohistochemistry, guiding individualised therapy.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3455"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425219","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":"Oncocytic intraductal papillary neoplasm of the pancreas: Multimodality imaging and cytopathologic correlation.","authors":"Anju Ranga, Pranav Gupta, Agrima Bansal, Ravindra K Saran, Sudeshdeep Sinha, Kalpana Bansal","doi":"10.4102/sajr.v30i1.3390","DOIUrl":"10.4102/sajr.v30i1.3390","url":null,"abstract":"<p><p>Intraductal oncocytic papillary neoplasm of the pancreas (IOPN-P) is a rare cystic epithelial tumour with distinctive imaging, cytological and histological features. This case report describes a 65-year-old female who presented with abdominal pain and vomiting for 6 months and was later diagnosed with IOPN-P. Multimodality imaging, including ultrasound, contrast-enhanced CT, MRI, MRCP and endoscopic ultrasound, played an important role in lesion evaluation. Cytopathological evaluation and immunohistochemistry confirmed the diagnosis.</p><p><strong>Contribution: </strong>The case highlights the importance of recognising radiological features of IOPN-P to differentiate it from more aggressive pancreatic neoplasms.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3390"},"PeriodicalIF":1.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212829","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}