SA Journal of Radiology最新文献

{"title":"Splenic pathologies: A pictorial review of common, wandering, twisting and rare presentations.","authors":"Audrey R Rumhumha, Phumudzo E Mphephu, Lungile M Gabuza","doi":"10.4102/sajr.v30i1.3366","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3366","url":null,"abstract":"<p><p>Splenic pathologies, often overlooked in abdominal imaging, encompass a broad spectrum of imaging appearances and diagnostic challenges, including congenital anomalies, benign cysts, infarcts, trauma, vascular lesions, infections and neoplasms. Recognising these entities is crucial to distinguish incidental benign findings from potentially life-threatening conditions. This pictorial review illustrates the spectrum through 20 cases, including a rare case of a wandering spleen complicated by torsion and auto-infarction that demonstrates the classical 'whorled pedicle' and 'twisted vascular pedicle' signs. Ultrasound, CT, MRI and PET-CT images demonstrate typical and atypical features, emphasising key differentiating points and teaching pearls. Although not exhaustive, this overview underscores that closer scrutiny of the spleen is rewarding: a structured approach focusing on lesion location, enhancement patterns and clinical context improves diagnostic accuracy and guides timely management.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3366"},"PeriodicalIF":0.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647000","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":"Atypical cardiovocal syndrome associated with right aortic arch and Kommerell diverticulum.","authors":"Chetna Mishra, Vikas Yadav, Rama Anand, Moazzam Mojahid","doi":"10.4102/sajr.v30i1.3382","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3382","url":null,"abstract":"<p><p>Vocal cord palsy (VCP) can be caused by laryngeal and extra-laryngeal pathologies affecting the recurrent laryngeal nerves (RLNs). Many cases of left VCP related to cardiovascular pathologies have been documented. However, right VCP associated with cardiovocal (Ortner) syndrome is an atypical and rare presentation. A case of right VCP caused by a right aortic arch (RAA) and Kommerell diverticulum (KD), diagnosed on CT angiography, and its association with the variant course of the right RLN, is described.</p><p><strong>Contribution: </strong>This case report highlights the rarity of cardiovocal syndrome causing a right VCP and the association of a RAA with the variant course of the right RLN hooking around the RAA in place of the right subclavian artery.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3382"},"PeriodicalIF":0.9,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647005","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":"<i>Chest In Time</i>: Investigating the utility of a novel X-ray based blunt chest trauma clinical prediction model in a resource-limited setting in South Africa.","authors":"Avika Kalideen, Tanusha Sewchuran","doi":"10.4102/sajr.v30i1.3344","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3344","url":null,"abstract":"<p><strong>Background: </strong>Blunt chest trauma (BCT) is a frequent manifestation of traumatic injury, either as isolated thoracic injury or in the setting of polytrauma.</p><p><strong>Objectives: </strong>Several chest trauma scores (CTSs) exist based on clinical, biochemical and imaging findings to assist in the risk stratification of patients who have sustained blunt chest trauma. These injuries are often not initially clinically evident and a risk stratification tool serves to identify patients at risk for pulmonary compromise and to establish early diagnostic and therapeutic strategies to improve morbidity and mortality.</p><p><strong>Method: </strong>Patient data were obtained from the Greys Hospital Emergency Department's triage books. The images for patients within the study sample were scored under the categories of age, number of rib fractures, bilaterality of rib fractures, presence and significance of pulmonary contusions, and pleural-based injury. Patients were classified as either critical or non-critical using final disposition as a surrogate. The seminal CTS was initially calculated, following which a novel South African chest trauma score (SA-CTS) was hypothesised and computed based on the chest X-ray alone for ease of applicability and reproducibility in resource-constrained settings.</p><p><strong>Results: </strong>A conventional CTS ≥ 5 was clinically significant for a critical outcome. However, with the SA-CTS, a score ≥ 4 was found to be statistically significant. Age was not found to be a significant contributing factor. Pleural-based injuries were found to be contributory factors to a critical outcome.</p><p><strong>Conclusion: </strong>Clinical prediction models serve in the risk stratification and early identification and pre-emptive management of patients at high risk for clinical decompensation. Based on the results, the incorporation of the SA-CTS into daily practice in the management of BCT patients is proposed.</p><p><strong>Contribution: </strong>This will prove especially useful in triggering early up-referral for both advanced imaging and tertiary level care in a resource limited setting.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3344"},"PeriodicalIF":0.9,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647062","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":"Knowledge, attitudes and current practices regarding LI-RADS^®: A survey from 14 countries in sub-Saharan Africa.","authors":"Rajshree Segobin, Dale Creamer, Rufaida Khan, Eduard Jonas, Sanju Sobnach, Sulaiman Moosa","doi":"10.4102/sajr.v30i1.3367","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3367","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is highly prevalent in sub-Saharan Africa (SSA). LI-RADS^® is a standardised system for imaging-based diagnosis and characterisation of HCC.</p><p><strong>Objectives: </strong>This study assessed knowledge, attitudes and current practices related to LI-RADS in SSA, with a view to identifying barriers to its utilisation and informing targeted educational interventions.</p><p><strong>Method: </strong>A 21-item anonymous electronic questionnaire was distributed to medical professionals in SSA using the SurveyMonkey online platform. Knowledge, attitudes and current practices regarding LI-RADS^® were assessed. Data were analysed using descriptive statistics, and comparisons were made between radiologists and non-radiologists.</p><p><strong>Results: </strong>There were 134 respondents from 14 of the 34 SSA countries. Radiologists significantly outperformed non-radiologists in LI-RADS^® knowledge, particularly regarding its purpose (65.6% vs 38.2%, <i>p</i> = 0.0007), arterial phase hyperenhancement definition (90.3% vs 59.8%, <i>p</i> = 0.004) and size criteria (77.4% vs 45.1%, <i>p</i> = 0.003) for diagnosing hepatocellular carcinoma (HCC). However, 43.8% of radiologists and 63.4% of non-radiologists did not recognise the limitations of LI-RADS^®. Only 34.3% stated that LI-RADS^® was their reporting standard and 29.1% of the respondents indicated that less than 25% of their radiological reports adhered to LI-RADS^®. The majority (78.3%) of participants stated they preferred radiology reports for high-risk liver lesions to be LI-RADS^®-standardised. The two main barriers to adopting LI-RADS^® included lack of consistency (44.8%) and unfamiliarity with the reporting system (27.6%).</p><p><strong>Conclusion: </strong>Although LI-RADS^® remains the preferred reporting system for HCC, there are significant gaps in its knowledge and implementation across SSA.</p><p><strong>Contribution: </strong>This survey highlights the needs for targeted educational initiatives and improved training to enhance the adoption and use of LI-RADS^® in SSA.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3367"},"PeriodicalIF":0.9,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436280","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":"Score to scan: Is there a link between Glasgow Coma Scale score and CT neuroimaging findings in trauma?","authors":"Kavishka Sewnarain, Shalendra K Misser, Jaynund Maharajh, S Sameer Nadvi","doi":"10.4102/sajr.v30i1.3304","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3304","url":null,"abstract":"<p><strong>Background: </strong>Many South African peripheral medical centres lack direct access to CT scans or neurosurgery. The Glasgow Coma Scale (GCS), used with or without other findings, remains widely utilised in traumatic brain injury (TBI) assessments with lack of standardisation between centres. There is limited data from South Africa (SA) correlating GCS scores to CT imaging in TBI.</p><p><strong>Objectives: </strong>This study aimed to assess CT findings at various GCS levels to determine whether GCS was a reliable indicator for imaging and referral.</p><p><strong>Method: </strong>A retrospective review of 385 patients categorised with mild, moderate or severe TBI was performed. The initial non-sedated post-resuscitation GCS score and initial CT brain findings were compared using the chi-square and Fisher's exact tests.</p><p><strong>Results: </strong>Increased intracranial pressure and subdural haemorrhage occurred in 41.7% and 53.7% of patients with GCS 9-12, respectively, and 30.5% and 41.4% of patients with GCS 13-15, respectively. The highest incidence of depressed skull fractures (51.3%; 95% confidence interval [CI], 43.2-59.3%; <i>p</i> < 0.001) and pneumocephalus (25.6%; 95% CI, 42.2-56.4; <i>p</i> < 0.001) were reported in the CGS 13-15 category. Neurosurgical intervention was required in 83.2% and 73.0% of patients with GCS scores of 9-12 and 13-15, respectively.</p><p><strong>Conclusion: </strong>The severe category of GCS predicts imaging and neurosurgery requirements while the mild to moderate categories underpredict the need for patient referral.</p><p><strong>Contribution: </strong>This study provides rationale for the development of a local, standardised assessment tool to guide referral of TBI patients for imaging in resource-limited settings.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3304"},"PeriodicalIF":0.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436300","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":"Multimodal imaging in conductive hearing loss: Optimising CT, MRI and CTA for accurate diagnosis and management.","authors":"Athanasios Vlachodimitropoulos, Michail Athanasopoulos, Afroditi Lepida, Pinelopi Samara, Ioannis E Papachristos, Theodoros Stathas, Spyridon Lygeros, Georgios Batsaouras","doi":"10.4102/sajr.v30i1.3278","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3278","url":null,"abstract":"<p><p>Conductive hearing loss (CHL) results from impaired mechanical transmission of sound through the external or middle ear and is commonly associated with conditions such as otosclerosis, cholesteatoma, ossicular discontinuity, congenital malformations and trauma. Less frequently, it may arise from vascular or neoplastic lesions. Imaging plays a central role in the evaluation of CHL, with high-resolution CT (HRCT) regarded as the gold standard for initial assessment because of its superior spatial resolution in detecting bony pathologies, including fenestral otosclerosis, ossicular chain defects, third-window lesions and trauma-related disruptions. MRI complements HRCT by providing excellent soft tissue contrast, facilitating the detection of postoperative cholesteatoma via non-echo-planar diffusion-weighted imaging and the characterisation of vascular tumours such as glomus tympanicum. CT angiography (CTA), while not routinely indicated, can be valuable for identifying vascular anomalies and aiding surgical planning in selected cases. Technical considerations, such as optimised scan parameters, strategies for radiation dose reduction in paediatric patients and the integration of multiple imaging modalities, are essential for accurate diagnosis and effective treatment planning. Collectively, HRCT, MRI and CTA provide a structured, evidence-based framework for the comprehensive evaluation and management of CHL.</p><p><strong>Contribution: </strong>This review synthesises current evidence on HRCT, MRI and CTA in the assessment of CHL, emphasising their complementary roles, protocol optimisation and multimodal integration to enhance diagnostic accuracy and surgical guidance in both paediatric and adult populations.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3278"},"PeriodicalIF":0.9,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436256","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":"A rare case of splenic arteriovenous fistula causing portal hypertension, treated by embolisation.","authors":"Dane J Rampini, John A Cantrell","doi":"10.4102/sajr.v30i1.3345","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3345","url":null,"abstract":"<p><p>This case report highlights the findings and treatment in a patient with a splenic arteriovenous fistula causing non-cirrhotic portal hypertension (NCPH). Splenic arteriovenous malformations (AVMs) are rare, and their management using percutaneous embolisation is an emerging alternative modality as opposed to open surgical intervention.</p><p><strong>Contribution: </strong>Similar cases have been published; however, few highlight the management role of interventional radiology.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3345"},"PeriodicalIF":0.9,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436312","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":"Congenital depressed skull fracture in a neonate without obstetric trauma.","authors":"Elliot K Mmutle, Baby S Lekhuleni, Luvo Gaxa","doi":"10.4102/sajr.v30i1.3305","DOIUrl":"https://doi.org/10.4102/sajr.v30i1.3305","url":null,"abstract":"<p><p>Congenital depressed skull fractures (ping-pong fractures) without obstetric trauma are rare. A term male neonate delivered via uncomplicated caesarean section, demonstrated a right parieto-temporal skull depression (5 cm × 5 cm) at birth. Computed tomography revealed a 4 mm parietal depression without intracranial injury. No instrumental delivery or maternal trauma were present. The likely aetiology was intrauterine compression ('faulty foetal packing'). The patient was managed conservatively with close follow-up.</p><p><strong>Contribution: </strong>This case underscores the importance of perinatal history and neuroimaging in distinguishing spontaneous from traumatic fractures and supports conservative management in neurologically intact infants.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3305"},"PeriodicalIF":0.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436248","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":"Isolated mediastinal lymphangioma in a child: A rare case report.","authors":"Ankita Gupta, Maheswar Chaudhury, Manoranjan Khuntia, Peeta H Prasad, Somadatta Das","doi":"10.4102/sajr.v29i1.3274","DOIUrl":"10.4102/sajr.v29i1.3274","url":null,"abstract":"<p><p>The mediastinum is an unusual location for cystic lymphangiomas. An 18-month-old male presented with acute fever, dry intermittent cough and respiratory distress. Chest radiography, ultrasonography, contrast-enhanced CT and MRI suggested a diagnosis of mediastinal cystic lymphangioma with internal haemorrhage. Surgical excision of the lesion and histopathological examination confirmed cystic lymphangioma.</p><p><strong>Contribution: </strong>This case highlights the multimodal radiological features of isolated mediastinal cystic lymphangioma for accurate diagnosis and improved management, to avoid unnecessary interventions and complications.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"29 1","pages":"3274"},"PeriodicalIF":0.9,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020161","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":"Correlation of clinical and radiological findings in patients with spinal trauma at Inkosi Albert Luthuli Central Hospital.","authors":"Lufuno J Badzhi, Timothy C Hardcastle, Pumersha Naidoo","doi":"10.4102/sajr.v29i1.3248","DOIUrl":"10.4102/sajr.v29i1.3248","url":null,"abstract":"<p><strong>Background: </strong>Assessment of spinal trauma entails a full neurological examination and radiological assessment to determine the level of spinal cord injury.</p><p><strong>Objectives: </strong>This study aimed to determine if further imaging is always required, whether the clinical picture correlates with imaging results and to compare clinical and radiological prediction accuracy.</p><p><strong>Method: </strong>This retrospective chart review compared and correlated clinical findings with radiological findings in patients with spinal trauma at Inkosi Albert Luthuli Central Hospital over a period of 6 years. Demographics and sensitivity and specificity of clinical to imaging correlation with positive predictive ratios were assessed.</p><p><strong>Results: </strong>A total of 290 patients admitted with spinal injury, who received CT and/or MRI, were evaluated. Cervical-spine injuries were common. For predicting abnormal CT findings, the sensitivity of motor and sensory findings was 69.2% with a specificity of 85.4%. The positive predictive value (PPV) of motor and sensory findings was 96.2%. The negative predictive value (NPV) of motor and sensory findings was 34.0%. On MRI, sensitivity for motor and sensory findings was 85.1% for correctly predicting abnormal MRI findings, while the specificity was 52.8%. The PPV of motor and sensory findings was 82.5% with a NPV of 57.6%.</p><p><strong>Conclusion: </strong>In this trauma population, correlation of clinical findings with abnormal CT findings was 84.4% and for MRI findings was 72.3%, indicating that clinical findings alone may not be sufficient to rule out the need for imaging; false negatives could lead to missed or incorrect level of injury diagnoses.</p><p><strong>Contribution: </strong>This study adds to the proof that while clinical findings are reasonably accurate for the determination of neurological spinal cord injury level, both CT and MRI add additional information, making these tests invaluable.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"29 1","pages":"3248"},"PeriodicalIF":0.9,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020126","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}