SA Journal of Radiology最新文献

{"title":"Communicating bronchopulmonary foregut malformations: Revisiting a rare entity.","authors":"Abhinav C Bhagat, Radha Sarawagi, Allen Johnson, Rajesh Malik, Anita Mathew","doi":"10.4102/sajr.v30i1.3453","DOIUrl":"10.4102/sajr.v30i1.3453","url":null,"abstract":"<p><p>Communicating bronchopulmonary foregut malformations (CBPFM) are rare developmental tracheo-bronchial anomalies characterised by a patent communication between the respiratory system and upper gastrointestinal tract. Clinical diagnosis is challenging because of non-specific symptoms and overlapping clinical presentation with tracheo-oesophageal fistula. Imaging plays a key role in early diagnosis and management of this rare entity. This case report describes two cases of CBPFM, highlighting the key imaging findings on various modalities along with a brief review of literature.</p><p><strong>Contribution: </strong>This case report underscores the typical imaging features of CBPFM and the role of imaging in differentiating it from the more common tracheo-oesophageal fistula.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3453"},"PeriodicalIF":1.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212860","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":"Redefining HIV-associated large-vessel vasculopathy in the antiretroviral therapy era: Multi-detector CT imaging findings and their correlation with intervention and patient outcomes.","authors":"S'yamthanda Zondi, Ntombizakhona Madlala, Balasoobramanien Pillay","doi":"10.4102/sajr.v30i1.3388","DOIUrl":"10.4102/sajr.v30i1.3388","url":null,"abstract":"<p><strong>Background: </strong>HIV-associated large-vessel vasculopathy (HALVV), previously described as a distinct entity characterised by young patients with atypical aneurysmal sites and few traditional risk factors, is now recognised across a wider age range in the antiretroviral therapy (ART) era. It continues to demonstrate aneurysmal and occlusive patterns distinct from conventional atherosclerotic disease. Despite its clinical importance, systematic correlations between imaging findings, management strategies and outcomes remain limited, particularly in sub-Saharan Africa.</p><p><strong>Objectives: </strong>This study aimed to characterise the multi-detector computed tomography (MDCT) angiographic features of HALVV and assess their association with intervention and clinical outcomes.</p><p><strong>Method: </strong>A retrospective observational study was conducted at Inkosi Albert Luthuli Central Hospital (IALCH) between 2018 and 2023. HIV-positive adults with extracranial large-vessel vasculopathy undergoing MDCT angiography were included. Associations between imaging findings, intervention and outcomes were assessed using the Pearson's chi-squared test (χ²) and logistic regression to identify predictors of adverse outcomes.</p><p><strong>Results: </strong>A total of 210 patients were included; 90 had aneurysmal disease, and 120 had occlusive disease. Fusiform aneurysms predominated (55.6%), and endovascular intervention was performed in 51.1% of cases. Device-related complications included type I and II endoleaks (13.3%) and stent failure (4.4%). Common iliac artery aneurysm independently predicted adverse device-related outcomes. Occlusive disease was predominantly long segment (85.8%), frequently multivessel (≥ 3 vessels in 70.8%) and associated with a high amputation rate (53.4%).</p><p><strong>Conclusion: </strong>Multi-detector CT angiography demonstrates distinct HALVV phenotypes with direct management implications. Endovascular treatment of aneurysmal HALVV shows favourable short-term outcomes but requires vigilant surveillance, particularly with iliac involvement. Occlusive HALVV is characterised by diffuse disease and poor limb salvage outcomes.</p><p><strong>Contribution: </strong>This study provides ART-era MDCT imaging-outcome correlations for HALVV in a South African tertiary setting.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3388"},"PeriodicalIF":1.0,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212780","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":"Bilateral cerebral peduncle infarct in a paediatric intensive care unit patient.","authors":"Fatimah Sheik, Rabia Abid","doi":"10.4102/sajr.v30i1.3433","DOIUrl":"10.4102/sajr.v30i1.3433","url":null,"abstract":"<p><p>Bilateral isolated cerebral peduncle infarction is a rare stroke, previously reported only in adults. This report describes a paediatric burns patient with preceding cardiac arrest who developed subtle neurology. Imaging revealed bilateral isolated peduncle infarcts with hypoplasia of the left posterior communicating and vertebral arteries. Despite supportive care, the patient deteriorated and demised. This case highlights the vulnerability of peduncular perforators to haemodynamic instability and emphasises the need for early imaging in the detection of paediatric stroke.</p><p><strong>Contribution: </strong>Isolated bilateral cerebral peduncle infarction is a rare form of stroke, particularly in the paediatric population, and is associated with a poor prognosis. Imaging plays an important role in the early diagnosis of this type of stroke.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"30 1","pages":"3433"},"PeriodicalIF":1.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869920","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":"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":"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":1.0,"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":"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":1.0,"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":"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":1.0,"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":"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":1.0,"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":"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":1.0,"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":"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":1.0,"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":"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":1.0,"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}