SA Journal of Radiology最新文献_第6页

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

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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

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

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SA Journal of Radiology Pub Date : 2022-03-24 DOI: 10.4102/sajr.v26i1.2350

Derik J. Basson, H. Moodley

{"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":"6 1","pages":""},"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

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SA Journal of Radiology Pub Date : 2022-03-24 DOI: 10.4102/sajr.v26i1.2321

Pilasande Hlwatika, T. Hardcastle

{"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":"2008 1","pages":""},"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

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SA Journal of Radiology Pub Date : 2022-02-28 DOI: 10.4102/sajr.v26i1.2280

Petri Ahlers, Mariam Q. Said-Hartley

{"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":"36 1","pages":""},"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

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SA Journal of Radiology Pub Date : 2022-02-22 DOI: 10.4102/sajr.v26i1.2311

Robyn M Wessels, H. Moodley

{"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":"3 1","pages":""},"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

Case discussions of missed traumatic fractures on computed tomography scans. 外伤性骨折计算机断层扫描漏诊的病例讨论。

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SA Journal of Radiology Pub Date : 2022-01-01 DOI: 10.4102/sajr.v26i1.2516

Amy J Spies, Maryna Steyn, Desiré Brits, Daniel N Prince

{"title":"Case discussions of missed traumatic fractures on computed tomography scans.","authors":"Amy J Spies, Maryna Steyn, Desiré Brits, Daniel N Prince","doi":"10.4102/sajr.v26i1.2516","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2516","url":null,"abstract":"Radiological diagnostic errors are common and may have severe consequences. Understanding these errors and their possible causes is crucial for optimising patient care and improving radiological training. Recent postmortem studies using an animal model highlighted the difficulties associated with accurate fracture diagnosis using radiological imaging. The present study aimed to highlight the fact that certain fractures are easily missed on CT scans in a clinical setting and that caution is advised. A few such cases were discussed to raise the level of suspicion to prevent similar diagnostic errors in future cases. Records of adult patients from the radiological department at an academic hospital in South Africa were retrospectively reviewed. Case studies were selected by identifying records of patients between January and June 2021 where traumatic fractures were missed during initial imaging interpretation but later detected during secondary analysis or on follow-up scans. Seven cases were identified, and the possible causes of the diagnostic errors were evaluated by reviewing the history of each case, level of experience of each reporting radiologist, scan quality and time of day that initial imaging interpretation of each scan was performed. The causes were multifactorial, potentially including a lack of experience, fatigue, heavy workloads or inadequate training of the initial reporting radiologist. Identifying these causes, openly discussing them and providing additional training for radiologists may aid in reducing these errors.Contribution: This article aimed to use case examples of missed injuries on CT scanning of patients in a South African emergency trauma setting in order to highlight and provide insight into common errors in scan interpretation, their causes and possible means of mitigating them.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"26 1","pages":"2516"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10379742","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

Imaging of the neurological manifestations of dengue: A case series. 登革热神经系统表现的影像学:一个病例系列。

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SA Journal of Radiology Pub Date : 2022-01-01 DOI: 10.4102/sajr.v26i1.2528

Varsha Rangankar, Divyajat Kumar, Rajesh Kuber, Tushar Kalekar

引用次数: 0

Paediatric minor head injury applied to Paediatric Emergency Care Applied Research Network CT recommendations: An audit. 儿科轻微头部损伤应用于儿科急诊护理应用研究网络CT建议:审计。

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SA Journal of Radiology Pub Date : 2022-01-01 DOI: 10.4102/sajr.v26i1.2289

Jacques du Plessis, Sharadini K Gounden, Carolyn Lewis

{"title":"Paediatric minor head injury applied to Paediatric Emergency Care Applied Research Network CT recommendations: An audit.","authors":"Jacques du Plessis, Sharadini K Gounden, Carolyn Lewis","doi":"10.4102/sajr.v26i1.2289","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2289","url":null,"abstract":"Background: Traumatic brain injury (TBI) is a common cause of paediatric morbidity and mortality, with higher TBI rates in low- and middle-income countries. Non-contrast brain CT is the gold standard for diagnosing intracranial injuries; however, it exposes patients to ionising radiation. The Paediatric Emergency Care Applied Research Network (PECARN) clinical decision rule (CDR) aids clinicians in their decision-making processes whilst deciding whether a patient at very low risk of a clinically important TBI (ciTBI) requires a CT scan.Objectives: To establish whether the introduction of the PECARN CDR would affect CT utilisation rates for paediatric patients presenting with minor blunt head injuries to an academic hospital in Gauteng, South Africa.Method: This was an audit of paediatric patients who presented with minor blunt head injuries and were referred for CT imaging at an academic hospital in Gauteng, compared with PECARN CDR recommendations, over a 1-year period.Results: A total of 100 patients were referred for CT imaging. Twenty patients were classified as very low risk, none of whom had any CT findings of a TBI or ciTBI (p < 0.01). A total of 61 patients were classified as intermediate risk and 19 as high risk. In all, 23% of the intermediate and 47% of the high-risk patients had CT features of a TBI, whilst 8% and 37% had a ciTBI, respectively.Conclusion: Computed tomography brain imaging may be omitted in patients classified as very low risk without missing a clinically important TBI. Implementing the PECARN CDR in appropriate patients would reduce CT utilisation rates.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"26 1","pages":"2289"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10598169","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

Journalism - De-constructing the jigsaw. 新闻——解构拼图。

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SA Journal of Radiology Pub Date : 2021-12-09 eCollection Date: 2021-01-01 DOI: 10.4102/sajr.v25i1.2356

Maya Patel

引用次数: 0

A case of racemose and intraventricular neurocysticercosis in an unusual location. 异常部位的总状脑室内神经囊虫病1例。

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SA Journal of Radiology Pub Date : 2021-12-06 eCollection Date: 2021-01-01 DOI: 10.4102/sajr.v25i1.2171

Priya Singh, Surya P Singh

引用次数: 0