SA Journal of RadiologyPub Date : 2022-07-22eCollection Date: 2022-01-01DOI: 10.4102/sajr.v26i1.2464
Yusuf Parak, Razaan Davis, Michelle Barnard, Amanda Fernandez, Keith Cloete, Matodzi Mukosi, Richard D Pitcher
{"title":"A 6-year audit of public-sector MR utilisation in the Western Cape province of South Africa.","authors":"Yusuf Parak, Razaan Davis, Michelle Barnard, Amanda Fernandez, Keith Cloete, Matodzi Mukosi, Richard D Pitcher","doi":"10.4102/sajr.v26i1.2464","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2464","url":null,"abstract":"<p><strong>Background: </strong>Disparities in MR access between different countries and healthcare systems are well documented. Determinants of unequal access within the same healthcare system and geographical region are poorly understood.</p><p><strong>Objective: </strong>An analysis of public sector MR utilisation in South Africa's Western Cape province (WCP).</p><p><strong>Methods: </strong>A retrospective study of WCP MR and population data for 2013 and 2018. MR units/10<sup>6</sup> people, studies, and studies/10<sup>3</sup> people were calculated for each year, for the whole province and the 'western' and 'eastern' referral pathways, stratified by age (0-14 years, > 14 years).</p><p><strong>Results: </strong>Between 2013 and 2018, the WCP population increased 8% (4.63 vs 5.08 × 10<sup>6</sup> people) while MR resources were unchanged ('western' = 2 units; 'eastern' = 1), equating to decreasing access (units/10<sup>6</sup> people) for the province (0.65 vs 0.59; -9.2%), the 'western' (0.97 vs 0.9; -7.2%) and 'eastern' (0.39 vs 0.35; -10.3%) pathways. In 2013, 40% (4005/10 090) of studies were in the 'eastern' pathway serving 55% (2 066 079/4 629 051) of the population. Between 2013 and 2018 'eastern' population growth (<i>n</i> = 286 781) exceeded 'western' (<i>n</i> = 168 469) by 70% (<i>n</i> = 118 312). By 2018, 38% (7939/12 848) of studies were performed in the 'eastern' pathway, then serving 56% (2 849 753/5 084 301) of the population. Among 0-14-year-olds, 'western' utilisation (studies/103 people) exceeded 'eastern' by a factor of approximately 2.4 throughout. In patients > 14 years, the utilisation differential increased from 1.78 to 1.98 in the review period.</p><p><strong>Conclusion: </strong>Ensuring equitable services on the same healthcare platform requires ongoing surveillance of resource and population distribution. MR access can serve as a proxy for equity in highly specialised services.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2464"},"PeriodicalIF":0.9,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40592564","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":"Revisiting the forgotten remnant: Imaging spectrum of Meckel's diverticulum.","authors":"Manish Kumar, Priya Singh, Priti Kumari, Rohit Kaushik","doi":"10.4102/sajr.v26i1.2431","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2431","url":null,"abstract":"<p><p>Meckel's diverticulum is a true diverticulum of the alimentary tract occurring resulting from the persistence of remnants of the vitello-intestinal duct. They are often asymptomatic and incidentally diagnosed during surgery. Complications such as intestinal obstruction, diverticulitis, intestinal haemorrhage and perforation may occur with Meckel's diverticulum, which renders them symptomatic. The clinical and imaging diagnosis of Meckel's diverticulum is very challenging. As a result of the rare occurrence of complicated Meckel's diverticulum and the difficult preoperative diagnosis, knowledge of its imaging features is limited. The presented case series describes a spectrum of complications caused by Meckel's diverticulum and its CT imaging features. It highlights the importance of a high clinical suspicion by carefully searching for a Meckel's diverticulum on CT in its characteristic location to avoid missing it preoperatively.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2431"},"PeriodicalIF":0.9,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40592562","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}
SA Journal of RadiologyPub Date : 2022-06-30eCollection Date: 2022-01-01DOI: 10.4102/sajr.v26i1.2347
Efosa P Iyawe, Bukunmi M Idowu, Olasubomi J Omoleye
{"title":"Corrigendum: Radiology subspecialisation in Africa: A review of the current status.","authors":"Efosa P Iyawe, Bukunmi M Idowu, Olasubomi J Omoleye","doi":"10.4102/sajr.v26i1.2347","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2347","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.4102/sajr.v25i1.2168.].</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2347"},"PeriodicalIF":0.9,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40507753","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 lumpy bumpy stomach: The more the murkier.","authors":"Binit Sureka, Siddhi Chawla, Sudeep Khera, Ashish Agarwal, Chhagan L Birda, Sandeep Bairwa","doi":"10.4102/sajr.v26i1.2437","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2437","url":null,"abstract":"<p><p>This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review differentiating the pathological subtypes, important for patient prognostication and planning of therapy.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2437"},"PeriodicalIF":0.9,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40591351","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}
SA Journal of RadiologyPub Date : 2022-06-27eCollection Date: 2022-01-01DOI: 10.4102/sajr.v26i1.2410
Pavel Burko, Nitin Juggath, Ruslan Iliasov, Mariya Fedorova, Natalia Nazarova
{"title":"A case report of multinodular hepatic steatosis mimicking pseudotumors of the liver.","authors":"Pavel Burko, Nitin Juggath, Ruslan Iliasov, Mariya Fedorova, Natalia Nazarova","doi":"10.4102/sajr.v26i1.2410","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2410","url":null,"abstract":"<p><p>Fatty liver disease (FLD) is a common, benign pathology often found incidentally. We present a clinical case in which metastatic liver disease was suspected on initial imaging studies. Following further investigations, a diagnosis of 'non-alcoholic fatty liver disease (NAFLD), multinodular type' was postulated. Subsequent histology confirmed the presence of liver steatosis. Multinodular type hepatic steatosis is a rare, but clinically important pathology to identify and differentiate from other multifocal lesions of the liver parenchyma.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2410"},"PeriodicalIF":0.9,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40591352","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}
SA Journal of RadiologyPub Date : 2022-05-20eCollection Date: 2022-01-01DOI: 10.4102/sajr.v26i1.2344
Monish G Karthikeyan, Poojitha Ronda, Prabhu C Sugumaran
{"title":"Factor XIII deficiency in a neonate presenting as subpial haemorrhage.","authors":"Monish G Karthikeyan, Poojitha Ronda, Prabhu C Sugumaran","doi":"10.4102/sajr.v26i1.2344","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2344","url":null,"abstract":"<p><p>Subpial haemorrhage is a rare cause of seizures in term neonates. A 3-day-old male infant, born at term with no history of perinatal hypoxia, presented with seizures and unremarkable physical examination in the interictal state. Imaging demonstrated left temporal subpial haemorrhage with the classic 'yin-yang sign' on MRI. The patient was subsequently diagnosed with factor XIII deficiency. Follow-up at 6 months and 12 months revealed encephalomalacia in the previous haemorrhagic areas with normal developmental milestones.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2344"},"PeriodicalIF":0.9,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394842","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}
SA Journal of RadiologyPub Date : 2022-05-20eCollection Date: 2022-01-01DOI: 10.4102/sajr.v26i1.2406
Humphrey Mapuranga, Bianca Douglas-Jones, Danelo du Plessis, Camilla E le Roux, Christel du Buisson, Shahida Moosa
{"title":"A rare case of tuberous sclerosis complex-associated renal cell carcinoma.","authors":"Humphrey Mapuranga, Bianca Douglas-Jones, Danelo du Plessis, Camilla E le Roux, Christel du Buisson, Shahida Moosa","doi":"10.4102/sajr.v26i1.2406","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2406","url":null,"abstract":"<p><p>Renal cell carcinoma is rarely described in paediatric patients with tuberous sclerosis complex. This report describes a case of an 11-year-old male with tuberous sclerosis-associated renal cell carcinoma.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2406"},"PeriodicalIF":0.9,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393544","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}
SA Journal of RadiologyPub Date : 2022-05-19eCollection Date: 2022-01-01DOI: 10.4102/sajr.v26i1.2386
Ranjit Singh, Mitchell P Wilson, Florin Manolea, Bilal Ahmed, Christopher Fung, Darryn Receveur, Gavin Low
{"title":"Diagnostic accuracy and inter-reader reliability of the MRI Liver Imaging Reporting and Data System (version 2018) risk stratification and management system.","authors":"Ranjit Singh, Mitchell P Wilson, Florin Manolea, Bilal Ahmed, Christopher Fung, Darryn Receveur, Gavin Low","doi":"10.4102/sajr.v26i1.2386","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2386","url":null,"abstract":"Background Hepatocellular carcinoma (HCC) can be diagnosed non-invasively, provided certain imaging criteria are met. However, the recent Liver Imaging Reporting and Data System (LI-RADS) version 2018 has not been widely validated. Objectives This study aimed to evaluate the diagnostic accuracy and reader reliability of the LI-RADS version 2018 lexicon amongst fellowship trained radiologists compared with an expert consensus reference standard. Method This retrospective study was conducted between 2018 and 2020. A total of 50 contrast enhanced liver magnetic resonance imaging (MRI) studies evaluating focal liver observations in patients with cirrhosis, hepatitis B virus (HBV) or prior HCC were acquired. The standard of reference was a consensus review by three fellowship-trained radiologists. Diagnostic accuracy including sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) and area under the curve (AUC) values were calculated per LI-RADS category for each reader. Kappa statistics were used to measure reader agreement. Results Readers demonstrated excellent specificities (88% – 100%) and NPVs (85% – 100%) across all LI-RADS categories. Sensitivities were variable, ranging from 67% to 83% for LI-RADS 1, 29% to 43% for LI-RADS 2, 100% for LI-RADS 3, 70% to 80% for LI-RADS 4 and 80% to 84% for LI-RADS 5. Readers showed excellent accuracy for differentiating benign and malignant liver lesions with AUC values > 0.90. Overall inter-reader agreement was ‘good’ (kappa = 0.76, p < 0.001). Pairwise inter-reader agreement was ‘very good’ (kappa ≥ 0.90, p < 0.001). Conclusion The LI-RADS version 2018 demonstrates excellent specificity, NPV and AUC values for risk stratification of liver observations by radiologists. Liver Imaging Reporting and Data System can reliably differentiate benign from malignant lesions when used in conjunction with corresponding LI-RADS management recommendations.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2386"},"PeriodicalIF":0.9,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394727","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":"Cervical extension of pancreatic pseudocyst: An unusual cause of neck stiffness and dysphagia.","authors":"Sneha Harish C, Rashmi Dixit, Sapna Singh, Anjali Prakash","doi":"10.4102/sajr.v26i1.2385","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2385","url":null,"abstract":"<p><p>Pancreatic pseudocyst is a common complication that can occur following acute or chronic pancreatitis. Commonly, they are peripancreatic in location. Rarely, they can extend to the mediastinum, and further extension to the neck is even rarer. A 55-year-old man who presented with neck stiffness and dysphagia and on imaging, was found to have a cystic lesion in the neck. Aspiration of the lesion revealed raised amylase levels suggestive of a pancreatic pseudocyst.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2385"},"PeriodicalIF":0.9,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394728","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}
Saumya Pandey, Nitin Agarwal, V. Gupta, Ashok K Sharma, A. Aggarwal, Sunita Gupta, Ram Krishan
{"title":"Diagnosing rare intraductal biliary neoplasms – Intraductal papillary neoplasm of the bile duct: A case report with typical imaging findings","authors":"Saumya Pandey, Nitin Agarwal, V. Gupta, Ashok K Sharma, A. Aggarwal, Sunita Gupta, Ram Krishan","doi":"10.4102/sajr.v26i1.2387","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2387","url":null,"abstract":"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.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"5 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89016800","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}