SA Journal of Radiology最新文献

{"title":"Accuracy of CT angiography for detecting ruptured intracranial aneurysms.","authors":"Nomasonto N Mkhize,&nbsp;Victor Mngomezulu,&nbsp;Thandi E Buthelezi","doi":"10.4102/sajr.v27i1.2636","DOIUrl":"https://doi.org/10.4102/sajr.v27i1.2636","url":null,"abstract":"<p><strong>Background: </strong>Digital subtraction angiography (DSA) is invasive, costly and unavailable in many South African hospitals; however, it remains the gold standard for imaging intracranial aneurysms. CT angiography (CTA) is a non-invasive and readily available screening tool prior to DSA.</p><p><strong>Objectives: </strong>This study aimed to evaluate the diagnostic performance of CTA in detecting ruptured intracranial aneurysms using DSA as the reference standard and to determine the effect of aneurysm size and location on CTA sensitivity.</p><p><strong>Method: </strong>A retrospective analysis of CTA and DSA data from reports of patients suspected to have aneurysmal subarachnoid haemorrhage (SAH) at Chris Hani Baragwanath Academic Hospital between January 2017 and June 2020.</p><p><strong>Results: </strong>Conventional DSA detected aneurysms in 94 out of 115 patients; while of these, CTA detected 75 and missed 19. The CTA sensitivity, specificity and accuracy was 80%, 43% and 73%, respectively. The CTA sensitivity for aneurysms < 3 mm and 3 mm - 5 mm in size was 30% and 81.5%, respectively (<i>p</i> = 0.024). Sensitivity of CTA for posterior communicating artery (PComm) aneurysms was 56% and lower than other major anterior circulation locations (83% - 91%) (<i>p</i> = 0.045).</p><p><strong>Conclusion: </strong>The CTA diagnostic efficiency was lower than previously reported, with even lower sensitivity for aneurysms < 3 mm and for those arising from the PComm. Thus, CTA should remain a screening tool prior to DSA in all local patients suspected to have aneurysmal SAH.</p><p><strong>Contribution: </strong>Larger, prospective studies are required to accurately define the role of CTA in diagnosing intracranial aneurysms in a developing country with limited resources.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"27 1","pages":"2636"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9607167","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":"Ultrasound and computed tomography in the evaluation of mesenteric lesions: A pictorial review.","authors":"Snehal I Kose,&nbsp;Sapna Singh,&nbsp;Anju Garg,&nbsp;Alpana Manchanda,&nbsp;Rajdeep Singh","doi":"10.4102/sajr.v27i1.2595","DOIUrl":"https://doi.org/10.4102/sajr.v27i1.2595","url":null,"abstract":"The mesentery is a broad fan-shaped fold of peritoneum that suspends the loops of small intestine from the posterior abdominal wall. Although primary neoplasms arising in the mesentery are rare, the mesentery is a major avenue for the dissemination of tumours, which can spread through hematogenous, lymphatic, direct or peritoneal seeding. Imaging helps in the diagnosis of these tumours and aids in directing appropriate treatment by assessing their size, extent and relationship with adjacent structures. The aim of this article is to describe the spectrum of imaging findings of the various mesenteric lesions using ultrasound and CT. Contribution Evaluation of the mesentery is often neglected during routine ultrasound (US) because of inadequate training and unfamiliarity with the common US features encountered with mesenteric disease. CT plays an essential role in the diagnosis of mesenteric disease. Knowledge of imaging characteristics of various mesenteric lesions helps in timely diagnosis and management.","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"27 1","pages":"2595"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9612960","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":"Radiology blues: Comparing occupational blue-light exposure to recommended safety standards.","authors":"Mari Wentzel,&nbsp;Jacques Janse van Rensburg,&nbsp;Jacobus J Terblans","doi":"10.4102/sajr.v27i1.2522","DOIUrl":"https://doi.org/10.4102/sajr.v27i1.2522","url":null,"abstract":"<p><strong>Background: </strong>The blue-light hazard is a well-documented entity addressing the detrimental health effects of high-energy visible light photons in the range of 305 nm - 450 nm. Radiologists spend long hours in front of multiple light-emitting diode (LED)-based diagnostic monitors emitting blue light, predisposing them to potentially higher blue-light dosages than other health professionals.</p><p><strong>Objectives: </strong>The authors aimed to quantify the blue light that radiology registrars are exposed to in daily viewing of diagnostic monitors and compared this with international occupational safety standards.</p><p><strong>Method: </strong>A limited cross-sectional observational study was conducted. Four radiology registrars at two academic hospitals in Bloemfontein from 01 October 2021 to 30 November 2021 participated. Diagnostic monitor viewing times on a standard workday were determined. Different image modalities obtained from 01 June 2019 to 30 November 2019 were assessed, and blue-light radiance was determined using a spectroscope and image analysis software. Blue-light radiance values were compared with international safety standards.</p><p><strong>Results: </strong>Radiology registrars spent on average 380 min in front of a diagnostic display unit daily. Blue-light radiance from diagnostic monitors was elevated in higher-intensity images such as chest radiographs and lower for darker images like MRI brain studies. The total blue-light radiance from diagnostic display units was more than 10 000 times below the recommended threshold value for blue-light exposure.</p><p><strong>Conclusion: </strong>Blue-light radiance from diagnostic displays measured well below the recommended values for occupational safety. Hence, blue-light exposure from diagnostic monitors does not significantly add to the occupational health burden of radiologists.</p><p><strong>Contribution: </strong>Despite spending long hours in front of diagnostic monitors, radiologists' exposure to effective blue-light radiance from monitors was far below hazardous values. This suggests that blue-light exposure from diagnostic monitors does not increase the occupational health burden of radiologists.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"27 1","pages":"2522"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10684103","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 in Van Wyk Grumbach syndrome: An uncommon presentation of hypothyroidism.","authors":"Poonam Sherwani,&nbsp;Khanak K Nandolia,&nbsp;Kirti Joshi,&nbsp;Radhapyari Lourembam","doi":"10.4102/sajr.v27i1.2572","DOIUrl":"https://doi.org/10.4102/sajr.v27i1.2572","url":null,"abstract":"<p><p>Isosexual precocious puberty with ovarian masses in long-standing juvenile hypothyroidism is well described in the literature as Van Wyk Grumbach syndrome (VWGS). The present case reports this rare entity in a 4-year-old girl who was referred for imaging to evaluate the cause of non-traumatic bleeding per vagina. Antecedent history, clinical features and thyroid function tests were consistent with long-standing juvenile hypothyroidism with documented clinical response to thyroxine replacement therapy.</p><p><strong>Contribution: </strong>Typical clinical and radiological features of the syndrome are reported, which helps in the early diagnosis and management, henceforth avoiding the associated complications.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"27 1","pages":"2572"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9687490","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":"Terminal quadrifurcation of the aorta: A case report.","authors":"Siviwe S Mpateni,&nbsp;Jacques Bence,&nbsp;Richard D Pitcher,&nbsp;Michelle Da Silva","doi":"10.4102/sajr.v27i1.2564","DOIUrl":"https://doi.org/10.4102/sajr.v27i1.2564","url":null,"abstract":"<p><p>Congenital anatomical variations of the terminal aorta are rare. Given the increasing number of endovascular and laparoscopic procedures, such variations are likely to assume greater clinical significance. A 15-year-old male sustained a pelvic vascular injury following a stab to the left gluteus. Computed tomographic angiography and digital subtraction angiography demonstrated a left superior gluteal artery pseudoaneurysm and absence of the common iliac arteries consistent with congenital quadrifurcation of the terminal aorta. The patient was subsequently treated with endovascular coil embolisation with a good angiographic and clinical outcome.</p><p><strong>Contribution: </strong>Terminal aortic variants are rare and given the increasing number of interventional endovascular procedures performed in the aorta, an awareness of the potential anatomical configurations of the distal aortic branches is of increasing relevance. The authors describe the imaging findings of one such anatomical variant.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"27 1","pages":"2564"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10742081","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":"Endovascular management of intracranial aneurysms at Chris Hani Baragwanath Academic Hospital.","authors":"Herchel Clarke,&nbsp;Trevor Nefale,&nbsp;Victor Mngomezulu","doi":"10.4102/sajr.v27i1.2634","DOIUrl":"https://doi.org/10.4102/sajr.v27i1.2634","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, intracranial aneurysms are associated with a high mortality rate. While endovascular management has proven to be the choice of treatment in selected patients, patient demographics and aneurysm characteristics differ between study populations.</p><p><strong>Objectives: </strong>This study aimed to investigate the profile of patients with intracranial aneurysms who underwent endovascular management in the Interventional Neuroradiology Unit at Chris Hani Baragwanath Academic Hospital. Patient demographics, risk factors, indications, aneurysm characteristics and intra-operative complications were studied.</p><p><strong>Method: </strong>This was a 3-year retrospective study of all adult patients between 01 January 2018 and 31 January 2021. The Chi-square test was used to compare categorical variables.</p><p><strong>Results: </strong>A total of 77 patients were included in this study. The mean age of the patients was 47 ± 11.6 with a male-to-female ratio of 1:1.8. Hypertension was the most reported risk factor in 27% of patients. There was no statistical correlation between the gender groups according to presentation, multiplicity, aneurysmal size dimensions and locations. According to the presentation, there was statistical significance in ruptured intracranial aneurysms (<i>p</i> = 0.020), neck size dimensions less than 4 mm (<i>p</i> = 0.010), and aneurysms located in the internal cerebral artery (ICA) circulation (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>The study findings support known parameters including females and anterior circulation aneurysm preponderance, and the low complication risk of endovascular management. Interestingly, intracranial aneurysms presented with rupture at smaller size dimensions.</p><p><strong>Contribution: </strong>This study provides valuable insights into intracranial aneurysm characteristics and endovascular management efficacy in a resource-limited setting.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"27 1","pages":"2634"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9612956","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":"'Techtorial': Changing paradigms.","authors":"Maya Patel","doi":"10.4102/sajr.v26i1.2571","DOIUrl":"10.4102/sajr.v26i1.2571","url":null,"abstract":"","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"1 1","pages":"2571"},"PeriodicalIF":0.7,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70480652","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":"Scar endometriosis: Looking beyond the diagnosis - A case series.","authors":"Stuti Chandola, Anju Garg","doi":"10.4102/sajr.v26i1.2493","DOIUrl":"10.4102/sajr.v26i1.2493","url":null,"abstract":"<p><p>Scar endometriosis usually affects the abdominal wall or the perineum. Virtually all cases are linked with some form of surgical manipulation. Although the clinical diagnosis of scar endometriosis may be straightforward with classical symptomology, imaging with ultrasound and MRI are important for the determination of its extent, which is imperative for adequate preoperative planning. In addition, assessment of perineal scar endometriosis also requires the identification of anal sphincter complex involvement, which can significantly impact the surgical approach. Radiology plays a vital role in its diagnosis in atypical clinical scenarios.</p><p><strong>Contribution: </strong>This series of four cases describes the morphology and highlights the importance of imaging in the surgical management of scar endometriosis; three with abdominal wall involvement and one with the involvement of perineum.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":"1 1","pages":"2493"},"PeriodicalIF":0.7,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43923076","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":"Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital.","authors":"Mirko Trentadue,&nbsp;Plinio Calligaro,&nbsp;Gianluigi Lazzarini,&nbsp;Fabio Bonomi Boseggia,&nbsp;Elena Residori,&nbsp;Jennifer Hu,&nbsp;Silvana Vanti,&nbsp;Linda Lillo,&nbsp;Giovanna Varischi,&nbsp;Roberto Cerini","doi":"10.4102/sajr.v26i1.2509","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2509","url":null,"abstract":"<p><strong>Background: </strong>Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management.</p><p><strong>Objectives: </strong>To highlight the characteristics of haemorrhages in patients with COVID-19 infection.</p><p><strong>Method: </strong>A retrospective study examined CT scans performed over a 13-month period in patients hospitalised with COVID-19 infection to determine those who developed spontaneous bleeding. The authors also investigated correlations between the bleeding events and the patients' characteristics.</p><p><strong>Results: </strong>Haemorrhages occurred in 2.22% (31/1396) of patients hospitalised with COVID-19 infection (7.88%, 19/241 in the intensive care unit). Bleeding, major in most cases, occurred in anticoagulated patients, especially males with multiple comorbidities, aged between 60 and 79 years and mainly appeared in a single anatomical region (especially retroperitoneal), with the most voluminous in the chest wall. The complication was diagnosed on average 16.7 days after admission and occurred predominantly in critically ill patients undergoing invasive ventilation and pronation-supination cycles. In just under half of the cases, the haematomas were active, and in these cases, mainly with a single contrast blush and with earlier onset after the start of anticoagulation than in non-active bleeding. Major bleeding was also earlier in the presence of multiple morbidity. The vast majority of patients were treated conservatively and survived.</p><p><strong>Conclusion: </strong>At COVID-19 hospital centres, it is advisable that there is knowledge of such a complication for which CT imaging is essential for diagnosis and proper management. Although some authors have expressed doubts about anticoagulant treatment in patients with COVID-19, the bleeding complication in this study did not significantly affect the outcome.</p><p><strong>Contribution: </strong>Spontaneous haemorrhage did not significantly affect the outcome in this series.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2509"},"PeriodicalIF":0.9,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446724","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 case of leiomyosarcoma of the ovarian vein with obstructive uropathy and hepatic metastasis.","authors":"Sanjay M Khaladkar,&nbsp;Tejvir Singh,&nbsp;Karthik Mohanan,&nbsp;Rajesh Kuber,&nbsp;Satvik Dhirawani","doi":"10.4102/sajr.v26i1.2501","DOIUrl":"https://doi.org/10.4102/sajr.v26i1.2501","url":null,"abstract":"<p><p>Leiomyosarcoma (LMS) is a smooth muscle-derived malignant mesenchymal tumour. Primary LMS arising from the ovarian vein is uncommon. A 51-year-old female presented with left loin pain and was diagnosed with a LMS arising from the gonadal vein. The patient refused any treatment. Early detection and timely diagnosis of retroperitoneal masses will improve the prognosis and survival rate in these patients. CT imaging plays an important role in diagnosis.</p><p><strong>Contribution: </strong>Retroperitoneal leiomyosarcoma of vascular origin is a rare entity. CT plays crucial role in diagnosing them by demonstrating the extent of the tumor along the gonadal vein. Early detection and timely diagnosis of retroperitoneal masses will improve the prognosis and survival rate in these patients.</p>","PeriodicalId":43442,"journal":{"name":"SA Journal of Radiology","volume":" ","pages":"2501"},"PeriodicalIF":0.9,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40456226","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}