Introduction: Spondylolisthesis is defined as a permanent anterior sliding of the vertebral body accompanied by the pedicles, the transverse processes and the posterior joints in relation to the underlying vertebra. T...Introduction: Spondylolisthesis is defined as a permanent anterior sliding of the vertebral body accompanied by the pedicles, the transverse processes and the posterior joints in relation to the underlying vertebra. The prevalence of spondylolisthesis varies between 4% and 9%, according to different authors in France, China and Japan. In Africa, some African authors find a spondylolisthesis rate of 9.93%. The objective of this study was to study the clinical and radiological aspects of spondylolisthesis at the Mother-Child Hospital of Bamako. Methods: Prospective and retrospective descriptive study carried out in the neurosurgery department of CH Mother-Child Luxembourg in Bamako from 2010 to 2018. Result: We collected 42 patients operated on for spondylolisthesis out of 145 patients, i.e., 29% of the department’s activities. The average age of our patients was 51 years old, with extremes of 20 and 75 years old. The sex ratio was 0.81 in favor of women. 61.9% of our patients performed work requiring physical strength. Neurogenic claudication was the predominant clinical sign with 88.1% of cases. CT was the most common way of exploration in 57.1% of cases and CT myelo in 47.6% of cases. Disc herniation was associated with spondylolisthesis in 23% of cases. Spondylolisthesis was grade 1 in 59.6% of cases and was responsible for mixed stenosis in 73.82% of cases. All our patients underwent laminectomy. The evolution at 6 months postoperative was favorable in 64.3% of cases. Conclusion: The diagnosis of spondylolisthesis is radiological and makes it possible to define the type of lesion according to its etiology and its severity, but also to highlight the conflicts with the nervous system which will have to be cured. Field and household work, pregnancy, carrying loads or children on the back could be incriminated.展开更多
Although gastric tumors have overlapping radiologic appearances, some unusual tumors may present specific imaging features. Using multidetector computed tomography(MDCT), with water as a negative oral contrast agent a...Although gastric tumors have overlapping radiologic appearances, some unusual tumors may present specific imaging features. Using multidetector computed tomography(MDCT), with water as a negative oral contrast agent and intravenous contrast medium, can provide critical information for the diagnosis of gastric diseases. In addition, MDCT can evaluate the involvement of the gastric wall and extragastric extent of the disease, as compared with gastroenteroscopy and double-contrast upper gastrointestinal study. Regarding lesion location and size, enhancing and growth patterns, presence of calcification or fat, and involvement of the gastric wall and adjacent structures, CT may provide useful information. In this review article, we review the relevant literature and discuss the CT features and the histopathologic findings of different types of gastric lesions. The lesions are divided into benign(glomus tumors, schwannomas, leiomyomas, and lipomas), malignant(gastrointestinal stromal tumors, mucinous carcinomas, lymphomas, and carcinoid tumors), and tumor-like lesions(ectopic pancreas and bezoar). Familiarity with imaging appearances and pathologic findings can help physicians make an accurate diagnosis.展开更多
Extrahepatic portal vein obstruction(EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahe...Extrahepatic portal vein obstruction(EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension(PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt(PSS) and revision of PSS.展开更多
To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantat...To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological findings.RESULTSAccording to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before TACE [Exp(b) = 4.7, p = 0.033] and a preoperative PLR > 150 [Exp(b) = 5.9, p = 0.046] were independent predictors of tumour recurrence.CONCLUSIONThe radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT.展开更多
In acute promyelocytic leukemia, differentiation thera-py based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome(DS). DS is a life-threatening complication, characterized ...In acute promyelocytic leukemia, differentiation thera-py based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome(DS). DS is a life-threatening complication, characterized by respiratory distress, unexplained fever, weight gain, interstitial lung infiltrates, pleural or pericardial effusions, hypotension and acute renal failure. The diagnosis of DS is made on clinical grounds and has proven to be difficult, because none of the symptoms is pathognomonic for the syndrome without any definitive diagnostic criteria. As DS can have subtle signs and symptoms at presentation but progress rapidly, end-stage DS clinical picture resembles the acute respiratory distress syndrome with extremely poor prognosis; so it is of absolute importance to be conscious of these complications and initiate therapy as soon as it was suspected. The radiologic appearance resembles the typical features of cardiogenic pulmonary edema. Diagnosis of DS remains a great skill for radiologists and haematologist but it is of an utmost importance the cooperation in suspect DS, detect the early signs of DS, examine the patients' behaviour and rapidly detect the complications.展开更多
CT-scan is the most irradiating tool in diagnostic radiology. For 5% - 10% of diagnostic X-ray procedures, it is responsible for 34% of irradiation according to UNSCEAR. Patients radiation protection must therefore be...CT-scan is the most irradiating tool in diagnostic radiology. For 5% - 10% of diagnostic X-ray procedures, it is responsible for 34% of irradiation according to UNSCEAR. Patients radiation protection must therefore be increased during CT-scan procedures. This requires the rigorous application of optimization principle which imposes to have “diagnostic reference levels”. Objective: The aim of this study was to determine the diagnostic reference levels (DRLs) of the four most frequent CT-scans examinations of adults in Cameroon. Material and Method: It was a cross-sectional pilot study carried out from April to September 2015 in five health facilities using CT-scan in Cameroon. The studied variables were: patients age and sex, type of CT-scan examination (cerebral, chest, abdomino-pelvic, lumbar spine), Used of IV contrast (IV﹣/ IV+), acquisition length, time of tube rotation, voltage (kV), mAs, pitch, thickness of slices, CTDIvol and DLP. For each type of examination, at least 30 patients were included per center, consecutively on the randomly predetermined days. The DRL for each type of examination was defined as the 75th percentile of its PDL and CTDIvol. Results: Of the 696 examinations, 41.2% were cerebral, 26.9% abdomino-pelvic, 17.7% lumbar spine and 14.2% chest. The mean age of patients was 52 ± 15 years [20 - 90 years], 58.9% were 50 years and older. The sex-ratio was 1.26 (55.9% males). The CT machines were 4, 8 and 16 multidetectors. The 75th percentile of DLP or DRLs [standard deviation] was: [1150 ± 278 mGy·cm], [770 ± 477 mGy·cm], [720 ± 170 mGy·cm] and [715 ± 187 mGy·cm] respectively for cerebral, lumbar spine, abdominopelvic and chest CT-scans. Taking in consideration the number of detectors, the 75th percentile of the Dose-Length product decreased with the increase number of detectors for cerebral examinations but was the highest with 16 MDCT for the abdominopelvic, lumbar spine and chest CT-scans. For the chest and lumbar spine examinations, there was a significant increase in patient-dose with the increase in the number of detectors. Conclusion: Our DRLs values lie between the norms of some European countries and those of some African countries. There is remarquable variation in dose for the commonest CT-scans examinations in Cameroon, requiring then an optimization process from these determined DRLs and establishment of national DRLs. Special attention to optimization should be paid when using 16 MDCT.展开更多
Background and Objectives: In clinical practice, spirometry plays a key role in the diagnosis of chronic obstructive pulmonary disease (COPD), however, it provides no information about structural pulmonary abnormality...Background and Objectives: In clinical practice, spirometry plays a key role in the diagnosis of chronic obstructive pulmonary disease (COPD), however, it provides no information about structural pulmonary abnormality. The aim of this study was to evaluate whether there is a relation between the clinical criteria and chest radiography or CT studies in differentiating chronic bronchitis from emphysema in COPD. Patients and methods: In a prospective study, data analysis on 165 COPD subjects who were enrolled between September, 2011 and December 2012 was completed. Data were collected including clinical characteristics of stable COPD, pulmonary function tests, chest X-ray and multidetector computerized tomography (MDCT) findings. Results: Emphysema was diagnosed in 90 (55%) of 165 CT scans. The median emphysema score was 58 (range 48 - 72) and significantly correlated with lower FEV1 values (r = 0.542, p = 0.003). In chronic bronchitis, bronchial wall thickening was diagnosed approximately as often in chest radiography (56%) as in CT (64%) as a major finding. Body mass index (BMI), forced expiratory volume in the first second (FEV1), and diffusion capacity of the lung for carbon monoxide (DL,CO) were significantly lower, whereas total lung capacity (TLC) was higher in patients with emphysema. Cardiovascular diseases and obstructive sleep apnea syndrome (OSAS) were more common in chronic bronchitis group. Conclusions: Chest radiography is a valuable, inexpensive means of diagnosing emphysema or bronchial wall thickening in chronic bronchitis. Emphysematous patients show a worse pulmonary function and a greater dyspnea. Greater comorbidity in chronic bronchitis may require specific treatment strategies in this subgroup.展开更多
This study sets the objective to involve undergraduate students in the evaluation of radiologic sciences and medical imaging technology programmes in Sudanese universities. Based on the analysis of survey results in w...This study sets the objective to involve undergraduate students in the evaluation of radiologic sciences and medical imaging technology programmes in Sudanese universities. Based on the analysis of survey results in which the participants (BSc students undertaking radiologic sciences and medical imaging technology programmes at university level) are asked to answer both closed and open-ended questions, the study seeks to reveal the participants’ perceptions and introspections about the radiologic sciences and medical imaging technology programmes in Sudan. It also attempts to explore the participants’ suggestions and recommendations as to enhance the quality of these programmes with an eye to helping syllabus designers to improve these programmes, thereby bettering healthcare services for the larger good to the community. A brief cross-sectional survey is completed by a total of 105 radiologic sciences and medical imaging technology students, i.e. 39 (37.1%) third-year students and 66 (62.9%) fourth-year students. The majority of participants is satisfied with the programmes, indicating that they are up-to-date and ran abreast with the latest developments in the field. Very few suggest that the programmes should be reviewed for revision, implying that there is room for improvement. Some participants recommend that more training hours in modern imaging modalities (e.g. MRI, CT and U/S) should be introduced. Only one participant recommends the introduction of advanced training centres.展开更多
Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if ...Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child’s welfare.展开更多
Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the developmen...Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the development of varicose veins include: Hereditary, prolonged standing, Increasing age, Heavy lifting, Prior superficial or deep vein clots, Female gender and Multiple pregnancies. In this manuscript, we report a case of inguinal varicose vein in connection with femoral vein, resulted from direct intravenous injection of drug. The diagnosis was made based on Doppler sonography.展开更多
Acute appendicitis is an acute inflammation of the appendix. It is a surgical emergency. It was a prospective, descriptive and analytical study, between September 2015 and October 2021, focusing on acute appendicitis....Acute appendicitis is an acute inflammation of the appendix. It is a surgical emergency. It was a prospective, descriptive and analytical study, between September 2015 and October 2021, focusing on acute appendicitis. It is seen mainly in young subjects and in children, but not exclusively. Its diagnosis is essentially clinical. These were 124 patients operated on for acute appendicitis, with a male predominance: 78 men (62.90%) against 46 women (37.10%). The majority of patients came from Franceville (n = 66) 53.22%. The average age was 29.4 years (extremes 4 years and 54 years). The average admission time was +5.16 or -5.58 hours. Abdominal pain was the main reason for consultation. Physical signs were dominated by MAC Burney sign positivity in 91.1% of cases. Faced with certain doubtful cases, we requested an abdominal ultrasound. Phlegmonous appendicitis was the most frequent (n = 47) 45.96%. The ileocecal localization represented (n = 82) 66.12%, and other particularities in particular: Claudius AMIAND (n = 6), an appendicular duplication, appendicitis and pregnancy a case of crural appendicitis. Conventional appendectomy with burial by Mac Burney was the most used technique (n = 119) 95.42%. Anatomy pathology was rarely performed. The postoperative course was simple in 95.4% of cases. The average stay in inpatient surgery was 4.8 days. Isolated or combined antibiotic therapy was the rule. Postoperative follow-up at 1 month was systematic. Parietal suppuration was the main complication.展开更多
This study was done to the review and documentation of brain CT investigations in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia in 2012 including CT findings for brain based on justifications for sca...This study was done to the review and documentation of brain CT investigations in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia in 2012 including CT findings for brain based on justifications for scan. The purpose of the study is to evaluate the situation of requesting CT brain versus the reporting findings. A retrospective study was carried out in the Department of Radiology, KAUH between 1 January and 31 December 2012. There were 417 children scanned by CT for brain, their data were reviewed and analyzed from radiology records to form the sample of the study. The study revealed that high percentages of radiological findings for CT brain did not confirm the clinical diagnosis. The percentages of such cases which observed in the three departments of emergency, inpatient and outpatient were 68.4%, 53.6% and 49.4% respectively. This result shows that a percentage of children were given unnecessary exposure to radiation among those who received CT brain from the radiology department in KAUH. From the study, it is concluded that most brain CT done for children were not justification as well as there were more brain CT findings not confirmed the clinical diagnosis, although the brain CT may be significant in most of the cases. Hence, there is a big concern about the increasing requests for unnecessary brain CT. Therefore, the paediatricians should be more careful in requesting of brain CT unless it is indispensible.展开更多
The objective of this study is to determine the epidemiological, clinical, paraclinical, therapeutic aspects, and the sensitivity to antibiotics for acute peritonitis at CHRAB Franceville. This was a prospective, desc...The objective of this study is to determine the epidemiological, clinical, paraclinical, therapeutic aspects, and the sensitivity to antibiotics for acute peritonitis at CHRAB Franceville. This was a prospective, descriptive and analytical study, between September 2015 and December 2021. Generalized acute peritonitis was one of the digestive surgical emergencies. There were 167 patients operated on for acute peritonitis, including 116 men (69.46%) and 51 women (30.34%). The majority of patients came from Franceville (n = 62) 37.12%. The average age was 33.4 years (extreme 4 years and 75 years). The admission time was on average +6.15 or -6.54 hours. The main etiology was acute appendicitis with (n = 122) 73.05%, followed by gastric perforations (n = 26) 15.56%, bowel perforations (n = 5) 2.99%. Some post-surgical cases (n = 4) 2.39%. Biological examinations found: hyperleukocytosis in 64.67% of cases, anemia in 52.9% of cases, and hematocrit down in 28.3% of cases. Ultrasounds found 17.36% peritoneal effusions and 12.57% acute appendicitis. The abdomen without preparation revealed 13.17% cases of pneumoperitoneum. Anatomy pathology found acute appendicitis, gastroduodenal ulcers, peritoneal tuberculosis, and peritoneal carcinomatosis. Biliary drainage choledotomy with Kher drain, supernumerary spleen splenectomy, hysterectomy. The average duration in intensive care was 6.5 days with extremes of 5 to 10 days. The average stay in inpatient surgery was 10.8 days. Isolated or combined antibiotic therapy was the rule. Postoperative follow-up at 1 month was systematic. Parietal suppuration was the main complication. We had recorded 2 cases of fistula and 4.19% of deaths.展开更多
Background: The need to establish a strong culture around radiation safety is derived from the assertion that medical practitioners, patients, and third parties should not be exposed to unnecessary radiation. Authorit...Background: The need to establish a strong culture around radiation safety is derived from the assertion that medical practitioners, patients, and third parties should not be exposed to unnecessary radiation. Authorities have endeavored to enact policies to protect all employers and patients in radiology departments. Objectives: To assess the impact of radiation safety practices and regulations on the ongoing improvements in radiation safety culture and practices in radiology departments. This will be achieved through a subjective assessment of national and international rules and regulations by healthcare professionals. Materials and Methods: We conducted a questionnaire survey in the radiology departments of three JCI-accredited hospitals in the Riyadh region to identify and assess the impact of national radiation regulations and the accompanying processes on the improvement of radiation safety culture and practices in radiology departments. Results: There were statistically significant differences in the grading system results among various groups of respondents, based on their educational level. Also, there are statistically significant differences between the assessments of safety level results in the answers provided by various groups of respondents according to education level in favor of the master’s degree. Conclusion: The study concludes that technicians with a diploma degree require stricter regulation. Furthermore, the results of this study suggest that an exposure tracking system and a regulatory action supporting it may be useful in the ongoing task of improving patients’ radiation safety.展开更多
Background: CT in pregnant patients requires careful consideration of the radiation dose and corresponding radiation risks from ionizing radiation to the unborn child. The determination of foetal dose in diagnostic ra...Background: CT in pregnant patients requires careful consideration of the radiation dose and corresponding radiation risks from ionizing radiation to the unborn child. The determination of foetal dose in diagnostic radiology is of interest as a basis for risk estimates from medical exposure of the pregnant patient. Objective: To evaluate the foetal-maternal radiation doses delivered during the CT-Pelvimetry procedure and to estimate the risk to the unborn child to develop a cancer in childhood and hereditary disease. Materials and Methods: We investigate the foetal-maternal radiation doses during CT-scan Pelvimetry in Douala (Cameroon). Data of 194 helical acquisition CT-Pelvimetry were collected between May 2017 and May 2019. An average DLP for the examination was established and the average effective dose was evaluated. The fetal dose was calculated and the FetDose V5 program was used for risk estimations. Results: The average dose length product (DLP) was 56.17 mGy·cm (range: 51.69 - 59.21 mGy·cm). The average effective dose received by women pregnant was 0.78 mSv. The mean individual fetal dose was 1.5 mGy (range: 0.76 - 1.87 mGy). The risk of Childhood Cancer calculated was: range 1 in 16,000 to 1 in 10,000 and 1 in 260,000 to 1 in 106,000 to the risk of Hereditary Disease, respectively. Conclusion: This study shows that the foetal-maternal doses delivered during CT-Pelvimetry examinations are very low and the risks of childhood cancers and hereditary diseases are derisory, the technology should be further investigated to ensure its full potential for optimal diagnostic accuracy.展开更多
Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department a...Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department and to evaluate the cost of radiopelvimetry. Patients and Method: This was a prospective, cross-sectional study that took place over a 12-month period from January 1 to December 31, 2018. It focused on pregnant women in whom scanopelvimetry was performed in the medical imaging department of Point G University Hospital during the study period. Results: Out of 8615 CT examinations performed in the radiology department, we collected 65 cases of scanopelvimetry, i.e., 0.7% of the CT examinations. Primigravida and paucigravida dominated the study (40% each). In 60% of the pregnant women the height was less than 150 cm. The most frequent indication for CT scanning was clinical pelvic narrowing (50%). In 80% of the cases, the scanopelvimetry was performed after 37 weeks of amenorrhea. A predominance of narrowing of the superior strait was noted (40%). 4.6% of the pregnant women had a Magnin index of less than 20. CT scanopelvimetry is a feasible examination in our context but the level of demand is low because of the high cost of the examination (49500 fca). Conclusion: In light of the results obtained, we can say that CT pelvimetry allows us to predict the probable route of delivery and thus we can reduce the risk of fetomaternal morbidity and mortality to improve maternal and child health.展开更多
Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy s...Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patients before the intervention. The average stone size was 12 mm and the largest was 23 mm. The majority of stones, i.e. 59% (18 patients), had a density greater than 1000 HU. The stone was unique in 19 patients (63%). The location of the stone was pyelic in 8 patients or 27%. An impact on the upper urinary tract was found in 16 of our patients or 53%. General anesthesia was used in 25 patients (83%). A digital flexible ureteroscopy was used in 24 patients and a semi-rigid ureteroscopy (URS) in 6 patients. Full-course fragmentation was the most used therapeutic method, 9 patients or 32%. The average duration of interventions was 61 minutes. Drainage by double J catheter at the end of the procedure was performed in all our patients. The length of hospitalization was 24 hours. Only one case of failure in the USSR was recorded, and one case of failure was in the semi-rigid URS. Conclusion: Laser ureteroscopy is an effective minimally invasive surgery in the management of lithiasis of the upper urinary tract. It significantly reduces the length of hospitalization. Mastery of this technique and the acquisition of the equipment necessary for its implementation is an undeniable asset in the management of renal and ureteral lithiasis.展开更多
Global mortality rates are greatly impacted by malignancies of the brain and nervous system.Although,Magnetic Resonance Imaging(MRI)plays a pivotal role in detecting brain tumors;however,manual assessment is time-cons...Global mortality rates are greatly impacted by malignancies of the brain and nervous system.Although,Magnetic Resonance Imaging(MRI)plays a pivotal role in detecting brain tumors;however,manual assessment is time-consuming and susceptible to human error.To address this,we introduce ICA2-SVM,an advanced computational framework integrating Independent Component Analysis Architecture-2(ICA2)and Support Vector Machine(SVM)for automated tumor segmentation and classification.ICA2 is utilized for image preprocessing and optimization,enhancing MRI consistency and contrast.The Fast-MarchingMethod(FMM)is employed to delineate tumor regions,followed by SVM for precise classification.Validation on the Contrast-Enhanced Magnetic Resonance Imaging(CEMRI)dataset demonstrates the superior performance of ICA2-SVM,achieving a Dice Similarity Coefficient(DSC)of 0.974,accuracy of 0.992,specificity of 0.99,and sensitivity of 0.99.Additionally,themodel surpasses existing approaches in computational efficiency,completing analysis within 0.41 s.By integrating state-of-the-art computational techniques,ICA2-SVM advances biomedical imaging,offering a highly accurate and efficient solution for brain tumor detection.Future research aims to incorporate multi-physics modeling and diverse classifiers to further enhance the adaptability and applicability of brain tumor diagnostic systems.展开更多
Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)for patients with acute appendicitis(AA).Methods:Fifty patients with suspected AA who visited the hospital from January 2023 to January 2025 ...Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)for patients with acute appendicitis(AA).Methods:Fifty patients with suspected AA who visited the hospital from January 2023 to January 2025 were selected as samples.All patients underwent MSCT and ultrasound diagnosis,and the diagnostic efficacy of MSCT was analyzed in comparison with pathology.Results:Pathology indicated 40 positive and 10 negative cases,ultrasound indicated 30 positive and 20 negative cases,and MSCT indicated 39 positive and 11 negative cases.The diagnostic efficacy of MSCT was higher than that of ultrasound(P<0.05).The accuracy of pathological classification of MSCT was higher than that of ultrasound(P<0.05).The detection rate of MSCT imaging indicators in AA patients was higher than that in non-AA patients(P<0.05).Conclusion:MSCT has high diagnostic efficacy in AA patients and can assist physicians in determining pathological classification.展开更多
The underlying electrophysiological mechanisms and clinical treatments of cardiovascular diseases,which are the most common cause of morbidity and mortality worldwide,have gotten a lot of attention and been widely exp...The underlying electrophysiological mechanisms and clinical treatments of cardiovascular diseases,which are the most common cause of morbidity and mortality worldwide,have gotten a lot of attention and been widely explored in recent decades.Along the way,techniques such as medical imaging,computing modeling,and artificial intelligence(AI)have always played significant roles in above studies.In this article,we illustrated the applications of AI in cardiac electrophysiological research and disease prediction.We summarized general principles of AI and then focused on the roles of AI in cardiac basic and clinical studies incorporating magnetic resonance imaging and computing modeling techniques.The main challenges and perspectives were also analyzed.展开更多
文摘Introduction: Spondylolisthesis is defined as a permanent anterior sliding of the vertebral body accompanied by the pedicles, the transverse processes and the posterior joints in relation to the underlying vertebra. The prevalence of spondylolisthesis varies between 4% and 9%, according to different authors in France, China and Japan. In Africa, some African authors find a spondylolisthesis rate of 9.93%. The objective of this study was to study the clinical and radiological aspects of spondylolisthesis at the Mother-Child Hospital of Bamako. Methods: Prospective and retrospective descriptive study carried out in the neurosurgery department of CH Mother-Child Luxembourg in Bamako from 2010 to 2018. Result: We collected 42 patients operated on for spondylolisthesis out of 145 patients, i.e., 29% of the department’s activities. The average age of our patients was 51 years old, with extremes of 20 and 75 years old. The sex ratio was 0.81 in favor of women. 61.9% of our patients performed work requiring physical strength. Neurogenic claudication was the predominant clinical sign with 88.1% of cases. CT was the most common way of exploration in 57.1% of cases and CT myelo in 47.6% of cases. Disc herniation was associated with spondylolisthesis in 23% of cases. Spondylolisthesis was grade 1 in 59.6% of cases and was responsible for mixed stenosis in 73.82% of cases. All our patients underwent laminectomy. The evolution at 6 months postoperative was favorable in 64.3% of cases. Conclusion: The diagnosis of spondylolisthesis is radiological and makes it possible to define the type of lesion according to its etiology and its severity, but also to highlight the conflicts with the nervous system which will have to be cured. Field and household work, pregnancy, carrying loads or children on the back could be incriminated.
文摘Although gastric tumors have overlapping radiologic appearances, some unusual tumors may present specific imaging features. Using multidetector computed tomography(MDCT), with water as a negative oral contrast agent and intravenous contrast medium, can provide critical information for the diagnosis of gastric diseases. In addition, MDCT can evaluate the involvement of the gastric wall and extragastric extent of the disease, as compared with gastroenteroscopy and double-contrast upper gastrointestinal study. Regarding lesion location and size, enhancing and growth patterns, presence of calcification or fat, and involvement of the gastric wall and adjacent structures, CT may provide useful information. In this review article, we review the relevant literature and discuss the CT features and the histopathologic findings of different types of gastric lesions. The lesions are divided into benign(glomus tumors, schwannomas, leiomyomas, and lipomas), malignant(gastrointestinal stromal tumors, mucinous carcinomas, lymphomas, and carcinoid tumors), and tumor-like lesions(ectopic pancreas and bezoar). Familiarity with imaging appearances and pathologic findings can help physicians make an accurate diagnosis.
文摘Extrahepatic portal vein obstruction(EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension(PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt(PSS) and revision of PSS.
文摘To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological findings.RESULTSAccording to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before TACE [Exp(b) = 4.7, p = 0.033] and a preoperative PLR > 150 [Exp(b) = 5.9, p = 0.046] were independent predictors of tumour recurrence.CONCLUSIONThe radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT.
文摘In acute promyelocytic leukemia, differentiation thera-py based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome(DS). DS is a life-threatening complication, characterized by respiratory distress, unexplained fever, weight gain, interstitial lung infiltrates, pleural or pericardial effusions, hypotension and acute renal failure. The diagnosis of DS is made on clinical grounds and has proven to be difficult, because none of the symptoms is pathognomonic for the syndrome without any definitive diagnostic criteria. As DS can have subtle signs and symptoms at presentation but progress rapidly, end-stage DS clinical picture resembles the acute respiratory distress syndrome with extremely poor prognosis; so it is of absolute importance to be conscious of these complications and initiate therapy as soon as it was suspected. The radiologic appearance resembles the typical features of cardiogenic pulmonary edema. Diagnosis of DS remains a great skill for radiologists and haematologist but it is of an utmost importance the cooperation in suspect DS, detect the early signs of DS, examine the patients' behaviour and rapidly detect the complications.
文摘CT-scan is the most irradiating tool in diagnostic radiology. For 5% - 10% of diagnostic X-ray procedures, it is responsible for 34% of irradiation according to UNSCEAR. Patients radiation protection must therefore be increased during CT-scan procedures. This requires the rigorous application of optimization principle which imposes to have “diagnostic reference levels”. Objective: The aim of this study was to determine the diagnostic reference levels (DRLs) of the four most frequent CT-scans examinations of adults in Cameroon. Material and Method: It was a cross-sectional pilot study carried out from April to September 2015 in five health facilities using CT-scan in Cameroon. The studied variables were: patients age and sex, type of CT-scan examination (cerebral, chest, abdomino-pelvic, lumbar spine), Used of IV contrast (IV﹣/ IV+), acquisition length, time of tube rotation, voltage (kV), mAs, pitch, thickness of slices, CTDIvol and DLP. For each type of examination, at least 30 patients were included per center, consecutively on the randomly predetermined days. The DRL for each type of examination was defined as the 75th percentile of its PDL and CTDIvol. Results: Of the 696 examinations, 41.2% were cerebral, 26.9% abdomino-pelvic, 17.7% lumbar spine and 14.2% chest. The mean age of patients was 52 ± 15 years [20 - 90 years], 58.9% were 50 years and older. The sex-ratio was 1.26 (55.9% males). The CT machines were 4, 8 and 16 multidetectors. The 75th percentile of DLP or DRLs [standard deviation] was: [1150 ± 278 mGy·cm], [770 ± 477 mGy·cm], [720 ± 170 mGy·cm] and [715 ± 187 mGy·cm] respectively for cerebral, lumbar spine, abdominopelvic and chest CT-scans. Taking in consideration the number of detectors, the 75th percentile of the Dose-Length product decreased with the increase number of detectors for cerebral examinations but was the highest with 16 MDCT for the abdominopelvic, lumbar spine and chest CT-scans. For the chest and lumbar spine examinations, there was a significant increase in patient-dose with the increase in the number of detectors. Conclusion: Our DRLs values lie between the norms of some European countries and those of some African countries. There is remarquable variation in dose for the commonest CT-scans examinations in Cameroon, requiring then an optimization process from these determined DRLs and establishment of national DRLs. Special attention to optimization should be paid when using 16 MDCT.
文摘Background and Objectives: In clinical practice, spirometry plays a key role in the diagnosis of chronic obstructive pulmonary disease (COPD), however, it provides no information about structural pulmonary abnormality. The aim of this study was to evaluate whether there is a relation between the clinical criteria and chest radiography or CT studies in differentiating chronic bronchitis from emphysema in COPD. Patients and methods: In a prospective study, data analysis on 165 COPD subjects who were enrolled between September, 2011 and December 2012 was completed. Data were collected including clinical characteristics of stable COPD, pulmonary function tests, chest X-ray and multidetector computerized tomography (MDCT) findings. Results: Emphysema was diagnosed in 90 (55%) of 165 CT scans. The median emphysema score was 58 (range 48 - 72) and significantly correlated with lower FEV1 values (r = 0.542, p = 0.003). In chronic bronchitis, bronchial wall thickening was diagnosed approximately as often in chest radiography (56%) as in CT (64%) as a major finding. Body mass index (BMI), forced expiratory volume in the first second (FEV1), and diffusion capacity of the lung for carbon monoxide (DL,CO) were significantly lower, whereas total lung capacity (TLC) was higher in patients with emphysema. Cardiovascular diseases and obstructive sleep apnea syndrome (OSAS) were more common in chronic bronchitis group. Conclusions: Chest radiography is a valuable, inexpensive means of diagnosing emphysema or bronchial wall thickening in chronic bronchitis. Emphysematous patients show a worse pulmonary function and a greater dyspnea. Greater comorbidity in chronic bronchitis may require specific treatment strategies in this subgroup.
文摘This study sets the objective to involve undergraduate students in the evaluation of radiologic sciences and medical imaging technology programmes in Sudanese universities. Based on the analysis of survey results in which the participants (BSc students undertaking radiologic sciences and medical imaging technology programmes at university level) are asked to answer both closed and open-ended questions, the study seeks to reveal the participants’ perceptions and introspections about the radiologic sciences and medical imaging technology programmes in Sudan. It also attempts to explore the participants’ suggestions and recommendations as to enhance the quality of these programmes with an eye to helping syllabus designers to improve these programmes, thereby bettering healthcare services for the larger good to the community. A brief cross-sectional survey is completed by a total of 105 radiologic sciences and medical imaging technology students, i.e. 39 (37.1%) third-year students and 66 (62.9%) fourth-year students. The majority of participants is satisfied with the programmes, indicating that they are up-to-date and ran abreast with the latest developments in the field. Very few suggest that the programmes should be reviewed for revision, implying that there is room for improvement. Some participants recommend that more training hours in modern imaging modalities (e.g. MRI, CT and U/S) should be introduced. Only one participant recommends the introduction of advanced training centres.
文摘Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child’s welfare.
文摘Varicose veins are enlarged, protuberant superficial veins that are palpable beneath the skin. The causes of such a venous pathology may be primary, secondary, or congenital. The major agents leading to the development of varicose veins include: Hereditary, prolonged standing, Increasing age, Heavy lifting, Prior superficial or deep vein clots, Female gender and Multiple pregnancies. In this manuscript, we report a case of inguinal varicose vein in connection with femoral vein, resulted from direct intravenous injection of drug. The diagnosis was made based on Doppler sonography.
文摘Acute appendicitis is an acute inflammation of the appendix. It is a surgical emergency. It was a prospective, descriptive and analytical study, between September 2015 and October 2021, focusing on acute appendicitis. It is seen mainly in young subjects and in children, but not exclusively. Its diagnosis is essentially clinical. These were 124 patients operated on for acute appendicitis, with a male predominance: 78 men (62.90%) against 46 women (37.10%). The majority of patients came from Franceville (n = 66) 53.22%. The average age was 29.4 years (extremes 4 years and 54 years). The average admission time was +5.16 or -5.58 hours. Abdominal pain was the main reason for consultation. Physical signs were dominated by MAC Burney sign positivity in 91.1% of cases. Faced with certain doubtful cases, we requested an abdominal ultrasound. Phlegmonous appendicitis was the most frequent (n = 47) 45.96%. The ileocecal localization represented (n = 82) 66.12%, and other particularities in particular: Claudius AMIAND (n = 6), an appendicular duplication, appendicitis and pregnancy a case of crural appendicitis. Conventional appendectomy with burial by Mac Burney was the most used technique (n = 119) 95.42%. Anatomy pathology was rarely performed. The postoperative course was simple in 95.4% of cases. The average stay in inpatient surgery was 4.8 days. Isolated or combined antibiotic therapy was the rule. Postoperative follow-up at 1 month was systematic. Parietal suppuration was the main complication.
文摘This study was done to the review and documentation of brain CT investigations in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia in 2012 including CT findings for brain based on justifications for scan. The purpose of the study is to evaluate the situation of requesting CT brain versus the reporting findings. A retrospective study was carried out in the Department of Radiology, KAUH between 1 January and 31 December 2012. There were 417 children scanned by CT for brain, their data were reviewed and analyzed from radiology records to form the sample of the study. The study revealed that high percentages of radiological findings for CT brain did not confirm the clinical diagnosis. The percentages of such cases which observed in the three departments of emergency, inpatient and outpatient were 68.4%, 53.6% and 49.4% respectively. This result shows that a percentage of children were given unnecessary exposure to radiation among those who received CT brain from the radiology department in KAUH. From the study, it is concluded that most brain CT done for children were not justification as well as there were more brain CT findings not confirmed the clinical diagnosis, although the brain CT may be significant in most of the cases. Hence, there is a big concern about the increasing requests for unnecessary brain CT. Therefore, the paediatricians should be more careful in requesting of brain CT unless it is indispensible.
文摘The objective of this study is to determine the epidemiological, clinical, paraclinical, therapeutic aspects, and the sensitivity to antibiotics for acute peritonitis at CHRAB Franceville. This was a prospective, descriptive and analytical study, between September 2015 and December 2021. Generalized acute peritonitis was one of the digestive surgical emergencies. There were 167 patients operated on for acute peritonitis, including 116 men (69.46%) and 51 women (30.34%). The majority of patients came from Franceville (n = 62) 37.12%. The average age was 33.4 years (extreme 4 years and 75 years). The admission time was on average +6.15 or -6.54 hours. The main etiology was acute appendicitis with (n = 122) 73.05%, followed by gastric perforations (n = 26) 15.56%, bowel perforations (n = 5) 2.99%. Some post-surgical cases (n = 4) 2.39%. Biological examinations found: hyperleukocytosis in 64.67% of cases, anemia in 52.9% of cases, and hematocrit down in 28.3% of cases. Ultrasounds found 17.36% peritoneal effusions and 12.57% acute appendicitis. The abdomen without preparation revealed 13.17% cases of pneumoperitoneum. Anatomy pathology found acute appendicitis, gastroduodenal ulcers, peritoneal tuberculosis, and peritoneal carcinomatosis. Biliary drainage choledotomy with Kher drain, supernumerary spleen splenectomy, hysterectomy. The average duration in intensive care was 6.5 days with extremes of 5 to 10 days. The average stay in inpatient surgery was 10.8 days. Isolated or combined antibiotic therapy was the rule. Postoperative follow-up at 1 month was systematic. Parietal suppuration was the main complication. We had recorded 2 cases of fistula and 4.19% of deaths.
文摘Background: The need to establish a strong culture around radiation safety is derived from the assertion that medical practitioners, patients, and third parties should not be exposed to unnecessary radiation. Authorities have endeavored to enact policies to protect all employers and patients in radiology departments. Objectives: To assess the impact of radiation safety practices and regulations on the ongoing improvements in radiation safety culture and practices in radiology departments. This will be achieved through a subjective assessment of national and international rules and regulations by healthcare professionals. Materials and Methods: We conducted a questionnaire survey in the radiology departments of three JCI-accredited hospitals in the Riyadh region to identify and assess the impact of national radiation regulations and the accompanying processes on the improvement of radiation safety culture and practices in radiology departments. Results: There were statistically significant differences in the grading system results among various groups of respondents, based on their educational level. Also, there are statistically significant differences between the assessments of safety level results in the answers provided by various groups of respondents according to education level in favor of the master’s degree. Conclusion: The study concludes that technicians with a diploma degree require stricter regulation. Furthermore, the results of this study suggest that an exposure tracking system and a regulatory action supporting it may be useful in the ongoing task of improving patients’ radiation safety.
文摘Background: CT in pregnant patients requires careful consideration of the radiation dose and corresponding radiation risks from ionizing radiation to the unborn child. The determination of foetal dose in diagnostic radiology is of interest as a basis for risk estimates from medical exposure of the pregnant patient. Objective: To evaluate the foetal-maternal radiation doses delivered during the CT-Pelvimetry procedure and to estimate the risk to the unborn child to develop a cancer in childhood and hereditary disease. Materials and Methods: We investigate the foetal-maternal radiation doses during CT-scan Pelvimetry in Douala (Cameroon). Data of 194 helical acquisition CT-Pelvimetry were collected between May 2017 and May 2019. An average DLP for the examination was established and the average effective dose was evaluated. The fetal dose was calculated and the FetDose V5 program was used for risk estimations. Results: The average dose length product (DLP) was 56.17 mGy·cm (range: 51.69 - 59.21 mGy·cm). The average effective dose received by women pregnant was 0.78 mSv. The mean individual fetal dose was 1.5 mGy (range: 0.76 - 1.87 mGy). The risk of Childhood Cancer calculated was: range 1 in 16,000 to 1 in 10,000 and 1 in 260,000 to 1 in 106,000 to the risk of Hereditary Disease, respectively. Conclusion: This study shows that the foetal-maternal doses delivered during CT-Pelvimetry examinations are very low and the risks of childhood cancers and hereditary diseases are derisory, the technology should be further investigated to ensure its full potential for optimal diagnostic accuracy.
文摘Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department and to evaluate the cost of radiopelvimetry. Patients and Method: This was a prospective, cross-sectional study that took place over a 12-month period from January 1 to December 31, 2018. It focused on pregnant women in whom scanopelvimetry was performed in the medical imaging department of Point G University Hospital during the study period. Results: Out of 8615 CT examinations performed in the radiology department, we collected 65 cases of scanopelvimetry, i.e., 0.7% of the CT examinations. Primigravida and paucigravida dominated the study (40% each). In 60% of the pregnant women the height was less than 150 cm. The most frequent indication for CT scanning was clinical pelvic narrowing (50%). In 80% of the cases, the scanopelvimetry was performed after 37 weeks of amenorrhea. A predominance of narrowing of the superior strait was noted (40%). 4.6% of the pregnant women had a Magnin index of less than 20. CT scanopelvimetry is a feasible examination in our context but the level of demand is low because of the high cost of the examination (49500 fca). Conclusion: In light of the results obtained, we can say that CT pelvimetry allows us to predict the probable route of delivery and thus we can reduce the risk of fetomaternal morbidity and mortality to improve maternal and child health.
文摘Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patients before the intervention. The average stone size was 12 mm and the largest was 23 mm. The majority of stones, i.e. 59% (18 patients), had a density greater than 1000 HU. The stone was unique in 19 patients (63%). The location of the stone was pyelic in 8 patients or 27%. An impact on the upper urinary tract was found in 16 of our patients or 53%. General anesthesia was used in 25 patients (83%). A digital flexible ureteroscopy was used in 24 patients and a semi-rigid ureteroscopy (URS) in 6 patients. Full-course fragmentation was the most used therapeutic method, 9 patients or 32%. The average duration of interventions was 61 minutes. Drainage by double J catheter at the end of the procedure was performed in all our patients. The length of hospitalization was 24 hours. Only one case of failure in the USSR was recorded, and one case of failure was in the semi-rigid URS. Conclusion: Laser ureteroscopy is an effective minimally invasive surgery in the management of lithiasis of the upper urinary tract. It significantly reduces the length of hospitalization. Mastery of this technique and the acquisition of the equipment necessary for its implementation is an undeniable asset in the management of renal and ureteral lithiasis.
基金supported by the Deanship of Graduate Studies and Scientific Research at Najran University through funding code NU/GP/MRC/13/771-1.
文摘Global mortality rates are greatly impacted by malignancies of the brain and nervous system.Although,Magnetic Resonance Imaging(MRI)plays a pivotal role in detecting brain tumors;however,manual assessment is time-consuming and susceptible to human error.To address this,we introduce ICA2-SVM,an advanced computational framework integrating Independent Component Analysis Architecture-2(ICA2)and Support Vector Machine(SVM)for automated tumor segmentation and classification.ICA2 is utilized for image preprocessing and optimization,enhancing MRI consistency and contrast.The Fast-MarchingMethod(FMM)is employed to delineate tumor regions,followed by SVM for precise classification.Validation on the Contrast-Enhanced Magnetic Resonance Imaging(CEMRI)dataset demonstrates the superior performance of ICA2-SVM,achieving a Dice Similarity Coefficient(DSC)of 0.974,accuracy of 0.992,specificity of 0.99,and sensitivity of 0.99.Additionally,themodel surpasses existing approaches in computational efficiency,completing analysis within 0.41 s.By integrating state-of-the-art computational techniques,ICA2-SVM advances biomedical imaging,offering a highly accurate and efficient solution for brain tumor detection.Future research aims to incorporate multi-physics modeling and diverse classifiers to further enhance the adaptability and applicability of brain tumor diagnostic systems.
文摘Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)for patients with acute appendicitis(AA).Methods:Fifty patients with suspected AA who visited the hospital from January 2023 to January 2025 were selected as samples.All patients underwent MSCT and ultrasound diagnosis,and the diagnostic efficacy of MSCT was analyzed in comparison with pathology.Results:Pathology indicated 40 positive and 10 negative cases,ultrasound indicated 30 positive and 20 negative cases,and MSCT indicated 39 positive and 11 negative cases.The diagnostic efficacy of MSCT was higher than that of ultrasound(P<0.05).The accuracy of pathological classification of MSCT was higher than that of ultrasound(P<0.05).The detection rate of MSCT imaging indicators in AA patients was higher than that in non-AA patients(P<0.05).Conclusion:MSCT has high diagnostic efficacy in AA patients and can assist physicians in determining pathological classification.
基金the Hainan Provincial Natural Science Foundation of China(No.820RC625)the National Natural Science Foundation of China(No.82060332)。
文摘The underlying electrophysiological mechanisms and clinical treatments of cardiovascular diseases,which are the most common cause of morbidity and mortality worldwide,have gotten a lot of attention and been widely explored in recent decades.Along the way,techniques such as medical imaging,computing modeling,and artificial intelligence(AI)have always played significant roles in above studies.In this article,we illustrated the applications of AI in cardiac electrophysiological research and disease prediction.We summarized general principles of AI and then focused on the roles of AI in cardiac basic and clinical studies incorporating magnetic resonance imaging and computing modeling techniques.The main challenges and perspectives were also analyzed.
