The Influence of Ultrasound Equipment Knobology in Abdominal Sonography

Ultrasonography is a highly operator dependent imaging modality with a number of knobology variables that are under the control of the operator. Knobology is a terminology that describes the manipulation of ultrasound knobs and system controls in order to obtain the best image possible from diagnostic ultrasound. The inadequate use of knobology variables may impair image quality and can result in misdiagnosis. In abdominal sonography, selecting the appropriate application preset for abdominal examination is first step towards achieving an optimum image. The next step is to select an appropriate transducer frequency which must take the size of the patient into account. Transducer frequency is typically in the range of 3–5 MHz, but a lower frequency may achieve better depth penetration in larger patients. While the output power may improve image quality by increasing the intensity of transmitted sound energy, the impact is usually insignificant. The practice of using high output power should therefore be limited because of the risk of biologic effect. Other essential knobs for better image optimization include controlling the overall gain, time gain compensation, focal zone, dynamic range and tissue harmonic imaging. In the assessment of blood flow in abdominal vessels the regulation of the pulse repetition frequency, Doppler gain, imaging angle, and wall filter improves the sensitivity of color and spectral Doppler

Accuracy of clinical diagnosis, mammography and ultrasonography in preoperative assessment of breast cancer

Background: Cancer of the breast is the most common malignancy affecting women in many parts of the world. Its early detection has, therefore, become necessary to reduce morbidity and mortality from the disease. In sub-Saharan Africa, radiological imaging, histology and management programs are associated with challenges.Objectives: This study seeks to assess the validity of clinical diagnosis, mammography and breast ultrasonography in the preoperative assessment of suspected breast cancer patients for accurate detection of the disease to enable appropriate management.Methods: A prospective cross-sectional study was carried out in the Radiology Department of Komfo Anokye Teaching Hospital, Kumasi, Ghana, between November 2007 and July 2008 with a sample size of 103. All patients with a clinical suspicion of breast cancer who gave informed consent were recruited, underwent bilateral mammography and whole breast ultrasonography and then biopsy for all BIRADS categories 4 or 5 lesions. The histopathology results were retrieved to complete the study.Result: In this study the definition of malignancy was made using histology as the gold standard. A total of 103 patients were recruited for this study with mean age of 55(+15) years, out of which 52 (50.5%) had malignant lesions. The overall sensitivity of clinical diagnosis was 50.5%. While the overall sensitivity and specificity for mammogram and ultrasound were 73.0%, 80.0% and 100%, 80.4% respectively. Conclusion: In conclusion, this study has demonstrated that clinical diagnosis, ultrasound and mammography can potentially predict breast cancer disease with considerable sensitivity and specificity. Funding: Not declaredKeywords: breast cancer, mammography, ultrasonography, histology, clinical diagnosi

The role of multimodality radiological imaging in extrauterine misplaced IUCD: A case report

Intrauterine contraceptive device (IUCD) is among the commonly used contraceptive methods in the world including sub-Saharan Africa but have been associated with a number of complications that although rare, can occur. Uterine perforation is the most serious complication of the IUCD. Surgical management is required in cases with complete uterine perforation, in which the IUCD is partially or completely within the peritoneal cavity. We present a case of a 27year old para 2 woman reporting with mild lower abdominal pains and the absence of IUCD string in the vagina after its insertion following evacuation of the uterus 2 years prior to this study. With the utilization of multiple imaging modalities, an exploratory laparotomy was done to remove the migrated IUCD and repair of the perforated bowel and urinary bladder.  Keywords: Migrated IUCD, uterine perforation, ultrasonography, radiography, Computed Tomography Le dispositif contraceptif intra-utérin (IUCD) fait partie des méthodes contraceptives couramment utilisées dans le monde, y compris en Afrique subsaharienne, mais a été associé à un certain nombre de complications qui, bien que rares, peuvent survenir. La perforation utérine est la complication la plus grave de l'IUCD. Une prise en charge chirurgicale est nécessaire dans les cas de perforation utérine complète, dans laquelle l'IUCD est partiellement ou complètement dans la cavité péritonéale. Nous présentons le cas d'une femme Para 2 de 27 ans qui a rapporté avec des légères douleurs abdominales basses et l'absence de fil du dispositif contraceptif intra-utérin dans le vagin après son insertion suite à l'évacuation de l'utérus 2 ans avant cette étude. L'utilisation des multiples modalités d'imagerie , une laparotomie exploratoire a été réalisée pour retirer l'IUCD migré et réparer l'intestin et la vessie perforés. Mots-clés: IUCD migré, perforation uterine, échographie, radiographie, Tomodensitométri

Chest radiography patterns of COVID-19 pneumonia in Kumasi, Ghana

Objectives: To document the pattern of chest radiographic findings in coronavirus disease 2019 (COVID-19) patients with moderate to severe disease. Design: Retrospective cross-sectional study. Setting: The study site was Komfo Anokye Teaching Hospital (KATH) located at Bantama in Kumasi, the capital town of the Ashanti Region. It is the second largest hospital in the country and the major referral site for Ashanti region and the northern part of the country. The hospital hosts a highly infectious isolation unit (HIIU) for COVID19 patients with moderate to severe infections and receives referred cases from the region and within the hospital. Participants: The study involved 27 patients admitted to the HIIU at KATH with COVID-19 infection who underwent chest X-ray as part of their investigations. Results: The study enrolled 12 males and 15 females. The common comorbidities were hypertension and diabetes. Chest x-ray findings in most of the patients (81.5%) revealed ground-glass opacities while a few of them (18.5%) had lung consolidations without ground-glass opacities. For those with ground-glass opacities, eight (29.6%) had superimposed consolidation. All the participants had positive chest x-ray findings. Conclusion: The chest x-ray findings in the 27 COVID-19 positive patients with moderate to severe disease on admission at the KATH HIIU enrolled in this study showed significant pulmonary abnormalities. The predominant pulmonary abnormalities were bilateral peripheral ground-glass opacities with the lower lung zones being mostly affected

Sonohysterography: Time to Step up its Use in Gynaecologic Imaging in West Africa

Sonohysterography is a simple, safe and convenient technique that is easily and rapidly performed in the ultrasound room; yet the technique seems to be underutilized in West Africa. We present two cases that were successfully carried out in our centre followed by detailed description, uses and challenges of the technique, with the hope of encouraging clinicians and sonographers in the sub-region to step up its use. Two women were referred for evaluation of their endometrial cavities on account of increasingly heavy menstrual bleeding. Sonohysterography revealed intracavity uterine masses with hyper-echoic focal thickening highly suggestive of endometrial polyps; histology confirmed the diagnosis of endometrial polyps. Sonohysterography is an affordable and feasible diagnostic modality for evaluating the endometrial cavity. Where equipment and skill permit, the technique should be used more often in the West African sub-region. (Afr J Reprod Health 2011; 15[3]: 149-155).La sonohyst érographie est une technique simple, non dangereuse et commode, qui est accomplie dans la salle d'ultrason ; pourtant, il semble que la technique est sous utilisée en Afrique de l'Ouest. Nous présentons deux cas qui ont été accomplis dans notre centre, suivi d'une description détaillée, l'emploi et les défis de la technique, avec l'espoir d'aider des cliniciens et des sonographes de la sous–région à augmenter son emploi. Deux femmes nous ont été envoyées pour l'évaluation de leurs cavités endométriales à cause dune hémorragie menstruelle excessive. La sonohystérographie a révélé des masses utérines d'intra cavité, ayant un épaissement focaux hyper-résonnant qui indique la présence des polypes endométriales; l'histologie a confirmé le diagnostic de polypes endométriales. La sonohystérographie est une modalité diagnostique faisable et abordable pour évaluer la cavité endométriale. Là ou l'on se dispose des équipements et le savoir- faire, il faut se servir de la technique plus souvent dans la sous-région ouest africaine

Dorsal Onlay Oral Mucosa Graft Urethroplasty: A Case Report and Review of Literature

The use of buccal mucosa grafts in urethral reconstruction for complex anterior urethral strictures has gained popularity over the years with very good outcomes reported in literature. We report on the successful repair of a complex anterior urethral stricture in a 14-year-old boy following catheterization using this method at the Komfo Anokye Teaching Hospital. The aim is to describe the method of dorsal onlay oral mucosa graft urethroplasty and to review the literature