Valeur diagnostique de la tomodensitométrie dans la cysticercose cérébrale à Lomé

La cysticercose a une prévalence élevée dans les pays sub-sahariens et son diagnostic reste difficile. Cette étude a pour but de déterminer la valeur diagnostique de la tomodensitométrie dans la cysticercose  cérébrale. Recrutement des patients ayant bénéficié d'une  tomodensitométrie cérébrale dans l'une des circonstances suivantes: épilepsie, hypertension intracrânienne, syndrome pyramidal, détérioration mentale, ataxie locomotrice ou une diminution de l'acuité visuelle. Les critères de Del Brutto et al. avaient permis de retenir le diagnostic positif de cysticercose cérébrale. Pendant la période, 4193 patients avaient été inclus à l'étude, dont 140 cas de cysticercose cérébrale (3,3%). L'âge moyen des patients de cysticercose cérébrale était de 36 ± 14 ans, avec des extrêmes de 17 ans et 59 ans. La sensibilité et la spécificité de la tomodensitométrie dans la cysticercose cérébrale sont respectivement de 96,4% et 98,3%. La valeur prédictive positive et la valeur prédictive  négative de la tomodensitométrie sont respectivement de 65,9% et  99,8%. Les aspects  tomodensitométriques chez les vrais positifs sont dominés par des lésions associées, 72 cas (53,3%), suivies d'une hypodensité nodulaire arrondie unique ou multiple sans prise de contraste iodée, 17cas (12,6%). La TDM est une technique d'imagerie qui a une sensibilité et une spécificité élevées dans le diagnostic de la cysticercose cérébrale. Cependant, les autres critères de diagnostic restent utiles du fait de l'existence de nombreux cas de faux positifs à la tomodensitométrie

Revue Des Doses d’Exposition Et Des Methode d’Optimisation En Tomodensitometrie (TDM) De l’Enfant Au Togo

Objectives: To assess the justification of indications of CT scans and the exposure doses of children during CT scans. Methods: Prospective study of 104 CT-sans of children collected over a period of 6 months. Results: Female children were predominant with a sex ratio female / male of 1.2. The predominant age group was the 10 to 15 years (41%). The CT-Scan of the head was the most practiced exam, with 64.42% (67/104). When analyzing information according to the recommendations of the Guide of well practices of French Society of Radiology (SFR) and the French Society of Biophysics and Nuclear Medicine (SFBMN), only 77% of CT-Scans were justified. Almost half (49.04%) of CT-Scans had a CT-Dose Index (CTDI) and Dose Length Product (DLP) greater than the French reference norms defined for each group of age. The average values of CTDI and DLP are above the norms for all CT-scans of the skull, facial bones and sinuses. Conclusion: The doses administered to children by CT-Scans are above accepted norms. Improved practices continue medical training of radiology manipulators and the creation of a regulatory or an agency of radioprotection is necessary

Analyse Du Rebut Des Cliches Radiographiques Dans Le Service De Radiologie Et Imagerie Médicale Du Chu Campus De Lomé Au Togo

Purpose: To analyze the waste factors of rejected X-rays films. Methodology: Descriptive and analytical prospective study from 1 January to 30 June 2017 carried out in the department of radiology and medical imaging of the Campus University Hospital of Lomé in Togo. Results: 4912 patients had received 5630 radiographic incidences, including 3288 (58.4%) on the analogy and 2342 (41.5%) on the digital. The reject rate was 12.5%. The vast majority of the X-rays films, 682 (96.9%) were rejected by the radiographers themselves just after development. The resumption frequency ranged from one repeat (550 X-rays films, or 78%) to 4 repeats (8 X-rays films, or 1%). Almost all of the rejected films, 702 (99.7%) came from the analogical room. Chest X-ray was the incidence with more rejection in 33.9% followed by pelvic and lower limb incidences in 21% of cases. More than 2/3 of the rejected films, 473 (67.2%), came from the students' act. The causes of the rejection were mainly centering (25.5%), underexposure (20.17%) and overexposure (12.93). The financial loss caused by the scrap of X-rays films amounted to about 418800F CFA or 638.5 €. Conclusion: Strengthening communication between radiographers and radiologists is necessary to avoid unnecessary repeats of patient’s radiographs

Imagerie Des Retars Psychomoteurs De L’enfant A Lome

Objective: To determine by radiology the different etiologies of psychomotor delays (PMD) in Lomé (Togo). Material and Method: Retrospective study of 12 months in the radiology department of CAMPUS Teaching Hospital, concerned images of CT and MRI scans of children 0-16 years of age with PMD. Results: The mean age was 4.4 years +/- 4.35. The result was pathological in 69.63% of the cases.Cerebral atrophy was the most frequent lesion (40.50%), followed by hydrocephalus (23.14%). The congenital stenosis of the Sylvius aqueduct was the most frequent malformation (37.93%). Triventricular hydrocephalus accounted for 45.61% of hydrocephalus. The most common tumor lesions were choroid plexus carcinoma and craniopharyngioma (28.57% each). Meningo-encephalitis accounted for half of infectious cases. Conclusion: PMD is most often the consequence of several cerebral pathologies. The most frequent of which is cerebral atrophy

Revue Des Doses D’exposition Et De La Justification Des Radiographies Standard En Pratique Pédiatrique Au Togo

Aims: To assess the justification of indications and exposure doses to children during radiographics. Methods: Prospective study of 102 X-ray exams of children collected over a period of 6 months in the Department of Radiology of Kara Teaching Hospital. Objectives: To assess the rationale guidance and exposure doses to children when standard radiographic examinations. Methodology: prospective observational study of 102 standard radiographs (Rx) collected in the radiology department of the University Hospital of Kara on a 6 month period. Results: Male children were predominant with a sex ratio boy / girl of 1.3. The predominant age group was the 5 to 10 years. Chest X-rays were the most practiced exam, with 43%. According to the Guide of well practices of French Society of Radiology (SFR) and the French Society of Biophysics and Nuclear Medicine (SFBMN), 80% of exams were justified. The comparison of our results to diagnostic reference levels (DRLs) shows that 43% and 39% of standard X-rays had dosimetric values exceeds the RDLs respectively the entrance Dose (De) and Dose Surface Product (DSP). Conclusion:Our study reveals that compliance guidance assessments to the proper use of medical imaging examinations guide was not always effective but satisfactory. The study dosimetric constants showed that the dose to children exceeded in a large proportion of the French and Belgian DRLs

Echographie Doppler Arterielle Testiculaire Dans L’infertilite Masculine A Lome

Objective: Determine the relationship between the testicular arterial resistance index (IR) and spermatogenesis. Material and method: prospective analytical study over a period of 12 months at CHU campus and National Institute of Hygiene of Lomé. The parameters studied were anomalies of sperm count, sperm volume, testis volume, and resistance index (RI). The study of the correlation between our variables was done using the Chi square test (χ2). Results: The mean age of men was 36.26 years. Sperm volume was normal in 73% men and abnormal in 27% men. 65% had normal sperm counts, and 35% had abnormal sperm counts. The normal testicular volume was found in 42% men and 58% had an abnormal testicular volume (hypotrophic testis). 51% men had the pathological RI while 49% had a normal RI. There was no statistically significant relationship between testicular volume and sperm count. Also, no statistically significant relationship between RI and testicular volume. But, there was a statistically significant correlation between RI and sperm count. No statistically significant difference between RI and sperm volume. Conclusion: RI can be used with sperm analysis and hormonal studies as part of the clinical evaluation of infertile men. An intratesticular RI greater than 0.6 is associated with decreased total motile sperm

Connaissances Et Motivations Des Medecins Dans La Prescription Des Examens D’imagerie Devant Une Urgence Abdominale Non Traumatique Au Togo: A Propos D’une Enquete Realisee Aupres Des Medecins

Objective: To evaluate physicians' knowledge of prescribing imaging modalities in non-traumatic abdominal emergencies. Materials and method: A transversal and analytical study, consisting of the filling of a questionnaire distributed to general physicians. The survey card included, among others, the first-line imaging modality and the most effective on four abdominal emergencies found in Togo. Results: Regarding acute appendicitis, 73% of physicians estimated the imaging needed. For 92%, ultrasound was the firstline imaging technique because of its availability according to 40%. For 87%, the scan was the most effective exam. In peritonitis, 69% of physicians considered imaging important. For 98% Conventional Chest and Abdominal Radiography was the first-line examination because 52% of physicians said it was the most available. 89% thought the CT scan was the most effective. In the case of bowel obstruction, 89% of physicians found the necessary imaging. For 96%, the first-line examination was the Conventional Chest and Abdominal Radiography because of its availability according to 51% of doctors. All physicians felt that the CT scan was the most effective examination. Concerning acute cholecystitis, 95% considered imaging very important. For 95%, ultrasound was the first-line examination. Its prescription was motivated by its availability according to 50% of doctors. 96% felt that CT was the most effective examination. Conclusion: From our study, it appears that in abdominal emergencies, imaging examinations necessary for diagnosis are prescribed according to their availability and cost, not according to their effectiveness

Apport de l’echographie dans les traumatismes abdominaux fermes (TAF). A propos de 132 observations aux chu de Lome.

Ils’agit de décrire les aspects épidémiologique et échographique des lésions viscérales, de corréler les diagnostics clinique, échographique et chirurgical, d’évaluer la spécificité, la sensibilité de l’échographie, de proposer enfin une démarche pratique. Ainsi à partir d’une série prospective de 132 patients, nous avons étudié l’apport de l’échographie dans l’exploration des traumatismes abdominaux fermés sur une période de 2 ans. Vingt neuf (29) patients sur les 132 ont été laparotomisés et les résultats échographiques ont été corrélés aux résultats de la laparotomie. Ceci nous a permis de faire le diagnostic de 16 lésions spléniques, 2 hépatiques, 1 rénale, 1 vésicale et 37 épanchements péritonéaux. L’échographie est peu sensible dans les lésions pancréatiques et intestinales. Les indices informationnels de l’échographie évalués par rapport aux 29 patients laparotomisés donnent une sensibilité de 83,82% et une spécificité de 98,72%. Elle a contribué à réduire le taux des laparotomies évalué à 6,8%.L’échographie couplée si besoin à l’ASP est le moyen d’investigation paraclinique le mieux indiqué avant la prise de décision thérapeutique du fait de sa fiabilité, de sa disponibilité et de son coût abordable en milieu peu médicalisé. The aim of this study is to describe the epidemiological and sonographic aspects of visceral lesions, to correlate the clinical, sonographic and surgical diagnoses, to assess the specificity, the sensitiveness of sonography, suggest a practical approach. Then it concerns a prospective series of 132 patients, which study is the contribution of scan in the exploration of closed abdominal traumas over a two-year period. Twenty-nine (29) patients of the 132 had a laparotomy. The sonography results were correlated to those of the laparotomy. These results enabled us to make the diagnosis of 16 splenic, 2 hepatic, 1 vesical lesions and 37 peritoneal collection. The US is little sensitive in the pancreatic and intestinal lesions. The informational clues of US assessed for the 29 patients who had laparotomy give a sensitivity of 83.82% and a specificity of 98.72%. This helped to reduce the rate of the laparotomies valued at 6. 8%. Ultrasonography is the most indicated paraclinical investigation before any therapeutic decision because of its reability, availability and its affordable cost in lower medical equipment environment

Apport de l\'urographie intraveineuse (UIV) dans le diagnostic des lithiases urinaires

No Abstract. Journal de la Recherche Scientifique de l\'Universite du Benin Vol. 4 (2) 2000: pp. 259-26

Etude anatomique et radiologique de jumeaux conjoints thoraco omphalopages nes vivants : a propos de deux cas avec revue de la litterature

Les jumeaux conjoints du groupe des thoracopages sont des monstres doubles qui résultent d’une anomalie malformative au cours de la grossesse gémellaire et qui présentent un cordon ombilical avec une fusion au niveau de la région thoracique. De tout ce groupe des tératopages, les thoracopages et les omphalopages sont les plus fréquemment rapportés dans la littérature. Ce sont des malformations rares qui représentent 1 pour 50000 naissances. Le diagnostic morphologique peut être fait par un examen échographique anténatal.Observations :Nous rapportons deux cas de jumeaux thoraco-omphalopages nés vivants dans deux structures sanitaires du Togo. Il s’agissait de jumelles nées à terme par césarienne. Chez les premières, l’examen radiologique et surtout post-mortem a mis en évidence deux foies matures accolés l’un contre l’autre et deux coeurs enveloppés par un même péricarde. Chez les deuxièmes, il s’agissait d’un coeur et d’un foie unique malformé.Conclusion :Le développement des techniques chirurgicales et surtout des mesures de réanimation néonatale, permet de nos jours de réaliser une séparation chirurgicale lorsque ces jumeaux conjoints naissent vivants et surtout lorsque les éléments anatomiques thoraco-abdominaux sont bien constitués.Mot clés : Jumeau conjoint, monstre double, tératopage.ABSTRACTJoint twins of the thoracopagus group are dual monsters that result from malformative abnormality during the twin pregnancy and that show one umbilical cord with a fusion over the thoracic area. Among the teratopages, thoracopages and omphalopages are the most frequently reported in the literature. That are rare malformations representing 01 over 50 000 births. The morphologic diagnosis can be done by antenatal sonography.Observations: We report two cases of thoraco-omphalopagus twins born alive in two hospitals in TOGO. That was twins born over time by C-section. For the first case, the radiologic and post-mortem examinations shew two mature livers placed side by side and two hearts wrapped in the same pericardium. For the second case, that was one heart and one liver, both malformed.Conclusion: The surgical techniques development and especially neonatal resuscitation measures allow nowadays achieving a surgical separation when that joint twins are born alive and especially when thoraco-abdominal organs are well constituted.Key words: Conjoined twins, dual monster, teratopagus