13 research outputs found
Etat Des Lieux Et Evaluation Des Formations En Radiologie Dans Un Pays En Developpement, Cas Du Togo
Objective: to make an inventory and assess the training in radiology in Togo. Methodology: Descriptive study, with opinion survey, carried out from June to August 2016 including students in Master and Residents in radiology of the academic year 2015 - 2016. Results: The response rate was 91%. All the training sites had conventional radiography and functional ultrasound. For 57% of students the quality of practical instruction was 4/5. The availability of teachers was acceptable (3/5) to good (4/5) according to 84%. Competence for examinations varies from bad (2/5) to excellent (5/5) for the Master 1 and from good to excellent in Master 2. The difference in responses was not significant regardless of the year of study or training course (p> 0.05). For the performance and interpretation of radiological examinations, the junior residents were considered mediocre (1/5) to acceptable versus acceptable to seniors. For an ultrasound, this score varied from 1/5 for the juniors residents to 4/5 for the seniors. The competence to carry out a vessels ultrasound Doppler was 1/5 for the junior residents and 2/5 for the senior. Conclusion: Learners in radiology in Togo are generally satisfied with the training they receive. Acquisitions of significant skills have been observed from one level of training to another
Le fibromatosis colli ou torticolis congénital: son diagnostic et sa prise en charge à propos de deux cas
Le fibromatosis colli (FC) est pseudotumeur rare du muscle sterno-cléido-mastoïdien (SCM), à l'origine d'un torticolis dit congénital chez le nouveau-né ou le nourrisson. Le mécanisme étio-pathogénique de sa survenue est sujet à controverse. Son diagnostic fait appel à l'échographie qui permet de mettre en évidence un épaississement caractéristique du muscle. Nous rapportons deux cas diagnostiqués par l'échographie avec pour un cas une notion de malposition intra-utérine et pour l'autre cas une absence totale de malposition et de traumatisme obstétrical qui pourtant est évoqué comme élément du mécanisme de survenue du FC.Key words: Fibromatosis colli, torticolis congénital, sterno-cléido-mastoïdien, échographi
Evaluation of pulmonary computed tomography angiography protocols: A multicenter audit in Togo
Introduction : Pulmonary CT angiography is among the most challenging protocols to execute, with significant inter-center variability in image acquisition protocols and iodinated contrast media injection. This study aimed to ascertain whether the use of iodinated contrast media (ICM) and acquisition protocols are optimized during pulmonary CT angiography procedures.
Materials and methods : This multicentric cross-sectional study, descriptive and analytical with a prospective data collection was conducted in three radiology departments in Togo. It encompassed all pulmonary CT angiography examinations carried out from March 1st to June 30th, 2023.
Results : In total, 89 patients, of which 52 were females (58.43%), were registered. The average age was 59.97±14.34 years. The average volume of injected ICM was 67.08±14.21 ml. The mean iodine dose was 0.31±0.07 gI/Kg. Catheters of 20 G (44.94%) and 18 G (43.82%) were most frequently used. The mean injection rate was 4.22±0.64 ml/s. The bolus test technique was the most employed (75.28%). The average acquisition delay was 17.77±12.26 seconds, while the average acquisition duration was 10.56±2.56 seconds. The average dose-length product (DLP) was 390.09±236.69 mGy.cm, and the average volumetric computed tomography dose index (CTDI_vol) was 12.31±11.69 mGy. Vascular enhancement was insufficient in 7.87% of cases. No statistically significant difference was found on the rate of insufficient enhancement and optimization factors. Similarly, there was no enhancement difference between bolus test and bolus tracking techniques.
Conclusion : The vast majority of examinations allowed for optimal opacification of the pulmonary arteries. However, the optimization measures for the use of iodinated contrast media are not consistently applied
L’HÉMANGIO-ENDOTHÉLIOME ÉPITHÉLIOÏDE (HEE) HÉPATIQUE : ASPECT EN IMAGERIE D’UN CAS D’ÉVOLUTION FATALE CONFIRMÉ PAR L’HISTO-IMMUNOCHIMIE ET LA CYTOGÉNÉTIQUE
The authors report a case of Hepatic epithelioid hemangioendothelioma in a 40 years old woman admitted for abdominal and pelvic pains in a context of poor general condition. The abdomino- pelvic ultrasound and CT scan had found a diffuse tumor infiltration of the liver. Two liver biopsies, the first ultrasound-guided percutaneous liver biopsy and the second by trans-jugular approch, helped confirm the diagnosis by immunohistochemistry and cytogenetics. Awaiting a liver transplant, she presented a hepatopulmonary syn
Renal Leiomyosarcoma, a Rare Presentation
Renal sarcomas are very rare malignant tumours with a very poor prognosis. Renal leiomyosarcoma, a malignant tumour of smooth muscle origin, is the most common histological type. The article reports a case of leiomyosarcoma of renal location, with a review of the literature. A 38-year-old female patient, with no previous pathological history, consulted the nephrology department of the Teaching Hospital of Lomé for abdominal pain that had been present for 4 years. Histology showed a tumour proliferation of fasciculated architecture, made of spindle cells arranged in long bundles, with cytonuclear atypia and cytoarchitectural abnormalities. Immunohistochemical examination showed positive staining for smooth muscle actin, h-caldesmone, desmin and CD34 and negative for pancytokeratin (AE1/AE3), myogenin and PS100. Renal leiomyosarcoma is an exceptional malignancy. It remains the most common renal sarcoma, the differential diagnosis of which is based on immunohistochemical findings
Diagnostic Difficulties in Pathological Laboratories in Developing Countries: A Case Report of Differentiated Squamous Cell Carcinoma in a Young Togolese Woman
We report a case of poorly differentiated squamous cell carcinoma of the vulva induced by human papillomavirus in a 23-year-old woman, in whom we experienced diagnostic difficulties
Evaluation of Iodinated Contrast Media Use in Abdominal CT Scans in Cancer Assessments: A Cross-Sectional Study in Lomé (Togo)
Background. There is great variability between centers regarding contrast injection protocols. They should only be injected if they can provide useful information for diagnosis with the necessary and sufficient quantity of iodine. We wanted to know through this study if the use of iodinated contrast media is optimised in abdominal CT scans performed for cancer assessment in Lomé. Materials and Methods. It was a cross-sectional, descriptive, and analytical study with a prospective collection over a period of 6 months in three CT units in Lomé. It involved abdominal CT scans performed for oncological evaluation. Data were reported as the mean ± standard deviation. The Pearson correlation coefficient, ANOVA, chi-square, and the Fisher test were used. Results. A total of 218 examinations were recorded. The female sex represented 56.88% of the patients. The mean age was 50.92 ± 15.78 years. The mean weight was 70.46 ± 15.23 kg. The mean BMI was 24.91 ± 5.32 kg/m2. The examinations were performed with a voltage of 120 kV in 195 cases (89.45%). The mean dose of injected iodine was 0.42 ± 0.09 gI/kg with a dose of 0.40 gI/kg at 80 kV and 0.45 gI/kg at 130 kV. The mean injection rate was 2.90 ± 0.34 mL/s. The mean injected volume was 83.19 ± 7.29 mL. The mean duration of the injection was 30.60 ± 7.39 s. The mean iodine delivery rate was 0.98 ± 0.17 gI/s. There was no saline injection in 152 cases (69.72%). Liver contrast enhancement was satisfactory in 94.5% of cases. There was a strong negative linear correlation between the dose of injected iodine and weight. Conclusions. Optimization guidelines for the use of iodinated contrast media are not always applied. Therefore, monitoring and benchmarking programmes for iodinated contrast injection protocols that involve all radiology personnel should be implemented
Intravenous Contrast Medium Administration for Computed Tomography Scan in Emergency: A Possible Cause of Contrast-Induced Nephropathy
The goal of this study was to assess risk for CIN after CT Scan during an emergency and to identify risk factors for the patient. Prospective review of all patients admitted to the emergency room (ER) of the Teaching Hospital of Lomé (Togo) during a 2-year period. CIN was defined as an increase in serum creatinine by 0.5 mg/dL from admission after undergoing CT Scan with intravenous contrast. A total of 620 patients underwent a CT Scan in the emergency room using intravenous contrast and 672 patients took the CT Scan without intravenous contrast. Out of the patients who received intravenous contrast for CT Scan, three percent of them developed CIN during their admission. Moreover, upon discharge no patient had continued renal impairment. No patient required dialysis during their admission. The multivariate analysis of all patients who had serial creatinine levels (including those who did not receive any contrast load) shows no increased risk for acute kidney injury associated intravenous contrast (odds ratio = 0.619, p value = 0.886); only diabetes remains independent risk factor of acute kidney injury (odds ratio = 6.26, p value = 0.031)
Tuberculous Abscess of the Chest Wall Simulate Pyogenic Abscess
The chest wall tuberculosis abscesses is rare. We present a case of a 27-year-old immunocompetent male who presented chest wall abscesses. Imaging (chest radiographic, ultrasound, and computed tomography) and Ziehl-Neelsen staining demonstrated chest wall tuberculosis abscesses
Male Breast Cancer in Togo: Imaging and Clinicopathological Findings
Background. Breast cancer in men is a rare condition, often diagnosed late. The purpose of this study was to describe its epidemiological, histopathological, and radiographic aspects in Togo. Materials and Methods. This was a descriptive retrospective study on cases of breast cancer in humans diagnosed histologically at the Laboratory of Anatomy Pathological and Imagery of the University Hospital in Lomé, over a period of 25 years (1995 to 2019). The parameters studied were epidemiological, anatomopathological, and imaging. Results. Eighty-two (82) cases were diagnosed, an annual frequency of 3.28 cases. The mean age was 45±2.5 years; the range was 27-63 years. The family history of 47 patients (57.32%) was known. Carcinomas represented the predominant histological group with predominantly nonspecific invasive carcinoma (87.5%). These cancers were diagnosed at late stages (75.71% grade II). They were mainly of luminal B profile (38.75%) and associated with mutations of the BRCA2 and BRCA1 genes in 14.63% of the cases. The lesions were classified ACR 5 in 61.5% (11/18). Two cases of breast angiosarcoma were diagnosed by the identification of CD31 markers and factor VIII in immunohistochemistry. Hormone therapy such as tamoxifen was prescribed in all luminal patients (43 patients). Radiotherapy was administered to 15 patients (18.3%), with acute toxicity in 20% of the cases. After a median follow-up of 36 months, the evolution was complete remission in 27 patients (32.93%). Conclusion. Breast cancer in men is rare, often diagnosed late with a poor prognosis