Sonographic Analysis of Adult Polycystic Kidney Disease: Retrospective Data from South-East Nigeria

Background: Autosomal dominant polycystic kidney disease (APKD); an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease; has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease; there is paucity of local published data. As a result; true local incidence and peculiarities in clinical and sonographic characteristics are unknown.Aim: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period.Materials and Methods: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made; only 19 had complete records and were included in the study. Data extracted were- age; sex; working diagnosis; renal size; diameter of renal cysts; presence or absence of extrarenal cysts; family history of renal cystic disease; blood pressure at diagnosis; and patient outcome.Results: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5 of cases; no family history of APKD was obtained. Only six (31.6) patients were hypertensive at presentation and three patients (16) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm 2 for the right kidney and 98.97cm 2 for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure.Conclusion: APKD appears to be uncommon in our environment; however; more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed

Sonographic Evaluation of Cervical Length Changes during Normal Pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age; the absence of any risk factors for preterm birth; and uncomplicated pregnancy. Cervical length was measured in a straight line. Height; age and weight of patients were also obtained. There was a relationship between gestational age and cervical length; which could be described with a linear regression (R = 0.44; P0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth

Transverse thoracic diameter in frontal chest radiographs of an adult Nigerian population

Background: Normal standards for thoracic dimensions that are available in our environment are often based on studies conducted on Caucasians. Application of such published data to a Nigerian population may lead to erroneous conclusions in terms of clinical implication. Objective: Our study aimed to establish age and sex specific transverse thoracic diameter (TD) for our environment.Subjects and methods: The TD of 303 males and females aged between 20 and 93 were obtained in a cross sectional study at a tertiary hospital. Results: The mean values for the 20-39; 40-59 and the 3 60 year-old males were 29.6; 29.0; 27.8cm respectively. The corresponding values for females were 26.3; 27.1 and 25.1cm . Males had significantly larger thoracic diameter than females. The largest mean TD in males and females were in the 20-39 and 40-59 age groups respectively. The TD had a significant positive correlation with weight; height; body mass index and body surface area. The best correlations were with body surface area and weight. Conclusions: Nigerians have a smaller TD than Caucasians. Smaller TD in Nigerians is likely to be responsible for their high cardiothoracic ratios in comparison with Caucasians or Asians

Relationship between sonographic renal length and renal parenchymal thickness in normal adult southeast Nigerians

Aim: To determine the relationship between sonographic renal parenchymal thickness (RPT) and renal length (RL) in normal adult Nigerian. Study design: The RL and RPT of 309 normal subjects within the age range of 18 - 80years were measured sonographically and prospectively. Correlation was performed between RL values and RPT using Pearson Linear `r' test Results: The range of RL value were 8.5-12.9cm and the corresponding mean were 10.33+ 0.7cm and 10.45+ 0.63cm for the right and left kidneys respectively. The range of values for the RPT was 1.40 - 2.4 and the corresponding mean values were 1.91+ 0.20cm and 1.95+ 0.19cm for the right and left kidneys respectively. There was a strong positive correlation between RPT and RL (r = 0.72 and 0.77 for the right and left kidney respectively. However for RL values above 11.0cm the RPT values fluctuated. Conclusion: From this study; for RL above 11.0cm there was no relationship with RPT. The study suggests that for our population groups; kidneys with RL lower than 8.5cm and RPT of 1.40cm or less should not be biopsied in contrast to webb's criteria

Ultrasound in diagnosis of hepatic pathologies a review of two years experience in university of Nigeria teaching hospital; Enugu; Nigeria

We have tried to evaluate the diagnostic yield of abdominal sonology for detection of liver pathologies by reviewing the ultrasonic findings in our department over a period of two years. Analysis of 879 patients that underwent abdominal sonography between 2001 and 2002 revealed relative incidences of liver; renal; splenic; pancreatic and cholecystic pathologies. 43 cases out of those clinically suspected to have pathology related to liver; were ultrasonically negative. Evaluation of the 289 patients with positive ultrasound findings for liver pathology revealed that 46

Informed consent: the radiologist administering radiological contrast media

This study represents the understanding and practice of radiologists in Nigeria in obtaining informed consent from patients before administering radiological contrast media. 120 questionnaires were sent to radiologists practicing in Nigeria. 78(65%) responded, 60(76.9%) of the respondents understood informed consent to mean informing a patient about a procedure and obtaining consent to carry out the procedure. Whereas for consent to be informed it must include the nature of the procedure, purpose, risks and benefits. 52(66.7%) obtained either written or verbal consent while 26(33.3%) neither informed patient nor obtained consent. However, all respondents understood that failure to obtain consent may result in possible litigation by patient or relative while 69(88.5%) requested for a specific policy regarding informed consent. It is concluded that the radiologist in Nigeria does not fully understand the concept of informed consent. A specific policy should be made by the appropriate professional body in Nigeria as to what constitutes the requirements of a truly informed consent since there are simply no guidelines for now. Also informed consent forms, simple enough for patients to understand should be designed. These will assist the individual specialist in the conduct of their practice

Sonographic splenic sizes in normal adult nigerian population

This study aimed to establish ultrasonic splenic dimensions which can be used as normogram for adult Nigerians. 250 adult subjects were scanned prospectively using a 3.5MHZ ultrasound sector probe. The splenic length; width and thickness were btained in the supine position and the weight calculated using Downey's formula. Differences in splenic dimensions were determined using Z test; while the relationship between the splenic dimension and the subjects age; BMI; and height were analysed using Pearson Moment Correlation. The normal splenic sizes obtained ranged from 9.9 -11.5cm (length - L); 6.0-7.5cm (Width W) and 4.0- 4.5cm (thickness -T). The splenic dimensions for males were 11.1 + 0.7cm (L); 7.3 + 0.2cm (w) and 4.2+ 0.2cm (T). The corresponding values for females were 10.6 + 0.7cm; 6.8 + 0.5cm and 4.2 + 0.2cm respectively; thus showing a statistically significant difference between the males and females (P 0.05). A poor correlation was shown to exist between splenic dimensions and age but splenic weight increased with body weight (r0.05); the maximum splenic weights t occurred in the 4 decade in Nigerians nd and in the 2 decade in Caucasians. This finding appears to bear credence to existing opinion by Chauhan et al that splenic recession rather than splenomegaly is prevalent in adults living in endemic falciparum zones. Statistically significant differences between splenic length and weights of the sexes have been established by the study. The good correlation between subject height and splenic length portends profound options of predicating subjects splenic size and matching his ultrasound values with this predicted splenic length (SPL = 1.2 + 0.063)

Relationship between umbilical vein diameter (UVD) and growth parameters in Nigerian foetuses

The intrahepatic diameter of the umbilical vein of 350 normal and singleton fetuses were measured sonographically to establish the relationship between umbilical vein diameter (UVD) and fetal growth parameters. Foetuses from 17 weeks to 40 weeks were evaluated sonographically in mothers who had no history of chronic illness or abnormal liquor volumes. The least squares method was used to fit mean UVD values against G.A. Pearson Moment Correlation analysis was also performed between the mean UVD and the other established growth parameters (BPD and AC) obtained concurrently. There was a steady increase in the foetal UVD with gestational age which is expressed by the equation. GA = 2.36 + 4.84 UVD. The fastest growth rate of the UVD occurred in the last 10 weeks of gestation with a maximum mean value of 9.85 + 0.71mm. The UVD correlated strongly and positively with both BPD and AC

Clinicians opinion on errors in ultrasound reports in South Eastern Nigeria

This study investigated clinicians opinion on common errors in ultrasound reports in South Eastern Nigerian. 238 clinicians from speicialities of internal medicine, surgery, general practice and obstetric/gynaecology selected through stratified random sampling were invloved in ths survey. A questionnaire with four response options ranging from 'very often' to 'never' were used to obtain respondents opinion on the frequency of their observation of common errors in ultrasound reports. The commonest errors identified by respondents were conflicting report (3.73 + 0.62) and missed diagnosis (3.66 + 0.69). On a 4 point scale clinicians indicated that irrespective of the common errors, the ultrasound report was still helpful. The overall mean rating of the clinicians on the extent of common errors in ultrasound report is 2.77 + 0.29. The response indicates that ultrasound reports in the locality are associated with significant errors