Évaluation tomodensitométrique des variations anatomiques du toit de l'os ethmoïde chez l'adulte noir / Computed tomography evaluation of anatomical variations of the ethmoid bone roof in black adults

Etudier à la tomodensitométrie, les variations anatomiques du toit de l'os ethmoïde en déterminant la prévalence des variantes à haut risque. Matériels et méthodes: Etude transversale, avec une collecte rétrospective, descriptive et analytique menée sur une période de 06 mois dans deux services de radiologie et imagerie médicale à Lomé. Elle portait sur des examens de tomodensitométrie normaux des sinus de l'adulte. Résultats: L'âge moyen était de 50,69 ± 16,18 ans. La profondeur moyenne de la fosse olfactive dans le sexe masculin était de 4,03± 1,40 mm contre 4,45±1,59 mm dans le sexe féminin (p=0,0136). Le type III de Keros a été retrouvé dans 11 cas (3,5%). L'asymétrie de la profondeur de la fosse olfactive a été observée chez 107 (69%) patients. L'angle de Gera mesurait en moyenne 58,5±14,6 degrés et 60 (19,4%) toits de l'ethmoïde étaient classés dans le type III. On notait une asymétrie de l'angle de Gera chez 102 (65,8%) patients. La longueur moyenne de la lamelle latérale de la lame criblée était de 5,34 ± 1,4 mm. La longueur moyenne de la fovéa ethmoïdale chez les hommes était de 10 ± 2,5 mm contre 9,3 ± 2,2 chez les femmes (p=0,0078). Il existait une corrélation linéaire positive entre la profondeur de la fosse olfactive et l'angle de Gera (r=0,498; p=0,002). Conclusion: La fréquence élevée de l'asymétrie du toit ethmoïdal suggère que ces variations soient précisées par les radiologues dans les compte-rendu des examens de tomodensitométrie des sinus pour bilan préopératoire

Factors motivating intent to leave amongst radiographers employed by public tertiary hospitals in the Gauteng Province, South Africa

Background: The elements of job satisfaction can be categorized into intrinsic and extrinsic factors. The presence of a higher level of intrinsic factors will result in increased motivation amongst employees, whilst extrinsic factors will result in job dissatisfaction. Decreased job satisfaction levels amongst healthcare professionals are known to create an intent to leave. Hence the need to explore these factors amongst radiographers employed by tertiary hospitals in the Gauteng province of South Africa. Objective: To determine the influence of intrinsic and extrinsic factors of job satisfaction on intent to leave amongst radiographers employed by public tertiary hospitals in the Gauteng province. Methods: A quantitative cross-sectional survey guided the study, and a self-administered questionnaire was used to collect data. The sampling technique used for this study was disproportional stratified sampling. Results: The study had a response rate of 62%. A significant number of the participants (50%) were between the ages of 21-33 years. Also, worth noting that 51% of the participants were newly qualified, 28% were employed for a period of 10-20 years and only 20% were employed for a period greater than 20 years. Diagnostic radiography had the most number of participants at 55%, followed by radiation therapist at 24%, nuclear medicine radiographers at 13%, mammography radiographers at 5% and only 3% were sonographers. Pearson's correlation showed a significant negative correlation with the following extrinsic factors: supervision, r= -.344, p=.000; satisfaction with PMDS, r=-.302, p=.000; human resources processes, r=-.249, p=.001; infrastructure, r=-.236, p=.001; the OSD policy, r=-.233, p=.002; satisfaction with remuneration, r=-.202, p=.006; satisfaction with CPD activities, r=-.201, p=.007; and satisfaction with equipment, r=-.163, p=.029. Conclusion: Both intrinsic and extrinsic factors are associated with an intent to leave amongst radiographers employed by public tertiary hospitals in the Gauteng province

The experiences of teleradiology end users regarding role extension in a rural district of the North West province: a qualitative analysis

Background: Teleradiology was implemented across South Africa, to provide reporting services to rural healthcare institutes without a radiologist. This is guided by standard operating procedure manuals (SOP) which standardise the quality of services provided. From observation, end users, namely, the radiographer and referring clinician, experience challenges in fulfilling the roles extending beyond the SOP. Aim: To explore the end users' experiences within this context and the impact it has on service delivery. Setting: A rural district in North West province, South Africa. Method: This was a qualitative, exploratory, descriptive study. Focus group discussions were held with radiographers and referring clinicians from the teleradiology site in the North West province. A one-on-one interview was conducted with a private radiologist at the reporting site in Gauteng. An interview guide was used to ask open-ended questions to address the aim of the study. Results: At the teleradiology site, radiographers and referring clinicians are performing extended roles, not described in the teleradiology service-level agreement (SLA) and felt poorly equipped to fulfil these roles. They also felt that the private radiologists needed training on interprofessional collaboration to understand the challenges facing health professionals at these rural sites. Conclusion: SLA's should align with the clinical needs and practices of the district. This should guide the specific training needs of the end users practicing in rural areas, to support their extended roles in the teleradiology setting. Training should be in-house, ongoing and consistent to cater for the influx of health professionals entering the rural setting using teleradiology systems

Interpretation of emergency CT scans in polytrauma: trauma surgeon vs radiologist

Introduction: Time is critical in the trauma setting. Emergency computed tomography (CT) scans are usually interpreted by the attending doctor and plans to manage the patient are implemented before the formal radiological report is available. This study aims to investigate the discrepancy in interpretation of emergency whole body CT scans in trauma patients by the trauma surgeon and radiologist and to determine if the difference in trauma surgeon and radiologist interpretation of emergency trauma CT scans has an impact on patient management. Method: This prospective observational comparative study was conducted over a 6 month period (01 April­30 September 2016) at the Inkosi Albert Luthuli Central Hospital which has a level 1 trauma department. The study population comprised 62 polytrauma patients who underwent a multiphase whole body CT scans as per the trauma imaging protocol. The trauma surgeons' initial interpretation of the CT scan and radiological report were compared. All CT scans reported by the radiology registrar were reviewed by a consultant radiologist. The time from completion of the CT scan and completion of the radiological report was analysed. Results: Since the trauma surgeon accompanied the patient to radiology and reviewed the images as soon as the scan was complete, the initial interpretation of the CT was performed within 15­30 min. The median time between the CT scan completion and reporting turnaround time was 75 (16­218) min. Critical findings were missed by the trauma surgeon in 4.8% of patients (bronchial transection, abdominal aortic intimal tear and cervical spine fracture) and non-critical/incidental findings in 41.94%. The trauma surgeon correctly detected and graded visceral injury in all cases. Conclusion: There was no significant discrepancy in the critical findings on interpretation of whole body CT scans in polytrauma patients by the trauma surgeon and radiologist and therefore no negative impact on patient management from missed injury or misdiagnosis. The turnaround time for the radiology report does not allow for timeous management of the trauma patient

False ground-glass opacity and suspicion of COVID-19, beware of the technique for performing the CT

Ground-glass opacity is a CT sign that is currently experiencing renewed interest since it is very common in patients with COVID-19. However, this sign is not specific to any disease. Besides, the possibility of false positive ground-glass opacity related to insufficient inspiration during the acquisition of the chest CT should be known. We report the case of a 36-year-old patient suspected of COVID-19 and in whom a second acquisition of chest CT was necessary to remove false ground-glass opacities that erroneously supported the diagnosis of COVID-19

Reliability assessment of a mechanism-based approach to post-injury knee magnetic resonance imaging interpretation by general radiologists

Background: A mechanism-based approach to post-injury knee magnetic resonance imaging (MRI) interpretation, following acute complex knee injury, is cited by several authors to provide increased reporting accuracy and efficiency, by allowing accurate prediction of injury to at-risk structures. This remains to our knowledge untested in a developing world setting and is of interest to us as South African general radiologists. Objective: To assess the reliability of a mechanism-based approach to complex post-trauma knee MRI interpretation when implemented by general radiologists in a South African setting, and compare our results with the findings of North American authors who compiled and assessed the same classification. To measure the agreement between the observers. Methods: A quantitative, observational, investigative, retrospective study was performed using a sample of 50 post-trauma knee MRI studies conducted at Grey's Hospital, Pietermaritzburg. Two investigators independently applied the consolidated mechanism-based approach compiled by Hayes et al. as a research tool to interpret the knee MRI studies, blinded to each other's findings. Results: Injury mechanism was assigned in 32% of cases by the principle investigator and in 20% of cases by the supervisor, with fair agreement between the observers (k = 0.39). Theinvestigators agreed that 62% of cases were not classifiable by mechanism, 26% because of highly complex injury and 26% because of non-specific findings. Conclusion: Our findings indicate that the Hayes et al. classification is a non-ideal tool when used by general radiologists in our setting, as the pure injury mechanisms described in the classification were rare in our study group. Patient epidemiology and investigator experience are highlighted as potential limiting factors in this study. Despite this, we advocate that the concept of a mechanism-based approach for the interpretation of acute post-trauma knee MRI holds value for general radiologists, particularly in patients imaged before resolution of bone bruising (within 12­16 weeks of injury), and those injured in sporting and similar athletic activities

Training requirements for the administration of intravenous contrast media by radiographers: Radiologists' perspective

Background. The administration of intravenous contrast media (IVCM) is one of the key areas currently under investigation for inclusion in the South African (SA) radiographers' scope of practice. However, for the radiographers to legally administer IVCM, training guidelines must first be identified, developed and accredited by the Health Professions Council of SA.Objective. To investigate the radiologists' perspective of the knowledge, skills and medicolegal training required of radiographers for the administration of IVCM to provide input for the development of national training guidelines. Methods. A quantitative, cross-sectional research study using an online survey, administered by SurveyMonkey, was conducted. The target population included all radiologists residing and practising in the province of KwaZulu-Natal, SA.Results. Fifty-nine participants (60.8%) completed the online survey. Twelve were excluded owing to incomplete surveys, resulting in a final response rate of 48.5% (n=47). The study revealed that various theoretical, clinical/practical and medicolegal study units should be included in the training, i.e. the study of the pharmacology of contrast media, practical training on cardiopulmonary resuscitation and basic life support, as well as the rights and responsibilities of a healthcare professional. In addition, both theory and practical/clinical assessments need to be included.Conclusion. Key data have been provided for the development of national training guidelines for radiographers to administer IVCM, based on scientific evidence that is relevant to the SA context. The study may be of value to other related health professions where scopes of practice are expanded through transforming the education and training curricula