Multicenter, international study of CT practices and radiation doses from 10 African countries: An International Atomic Energy Agency (IAEA) baseline study.

PURPOSE: The objective of our IAEA-coordinated international study was to assess CT practices and radiation doses from multiple hospitals across several African countries. METHODS: The study included 13 hospitals from Africa which contributed information on minimum of 20 consecutive patients who underwent head, chest, and/or abdomen-pelvis CT. Prior to the data recording step, all hospitals had a mandatory one-hour training on the best practices in recording the relevant data elements. The recorded data elements included patient age, weight, protocol name, scanner information, acquisition parameters, and radiation dose descriptors including phase-specific CT dose index volume (CTDIvol in mGy) and dose length product (DLP in mGy.cm). We estimated the median and interquartile range of body-region specific CTDIvol and DLP and compared data across sites and countries using the Kruskal-Wallis H Test for non-normal distribution, analysis of variance. RESULTS: A total of 1061 patients (mean age 50 ± 19 years) were included in the study. 16 % of CT exams had no stated clinical indications for CT examinations of the head (32/343, 9 %), chest (50/281, 18 %), abdomen-pelvis (67/243, 28 %), and/or chest-abdomen-pelvis CT (24/194, 12 %). Most hospitals used multiphase CT protocols for abdomen-pelvis (9/11 hospitals) and chest CT (10/12 hospitals), regardless of clinical indications. Total median DLP values for head (953 mGy.cm), chest (405 mGy.cm), and abdomen-pelvis (1195 mGy.cm) CT were above the UK, German, and American College of Radiology Diagnostic Reference Levels (DRLs). CONCLUSIONS: Concerning variations in CT practices and protocols across several hospitals in Africa were demonstrated, emphasizing the need for better protocol optimization to improve patient safety.

Cystic adventitial disease of the popliteal artery with unusual spontaneous regression: A case report with literature review.

This report highlights the case of cystic adventitial disease of the left popliteal artery in a 45-year-old male patient. Imaging modalities confirmed the diagnosis and high resolution MRI found a cystic connection to the adjacent knee joint. The evolution was unusual with spontaneous regression of the symptoms.

Pheochromocytoma presenting as fulminant myocarditis mimicking COVID-19 pneumonia.

Adrenergic cardiomyopathy is uncommon but can be fulminant and life-threatening. Nowadays, the need to exclude the possibility of COVID-19 pneumonia in patients with acute dyspnea in a previously healthy adult may cause a delay in the diagnosis.

Distance education in times of covid 19: a leap into the future?

INTRODUCTION: Online education has grown a lot in recent months in our country during the global health crisis (COVID19). It has been widely used at all levels and fields of education ranging from elementary school to graduate and postgraduate studies. The aim of this study is to evaluate this teaching method compared to classical face-to-face teaching by referring to the learner's point of view. METHODS: It was a prospective and descriptive cross-sectional study targeting residents in medical imaging (all levels approximately 200 people) It was based on an online questionnaire sent to all residents after attending synchronous online teaching sessions at the College of Medical Imaging and Nuclear Medicine. The assessment was done by the learners using a 5 points Likert scale. RESULTS:    Ninety-seven residents answered the questionnaire. Sixty percent of our learners were satisfied with this new way of teaching. 73% of the students found the logistical means suitable for this course. The main advantages noted by our residents were accessibility to sessions from any location and the ability to replay lessons later. The weaknesses put forward were the lack of interaction with the teacher compared to face-to-face teaching and the occurrence of technical problems which could sometimes hamper the smooth running of the sessions. CONCLUSION: Our study allowed us to get feedback from our learners on this teaching. The multiplication of learning means, in particular a hybrid education should be considered to overcome the shortcomings of exclusive online teaching.

Unusual cause of laryngeal dyspnea and swallowing troubles in a 2-year old child.

Plexiform neurofibromas are rare benign tumors developed from peripheral nervous system often associated with neurofibromatosis type 1. We report the case of multifocal plexiform neurofibromas in a 2-year-old child with cervical mass obstructing the trachea causing respiratory distress. A cervical ultrasound examination was performed followed by enhanced CT and MRI. Imaging revealed an expansive cervical mass extended from the base of the skull to the mediastinum associated with similar pelvic and sacral foraminal masses. The target like MRI aspect on T2-weighted images was suggestive of the neural origin. Biopsy under ultrasound control confirmed the diagnosis of plexiform neurofibroma.

Radiofrequency ablathermia of pulmonary nodules : CT follow-up and prognostic study.

INTRODUCTION: Radiofrequency ablathermia of pulmonary nodules is a local curative treatment whose efficacy assessment is still a current topic. AIMS: To specify the monitoring protocol, the scannographic aspects of treated lesions, deduce criteria of incomplete ablation, and identify the prognostic factors influencing overall and progression-free survivals. METHODS: A prognostic descriptive retrospective study conducted in the medical imaging department of Abderrahman Mami Hospital. The nodules were monitored at 24-hour, 2.4,6,9,12,15,18 and 24 months after treatment and then once a year. The study of overall and progression-free survivals was done using Kaplan Meier's method. RESULTS: Sixteen patients with 21 nodules were included, 20% of them were pulmonary carcinomas and 80% were secondary nodules. 6 nodules presented an incomplete response.The appearance of a convex outline was the first sign of incomplete ablation. 5 out of 6 nodules had a nodular focal enhancement. The cumulative probability of overall survival at 12, 36, and 60 months was 80%, 66% and 39% with a median survival of 31 months. The number of nodules treated was found to be directly related to overall survival. The cumulative probability of progression-free survival was 65% at 12, 36 and 60 months. Pleural contact was the factor influencing progression-free survival. CONCLUSION: Radiofrequency ablathermia is an effective technique. Regular CT monitoring allows early detection of tumor recurrence.

Spontaneous hemothorax and neurofibromatosis type 1: How to explain it, how to explore it and how to treat it?

Neurofibromatosis type 1 (NF1), also known as Von Recklinghausen's disease is an autosomal dominant genetic disorder. It is the most common of phacomatoses. Pulmonary complications have been rarely described in the literature. It is generally a benign disease, but has the potential for rare and fatal complications, such as spontaneous hemothorax. We reported two cases of patients with a history of von Recklinghausen's disease. Both of them suffered sudden chest pain. Chest-X ray revealed a hemi-thoracic opacity. Enhanced chest computed tomography showed massive hemothorax, but no evidence of tumors or an obvious bleeding point in the thorax. After we had ensured a stable hemodynamic condition, we performed video-assisted thoracic surgery to remove the hematoma. No evidence of bleeding was noticed in the first patient whereas an active bleeding was observed in the second patient. We could not determine which vessel was responsible of the hemorrhage. Electrocoagulation and clot removal were performed.  Evolution was favorable for both patients. Spontaneous hemothorax is a rare and potentially life threatening NF1's complication. A tumor like neurofibroma or more rarely vascular involvement of large or small caliber arteries may be at hemothorax's origin.