Doppler Ultrasonographic Evaluation of Erectile Dysfunction in a Northern Nigerian Tertiary Hospital.

Background: Colour duplex Doppler is a noninvasive tool for the evaluation of the vascular mechanism of erectile dysfunction (ED). It can be used to determine the integrity of the vascular mechanism and to differentiate between arterial and venous insufficiency. Objectives: To identify the vasculogenic causes of ED and subclassify them into arteriogenic, venogenic, or mixed to assist in predicting the clinical outcome. Materials and Methods: A retrospective study was conducted at the Department of Radiology, ABUTH Zaria, from records of patients who had presented to the Doppler suite with symptoms of ED available between July 2020 and August 2022. Results: A total of 23 patients were involved in this study. The age range was 25-66 years. The majority of the patients were seen in age groups 51-60 years and 41-50 years with 48% (11) and 22% (5), respectively. Only 3 (13%) of the patients were found to have normal penile Doppler study, 12 (52%) patients were found to have arteriogenic, and another 4 (17.4%) patients were found to have venogenic cause. In four (17.4%) patients, there was mixed/inconclusive picture. Among the nine (39%) patients with Peyronie's disease, only one showed normal Doppler study. The incidence of vasculogenic cause of ED was found to increase with age. Conclusions: The colour Doppler study is an important noninvasive nonionizing radiation tool for swift evaluation of penile erectile function and, thus, helps in classifying ED causes into structural, vascular, or possibly psychogenic, hence guiding the clinicians on the therapeutic options.

Efficacy of Computed Tomography and Ultrasonography in Diagnosis of Metastatic Cervical Lymph Nodes in Orofacial Cancer.

INTRODUCTION: There is no consensus on which imaging modality is better for the detection of metastatic cervical lymph nodes in orofacial malignancies. This study evaluates the efficacy of computed tomography (CT) and ultrasonography (US) in diagnosis of metastatic cervical lymph nodes in orofacial cancer. MATERIALS AND METHODS: Sixty patients with various histologically diagnosed orofacial malignant lesions and clinical evidence of cervical lymph node metastasis were examined using US and CT. Further, the affected lymph nodes were biopsied and examined histologically. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the techniques were calculated. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 19 (SPSS Inc., Chicago, IL, USA) and Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). Test of statistical significance was set at 0.05. RESULTS: US recorded a sensitivity, specificity, PPV, NPV, and accuracy of 80.0%, 57.1%, 77.5%, 60.0%, and 71.7%, respectively (P = 0.004), while CT recorded a sensitivity, specificity, PPV, NPV, and accuracy of 87.1%, 71.4%, 85.0%, 75.0%, and 81.7%, respectively (P< 0.0001). Lymph node size was the commonest criterion in the diagnoses of metastases in cases with cervical lymph nodes. CONCLUSION: Although we obtained great results using US, our results indicated CT to be a better imaging modality for detecting metastatic cervical lymph nodes in orofacial malignancies.

Doppler ultrasonographic evaluation of lower limbs deep-vein thrombosis in a teaching hospital, Northwestern Nigeria.

Background: Deep-venous thrombosis (DVT) of lower limbs is one of the most common causes of death caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. B-mode and color Doppler imaging are needed for the early diagnosis of DVT to prevent complications and sequalae of DVT. Objectives: The objectives of this study are to evaluate the role of Doppler ultrasound in diagnosing DVT of lower limbs and to study the spectrum of findings in patients with DVT in Zaria. Methodology: A retrospective study was carried out on patients who had Venous Doppler Scan in the Department of Radiology ABUTH, Zaria, Nigeria, for suspected DVT over a period of 4 years from February 2014 to January 2018. Scans were done using DC-3 and DC-6 Mindray Ultrasound machines (2009 and 2013 Models, respectively, Shantou, China) coupled with high-frequency (7.5-12 MHz) linear and low-frequency curvilinear (2-5 MHz) transducers. Analysis of cases of DVT was performed in terms of age, sex, clinical features, predisposing conditions, anatomic distribution, stage, and pattern of thrombus involvement in the veins. Data were analyzed using the SPSS version 20.0 and value of P < 0.005 was considered as statistically significant. Results: A total of 252 patients' results were reviewed which consisted of 122 males (48.4%) and 130 females (51.6%). The patients' ages ranged from 11 to 80 years, averaging 45.5 ± 9.56 years. The most common indication for Doppler request was leg swellings. The most common risk factor for DVT was malignancy (36%), cardiac disorders (18%), and traumas (14%). Sixty-six (61%) cases showed left-sided and 26 (24%) right-sided, whereas 16 (15%) cases showed bilateral lower limb involvement. Predominant thrombus was above-knee region with 54% in the superficial femoral vein. Chronic stage was seen in 46 (42%) cases, subacute in 44 (41%) cases, and acute in 18 (17%) cases. Conclusion: Middle-aged females, left-sided leg, and above-knee segment were predominantly affected with DVT; hence, this buttresses the need for Doppler ultrasound in the diagnosis of DVT in all patients.

RésuméContexte: La thrombose veineuse profonde (TVP) des membres inférieurs est l'une des causes les plus courantes de décès par embolie pulmonaire.De nombreux troubles médicaux et chirurgicaux sont compliqués par la TVP. L'imagerie Doppler en mode B et couleur est nécessaire pour le diagnostic précoce de TVP pour prévenir les complications et séquelles de la TVP. Objectifs: Les objectifs de cette étude sont d'évaluer le rôle des ultrasons Doppler.diagnostiquer la TVP des membres inférieurs et étudier le spectre des résultats chez les patients atteints de TVP à Zaria. Méthodologie: une étude rétrospective patients traités par Doppler veineux dans le département de radiologie ABUTH de Zaria (Nigeria) pour suspicion de TVP sur une période de période de 4 ans allant de février 2014 à janvier 2018. Les balayages ont été effectués à l'aide d'appareils à ultrasons DC-3 et DC-6 Mindray (2009 et 2013). Modèles, respectivement, Shantou, Chine) couplés à des transducteurs haute fréquence (7,5­12 MHz) et curvilignes basse fréquence (2­5 MHz).L'analyse des cas de TVP a été réalisée en termes d'âge, de sexe, de caractéristiques cliniques, de conditions prédisposantes, de distribution anatomique, de stade et de modèle.de la participation de thrombus dans les veines. Les données ont été analysées avec SPSS version 20.0 et une valeur de p <0,005 a été considérée statistiquement significatif. Résultats: Un total de 252 patients ont été examinés, soit 122 hommes (48,4%) et 130 femmes (51,6%). Les patients l'âge variait de 11 à 80 ans, avec une moyenne de 45,5 ± 9,56 ans. L'indication la plus courante pour la demande d'analyse était le gonflement des jambes. Le plus Le facteur de risque commun de TVP était la malignité (36%), les troubles cardiaques (18%) et les traumatismes (14%). Soixante-six (61%) des cas ont montré un côté gauche et 26 (24%) des cas ont montré une atteinte bilatérale des membres inférieurs. Le thrombus prédominant était au-dessus de la région du genou avec 54% dans la veine fémorale superficielle. Le stade chronique a été observé dans 46 cas (42%), subaiguë dans 44 cas (41%) et aigu dans 18 cas (17%). Conclusion: Les femmes d'âge moyen, jambe gauche et segment du genou étaient principalement atteintes de TVP; Par conséquent, cela renforce lanécessité de l'échographie Doppler dans le diagnostic de la TVP chez tous les patients.

Accuracy of ultrasonography in the evaluation of abdominal masses in children in Nigeria.

INTRODUCTION: Abdominal masses in children constitute a spectrum of lesions of diverse origin, nature and significance. In a low-income setting with limited investigative facilities, accurate diagnosis of abdominal masses can be very challenging. However, ultrasound has been used preferentially as a diagnostic tool in evaluating abdominal masses in children. This study aimed to determine the accuracy of ultrasound evaluation of abdominal masses in children. MATERIALS AND METHODS: This was a prospective descriptive study of 135 consecutive children presenting with palpable and/or suspected abdominal masses over a 1-year period at a tertiary hospital. Data analyses were done using SPSS version 17 software and level of significance was set at P < 0.05. RESULTS: Abdominal mass was located in the kidney in 40 (32.3%) patients. Definitive diagnoses of abdominal masses were confirmed intraoperatively in 33 (24.4%) and by histopathological examination in 102 (75.6%) cases. Abdominal masses were detected in 124/135 (91.9%) of the participants. Ultrasound (US) correctly identified 109/124 (87.9%) of the pathologies. The sensitivity and specificity of USS were 87.9% and 81.8%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) were 97.2%-98.2% and 37.5%-45.7%, respectively. The overall US diagnostic accuracy was 87.4%. The predictive value of US for intussusceptions, Wilms' tumour and hydronephrosis was high (sensitivity was 92.0%, 95.8% and 81.1% and PPV was 90.0%, 83.0% and 93.8%, respectively). On the other hand, the sensitivity indices for appendiceal mass/abscess, lymphoma and neuroblastoma were low (28.6%, 66.7% and 57.1%, respectively), while their PPV was low too (66.7%, 42.9% and 77.7%, respectively). The PPV was especially poor for lymphoma. The specificity and NPV indices for these six disease conditions were good. CONCLUSION: Ultrasound is a reliable tool in the evaluation of abdominal masses in children in this setting.

D-dimer levels as marker of deep vein thrombosis in patients with cervical cancer: A study of a northern Nigerian patient population

Background: Cervical cancer is the most common genital tract malignancy in Nigeria and an important cause of cancer­related death in women. Patients with advanced cervical cancer are often victims of deep venous thrombosis (DVT) that increases morbidity and mortality. Strategies at screening and early diagnosis enable prompt treatment which improves quality of life. Objectives: The objective of this study is to determine the plasma D­dimer level in patients with cervical cancer and its relationship to the presence of DVT,Well's score, and stage of malignancy. Materials and Methods: It is a prospective cross-sectional descriptive study of patients with histological diagnosis of cervical cancer in a Nigerian population. Patients' clinical, laboratory, and radiological data were obtained, and their body mass index (BMI) was calculated. Well's chart 17 was used to categorize patients using a cutoff of 2. Plasma D­dimer was quantified by immunoturbidimetric method and interpreted as significant if >0.099 g/dl.High­resolution ultrasound with 5­10 MHZ linear probe was used to evaluate the lower limbs veins of the patients. Data were analyzed with SPSS version 20. The test of association was done using Chi­square with a P < 0.05 considered statistically significant. Results: A total of 77 patients were enrolled, but 67 patients had complete data. The mean age was 54.7 ± 11.2 years. The average parity was 7.5 ± 3.1. Majority (47.8%) had normal BMI. D­dimer was positive in 58 (87%). Of the 17 (25%) with both elevated D­dimer and high probability of DVT, 5 (29%) had DVT. The incidence of DVT among our study population was 7.5%. There was statistically significant relationship between stage of diseaseand an elevated D­dimer value (χ2 = 5.82, α = 0.016, 95% confidence interval). Conclusion: Deep vein thrombosis occurred only in patients with high D­dimer and high Well's score, which makes their combination relevant in early diagnosis. Advanced age, high parity advanced stage of disease was the main associated risk factors. All cases with DVT occurred in patients with squamous cell cancer

Colour doppler sonography of the penis in the evaluation of erectile dysfunction: Our experience in Abuja, Nigeria.

BACKGROUND: Erectile dysfunction (ED) is an inability to achieve and maintain erectile rigidity sufficient for satisfactory sexual performance. It is either organic or psychogenic in origin. This study was aimed at establishing vasculogenic causes among patients being evaluated for ED using triplex Doppler Ultrasound. PATIENTS AND METHODS: This study was conducted at the Department of Radiology, Federal Medical Centre, Abuja, Nigeria from July 2015 to January 2017. Thirty-five consecutive patients with the clinical diagnosis of ED were evaluated with colour Doppler ultrasound scan using a high-frequency linear transducer. The penile scan was done before and after intracavernosal injection of 10-20 µg prostaglandin E1. The waveforms of cavernosal arteries (CAs) were obtained alternately using angle of inclination ≤60°. The spectral waveforms and peak systolic velocities (PSV) of the CA were documented at 5-min intervals, from 5 to 50 min. RESULTS: PSV of CA varied between 19.5 and 104.4 cm/s (mean: 42.4 ± 17.6) among the entire patients and between 19.5 and 24.7 cm/s (mean: 21.9 ± 1.7) among patients with arteriogenic ED. Arteriogenic ED was found in six patients (17%), while venogenic ED was observed in ten patients, which constituted 29% of the entire participants. None had combined arteriogenic and venogenic ED. Peyronie's disease was observed in seven patients, and none of these had vasculogenic ED. CONCLUSION: About 46% of the patients had vasculogenic ED. It is therefore imperative that patients with ED benefit from this safe, cheap and non-ionising diagnostic modality before initiating therapy as ED treatment is cause specific.