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.

Segmental renal vein thrombosis: An unusual complication of acute pyelonephritis.

Renal vein thrombosis is not a common manifestation in the context of acute pyelonephritis. We report the case of a 29-year-old female diabetic patient that was admitted to our department for an episode of complicated acute pyelonephritis. Initial imaging showed a left lower polar abscess of 27 mm and urine cultures grew community acquired K. Pneumoniae. Two days after the patient was discharged, she was readmitted with worsening symptoms. Repeat imaging showed stability in the size of the abscess and revealed a left lower segmental vein thrombosis. The patient responded favorably to antibiotics and heparin-warfarin therapy.

Sporadic Burkitt lymphoma presenting with peritoneal lymphomatosis.

Burkitt lymphoma (BL) is a highly aggressive non-Hodgkin B-cell lymphoma. It has a doubling time of 24 h. Fortunately, it is highly sensitive to aggressive chemotherapy. Sporadic BL often affects the mesenteric and retroperitoneal lymph nodes. Extra-nodal involvement includes the ileocecal area, stomach, kidneys, gonads, and central nervous system. Peritoneal lymphomatosis is a rare presentation. We report a case of BL presenting with peritoneal lymphomatosis to emphasize the importance of early histological diagnosis of any peritoneal thickening.

Acute Painful Horner's Syndrome Revealing Eagle's Syndrome: A Report of Two Cases.

Eagle's syndrome (ES) is characterised by an abnormally elongated styloid process. It remains a complex pathology and the ophthalmological symptoms are relatively rare. Herein, we report two cases who presented to our clinic with unilateral and painful Horner's syndrome. Computed tomography scanning showed the presence of ES with unilateral extrinsic compression of the sympathetic plexus by the styloid.

Salmonella osteomyelitis complicating aseptic osteonecrosis: Don't forget about the antiphospholipid syndrome.

Osteonecrosis in antiphospholipid syndrome is a diagnostic challenge for clinicians. Early diagnosis and intervention are important for better prognosis.

Tunisian Consensus document on magnetic resonance imaging in patients with intracardiac devices.

INTRODUCTION: Patients with ferromagnetic cardiac devices, particularly cardiac implantable electronic devices (CIED) such as pacemakers or implantable cardioverter defibrillators, are often inappropriately deprived of magnetic resonance imaging (MRI) for safety reasons. This consensus document is written by a multidisciplinary working group involving rhythmologists, interventional cardiologists, echocardiographists and radiologists. Its objective is to establish good practice recommendations to optimize the management of patients with cardiac devices requiring MRI examination, while ensuring their safety and facilitating their access to MRI.

Extracranial head and neck neurogenic tumors: report of 47 cases.

UNLABELLED: Extracranial head and neck neurogenic tumors are rare and usually revealed by histological examination. The aim of this study was to review the clinical, radiological and therapeutic particularities of these tumors. METHODS: This retrospective study concerns 47 patients with neurogenic tumors of the head and neck, operated on between 1989 and 2011 (22 years period). All patients had complete physical examination and ultrasonography was performed when a cervical extension was found. CT scan and MRI were performed in 16 cases. Minimum follow up was 4 years. RESULTS:   A sinusonasal tumor was found in 9 cases and a cervical mass was seen in 28 cases. Parapharyngeal extension was observed in two cases. Two patients had tympano-jugular glomic tumors and 8 of them had a cervical soft tissue tumor. Complete surgical resection was performed in 46 patients. Histological examination revealed a benign tumor in 91% of cases (n=43), 24 of them were schwannomas. Malignant tumors were seen in 4 cases: esthesioneuroblastoma (3 cases) and malignant schwannoma (1 case). These patients received post operative radiotherapy. After surgery, two patients had Claude Bernard Horner syndrome and one had a definitive facial nerve palsy. CONCLUSION: Extracranial head and neck neurogenic tumors may have several aspects depending on their localisation and their histological type. Surgery, when performed, should be complete with minimum complications.

[Primary psoas abscesses of the psoas muscle in children]. / Les abcès primitifs du psoas chez l'enfant.

BACKGROUND: Primary psoas abscesses of the psoas muscle are relatively rare in childhood and can determine problems of diagnosis and therapeutic assumption. AIM: To demonstrate that ultrasonography is an excellent means in diagnosis and treatment of psoas abscess in children limiting the use of CT more costly and radiant and the surgery that is decaying. METHODS: Over a 15 years period (January 1995-december 2009), 16 children with psoas abscess were studied retrospectively. The diagnosis gait was based on questioning, clinical examination and imaging techniques and, in first sight, ultrasonography. RESULTS: Median age of our patients was 6.4 years (extremes 18 months-14 years) and mean delay of evolution was 12 days. Fever and lumbar pain were both constants, associated with another signs like painful boitery, psoitis, mictional burns and lumbar mass. The ultrasonography made in 16 patients allowed to the diagnosis in all cases. The tomodensitometry, made in 3 patients, confirmed the ultrasonography. Echo guided percutaneous drainage, made in 14 cases, was successful in 12. The examination of pus showed S Aureus in 11 cases and E coli in the other. CONCLUSION: Ultrasonography is a very important means in the primary psoas abscess in children. In addition to give diagnosis, this technique allows the drainage and the cure of the collection, limiting the open surgery to some particular cases.