Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study...Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.展开更多
Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The ...Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDI<sub>vol</sub>) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDI<sub>vol</sub> and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDI<sub>vol</sub> and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.展开更多
Introduction: Pituitary apoplexy is an ischemic or hemorrhagic rearrangement within a pituitary adenoma. Pituitary apoplexy is a rare disease that constitutes a diagnosis and therapeutic emergency. Most of the time, a...Introduction: Pituitary apoplexy is an ischemic or hemorrhagic rearrangement within a pituitary adenoma. Pituitary apoplexy is a rare disease that constitutes a diagnosis and therapeutic emergency. Most of the time, apoplexy is the manifestation inaugural of an adenoma unknown, but it can also complicate a known adenoma. All adenomas can be concerned with the occurrence of apoplexy, with an equivalent risk, whether they are secreting or not and whatever the type of secretion. We report the case of a patient in whom the cranio-encephalic MRI enabled to make the diagnosis. Observation: A 57-years-old woman abruptly presented severe cephalodynia, followed by a left visual field defect. The clinical examination revealed an alteration of the consciousness to the type of obstruction and a decrease in left visual acuity is 4/10th. The cranio-encephalic MRI performed revealed an expansive intrasellar process with suprasellar extension of heterogeneous signal on all the sequences performed alternating hemorrhagic stigmata in the central tumor zone suggesting a macroadenoma having bled, compatible with pituitary apoplexy. She received medical treatment and hormonotherapy, followed by surgical excision. The outcome was satisfactory. Conclusion: Pituitary apoplexy is a rare but serious complication of pituitary adenomas. It is responsible for various neuro-ophthalmologic. Pituitary apoplexy involves the patient’s functional and vital prognosis due to acute panhypopituitarism. It is a diagnostic and therapeutic emergency. MRI is a major contribution to diagnosis. Treatment is based on the combination of hormone replacement therapy and trans-sphenoidal tumor excision.展开更多
Pelvic ultrasound is the first-line examination for the diagnosis of ovarian cysts. When coupled with Doppler, it allows the diagnosis to be directed towards the benign or malignant nature of the cyst. These benign tu...Pelvic ultrasound is the first-line examination for the diagnosis of ovarian cysts. When coupled with Doppler, it allows the diagnosis to be directed towards the benign or malignant nature of the cyst. These benign tumors are frequent in pubertal period. We report a descriptive study in 35 patients aged between 18 and 32 years of age who received a pelvic inflammatory etiology assessment. The purpose of this study was to show the place of pelvic ultrasound in the diagnosis of ovarian cysts.展开更多
Introduction: Devic’s neuromyelitis optica is an autoimmune and central nervous system demyelinating disease. It mainly affects the spinal chord and optic nerves. Considered for a long time as a special form of Multi...Introduction: Devic’s neuromyelitis optica is an autoimmune and central nervous system demyelinating disease. It mainly affects the spinal chord and optic nerves. Considered for a long time as a special form of Multiple Sclerosis (MS), it is distinguished clinically by its rarity and poor prognostic, biologically by NMO (IgG) antibody, radiologically by extended myelitis. Treatment include mega dose of methylprednisolone during relapses and immunosuppressive drug in prevention of recurrences. Observation: Devic’s disease manifests itself in outbreaks of neuritis optic or myelitis. We report the case of a patient who had no particular antecedents. She presented a spastic tetraparesis, accompanied by a decreasing left visual acuity (4/10th);the all evolving by thrust since one year. Spinal chord lesions on MRI, second stage brain damages appearance affecting the white substance and the discovery in the patient serum of anti-aquaporin 4 antibodies (anti-AQP4 Ab) allowed the diagnosis of Devic’s disease. Conclusion: Diagnosis of Devic’s neuromyelitis optica that was initially based on clinical examination and radiological assessment is currently confirmed by the discovery in the patient serum of the NMO immunoglobulin G directed against Aquaporin 4.展开更多
文摘Computed tomography is an indispensable X-ray imaging modality used to diagnose numerous pathologies, but it can also involve the delivery of high ionizing radiation doses harmful to the health of patients. This study aims to survey the level of radiation doses delivered to child patients during head exams in CT imaging to set up the Dosimetric Reference Levels (DRLs), a routine dose optimization tool, based on data acquired at the University Hospital of Angré (UHA), the University Hospital of Treichville (UHT) and the Polyclinic Hospital Farah (Farah) for optimizing procedures in Ivorian hospitals. Prospectively performed on 334 CT images of 186 child patients, this study was carried out on CT systems such as Hitachi Scenaria, Sinovision Insitum, and Philips Incisive used respectively at UHA, UHT and Farah. Children’s scan data were classified into four age bands: vol or dose-length product as DLP) value, whatever the hospital, increases with respect to the age of child patients. Based on the 75th percentile of the whole dose distributions, the DRLs of the CTDIvol is 54.37 mGy whatever the age groups and those of the DLP with respect to age bands are 1224.55 mGy∙cm, 1414.06 mGy∙cm, 1632.24 mGy.cm and 1544.57 mGy∙cm, respectively. The averaged values of CTDIvol and DLP smaller than the corresponding DRLs values suggest that practices in our three facilities are optimized. However, comparing our results with those from different international studies, we see that the CTDIvol and DLP values obtained in the present work are higher. These results suggest additional surveys to ensure our DRLs values and efforts from radiologists, imaging technicians and medical physicists to strengthen clinical procedures for the radiation protection of children undergoing CT scans in Côte d’Ivoire.
文摘Objectives: This study aims to evaluate the level of X-ray doses used in childhood’s head as Local Diagnostic Reference Levels (LDRLs) in computed tomography (CT) at a university hospital in Côte d’Ivoire. The Diagnostic Reference Level (DRL) have been set up and used to prevent unusually high radiation doses used in radiology departments and is therefore an optimization tool for practices and procedures in medical X-ray imaging for the radiation protection of patients. Methods: A prospective study of volume CT dose index (CTDI<sub>vol</sub>) and dose length product (DLP) was performed on images of childhood’s head obtained from a CT-scanner of 64 bars equipped with the tube current modulation capability and manufactured by Hitachi Medical System. 122 CT-scan data from 55 childhood’s head were analyzed. The scan data were stratified in four age groups: Results: The 75th percentile of CTDI<sub>vol</sub> and DLP (set as LDRL) obtained with respect to the stratified age groups are: 22.5 mGy and 452.5 mGy∙cm, 27.7 mGy and 690.6 mGy∙cm, 28 mGy and 722.4 mGy∙cm, 33.6 mGy and 736.8 mGy∙cm respectively. These outcome values increase with respect to the age of pediatric patients and are comparable to DRLs values obtained internationally. Conclusions: Obtaining good image quality while using low dose in children’s head computed tomography for radiation protection require to setup more surveys in Côte d’Ivoire for regional and national DRL. We proposed through this survey LDRLs in terms of CTDI<sub>vol</sub> and DLP, comparable to international DRLs values. This survey will be strengthened by additional surveys in order to obtain national DRLs for the radiation protection of the child patient in Côte d’Ivoire.
文摘Introduction: Pituitary apoplexy is an ischemic or hemorrhagic rearrangement within a pituitary adenoma. Pituitary apoplexy is a rare disease that constitutes a diagnosis and therapeutic emergency. Most of the time, apoplexy is the manifestation inaugural of an adenoma unknown, but it can also complicate a known adenoma. All adenomas can be concerned with the occurrence of apoplexy, with an equivalent risk, whether they are secreting or not and whatever the type of secretion. We report the case of a patient in whom the cranio-encephalic MRI enabled to make the diagnosis. Observation: A 57-years-old woman abruptly presented severe cephalodynia, followed by a left visual field defect. The clinical examination revealed an alteration of the consciousness to the type of obstruction and a decrease in left visual acuity is 4/10th. The cranio-encephalic MRI performed revealed an expansive intrasellar process with suprasellar extension of heterogeneous signal on all the sequences performed alternating hemorrhagic stigmata in the central tumor zone suggesting a macroadenoma having bled, compatible with pituitary apoplexy. She received medical treatment and hormonotherapy, followed by surgical excision. The outcome was satisfactory. Conclusion: Pituitary apoplexy is a rare but serious complication of pituitary adenomas. It is responsible for various neuro-ophthalmologic. Pituitary apoplexy involves the patient’s functional and vital prognosis due to acute panhypopituitarism. It is a diagnostic and therapeutic emergency. MRI is a major contribution to diagnosis. Treatment is based on the combination of hormone replacement therapy and trans-sphenoidal tumor excision.
文摘Pelvic ultrasound is the first-line examination for the diagnosis of ovarian cysts. When coupled with Doppler, it allows the diagnosis to be directed towards the benign or malignant nature of the cyst. These benign tumors are frequent in pubertal period. We report a descriptive study in 35 patients aged between 18 and 32 years of age who received a pelvic inflammatory etiology assessment. The purpose of this study was to show the place of pelvic ultrasound in the diagnosis of ovarian cysts.
文摘Introduction: Devic’s neuromyelitis optica is an autoimmune and central nervous system demyelinating disease. It mainly affects the spinal chord and optic nerves. Considered for a long time as a special form of Multiple Sclerosis (MS), it is distinguished clinically by its rarity and poor prognostic, biologically by NMO (IgG) antibody, radiologically by extended myelitis. Treatment include mega dose of methylprednisolone during relapses and immunosuppressive drug in prevention of recurrences. Observation: Devic’s disease manifests itself in outbreaks of neuritis optic or myelitis. We report the case of a patient who had no particular antecedents. She presented a spastic tetraparesis, accompanied by a decreasing left visual acuity (4/10th);the all evolving by thrust since one year. Spinal chord lesions on MRI, second stage brain damages appearance affecting the white substance and the discovery in the patient serum of anti-aquaporin 4 antibodies (anti-AQP4 Ab) allowed the diagnosis of Devic’s disease. Conclusion: Diagnosis of Devic’s neuromyelitis optica that was initially based on clinical examination and radiological assessment is currently confirmed by the discovery in the patient serum of the NMO immunoglobulin G directed against Aquaporin 4.
