SA Journal of Radiology - Volume 17, Issue 3, 2013
Volume 17, Issue 3, 2013
Author Razaan DavisSource: SA Journal of Radiology 17 (2013)More Less
Thank you to those members of the RSSA who participated in the recent April 2013 RSSA/SAJR poll conducted to obtain a formal record indicating their preferences when accessing journal content.
Of the 213 responses, 55% indicated a preference for a digital-only format that includes online journal access and digital applications for mobile devices. Interestingly, 45% indicated a preference for the printedjournal along with either online access (21%) or digital applications for mobile devices (24%).
The first issue of the SAJR was published on 6 April 1963 as a supplement to the South African Medical Journal, and was recognised as the official journal of the RSSA. Issues were printed on 'special art paper, so necessary for the reproduction of radiographs' as the need forhigh-resolution print images was required.
Source: SA Journal of Radiology 17, pp 84 –88 (2013)More Less
Background. The use of X-ray imaging is ever increasing in proportion to the need for radiological services and the latest technology. Quality management of patient radiation dose monitoring is fundamental to safety and quality improvement of radiological services.
Objective. To assess the level of quality management systems in medical X-ray facilities in Kenya.
Methods. Quality management inspection, quality control performance tests and patient radiation exposure were assessed in 54 representative X-ray medical facilities. Additionally, a survey of X-ray examination frequency was conducted in 140 hospitals across the country.
Results. The overall findings placed the country’s X-ray imaging quality management systems at 61±3% out of a possible 100%. The most and the least quality assurance performance indicators were general radiography X-ray equipment quality control tests at 88±4%, and the interventional cardiology adult examinations below diagnostic reference level at 25±1%, respectively.
Conclusions. The study used a systematic evidence-based approach for assessing national quality management systems in radiological practice in clinical application, technical conduct of the procedure, image quality criteria, and patient characteristics as part of the quality management programme.
Source: SA Journal of Radiology 17, pp 88 –90 (2013)More Less
Moyamoya is a rare cerebrovascular disease characterised by progressive stenosis of the terminal portion of the internal carotid artery and its main branches. We report on the progression of the disease in a 3-year-old boy, confirmed to have idiopathic moyamoya disease, over 6 ensuing years, using serial magnetic resonance imaging with MR angiography. Comparison is also made with conventional angiography at the last visit. Characteristic imaging appearances of asymmetric narrowing of the internal carotid arteries (especially the supraclinoid portion) with numerous collateral vessels around the brain stem, especially within the ambient and quadrigeminal plate cisterns, are demonstrated with progression.
Author A. AhmedSource: SA Journal of Radiology 17, pp 91 –97 (2013)More Less
Sinus development is a dynamic process in children, and appropriate imaging is necessary to adequately demonstrate pathology in our vulnerable paediatric population. The paediatric paranasal sinuses are affected by a wide spectrum of conditions including congenital abnormalities and inflammatory, traumatic and neoplastic diseases.
The purpose of this review is to illustrate the normal pattern of development and the complex anatomy of the sinuses, which should guide imaging protocols. Common anatomical variations and their clinical relevance are described. The paper also describes the various conditions affecting the paediatric paranasal sinuses, with emphasis on imaging features. The diagnostic algorithm for sinus disease continues to evolve along with advances in imaging modalities, and this review discusses suggested imaging guidelines for sinus imaging in children.
Source: SA Journal of Radiology 17, pp 98 –99 (2013)More Less
Until recently, obstetric claims (which are invariably high-value) used to be clustered around problems related to labour. However, a second group of high-value claims is emerging: those related to missed abnormaltities. The value of claims is now so high that a single individual is unable to compensate a claimant adequately, and indemnity is therefore essential. Although such claims are relatively rare, indemnity costs are high as the claims are large. The high value of obstetric claims, including those for missed abnormalities, is reflected in the cost of indemnity for obstetricians and those performing antenatal ultrasound.
Source: SA Journal of Radiology 17, pp 102 –103 (2013)More Less
The molar tooth sign was initially identified in Joubert syndrome, named after Marie Joubert who first described it in 1968 as a rare autosomal recessive disorder characterised by the neuroradiological hallmark of the molar tooth sign caused by cerebellar vermian hypoplasia. Subsequently, it emerged that the molar tooth sign encompasses many syndromes that are now grouped together and termed Joubert syndrome and related disorders (JSRDs). Knowledge of the newer classification system and the subtypes is important and helps to direct and interpret imaging studies based on clinical signs so as to avoid delay in diagnosis of the hepatic, oculorenal and renal subtypes of JSRDs in patients in whom the molar tooth sign is identified on brain MRI.
Source: SA Journal of Radiology 17 (2013)More Less
Wilson disease usually presents with neurological or hepatic manifestations. Magnetic resonance imaging (MRI) of the brain is most informative in diagnosing this disease, especially in patients with neurological features. High T2 signal intensity in the corpus striatum is the most commonly encountered MRI finding. The 'face of the giant panda' sign, seen on axial T2-weighted MRI, results from abnormal signal intensities in the midbrain. Though uncommon, the sign is regarded as the pathognomonic MRI sign of Wilson disease.
Source: SA Journal of Radiology 17, pp 106 –107 (2013)More Less
Nephrogenic systemic fibrosis (NSF), unknown before March 1997 and first described in 2000, is a systemic disorder characterised by widespread tissue fibrosis. The first known case occurred in 1997, after the use of gadolinium-based contrast agents (GBCAs) at high doses in patients with renal failure had become routine. An overwhelming majority occurred within weeks to months after injection of a GBCA. The link between nephrogenic systemic fibrosis (NSF) and GBCAs was recognised in 2006. This note comprises guidelines on the prevention of NSF.
Source: SA Journal of Radiology 17, pp 108 –111 (2013)More Less
Source: SA Journal of Radiology 17, pp 113 –114 (2013)More Less
Source: SA Journal of Radiology 17, pp 114 –115 (2013)More Less
A 59-year-old man presented with anaemia and complaints of abdominal pain, weight loss, fatigue and dizziness. Computed tomography (CT) scans of the chest revealed bilateral paravertebral masses. The CT features were typical of extramedullary haematopoiesis (EMH). EMH should be strongly considered in a patient with bilateral, well-marginated, paravertebral thoracic masses and a history of chronic, severe anaemia.
Source: SA Journal of Radiology 17, pp 117 –118 (2013)More Less
We congratulate Drs Vanesha Naidu of King Edward VIII Hospital, Durban, and Ayesha Mitha of Inkosi Albert Luthuli Central Hospital, Durban, for their excellent diagnoses, for which they share the award of R1 000 from the RSSA. Drs Misser et al. elaborate below on the imagesand findings. Please refer to pages 74-76 of the June 2013 issue of the SAJR (http://www.sajr.org.za/index.php/sajr/article/view/890/724) for the presenting details (recent onset personality change, depression and cognitive impairment) and the investigative images.