Radiology

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Browsing Radiology by Author "Alwan Amir"

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    Assessment of the Distribution and the Morphologic Patterns of Bronchiectasis on Computed tomography at Tikur Anbessa Specialized Hospital, Addis Ababa University,Addis Abeba,Ethiopia.
    (Addis Abeba University, 2018-12) Birhanu Mekonnen; Alwan Amir; Gissila Azmera
    Objective: is to assess the distribution and the morphologic patterns of bronchiectasis on computed tomography at Tikur Anbessa specialized hospital, Addis Ababa University. Methods: Hospital based Retrospective Descriptive study design was conducted by reviewing the request format and the CT scan images of the patients sent for interpretation Chest CT at department of radiology, Tikur Anbessa specialized hospital, Addis Ababa University from Month of December 2010 E.C to month of November 2011 E.C. It was accomplished by filling of the prepared questioner format. The data was analyzed manually and by using SPSS software
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    A Cross Sectional Study of Chest Metastasis Patterns of all Malignancies Presented to Radiology Department at Tikur Anbesa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia from October 2018 – May 2019.
    (Addis Abeba University, 2019-10) Mulugeta Sofia; Gissila Azmera; Alwan Amir
    Back ground: Chest is one of the commonest metastasis site of the thoracic or extra thoracicmalignancies and Pulmonary metastases have widely variable presentation on imaging and maysimulate primary lung tumor ornonmalignant diseases. Therefore, it is important for the radiologist to be familiar with the full spectrum of findings to facilitate correct diagnosis and thisstudy has tried to look for the pattern of chest metastasis. Objective: This study aimed to assess the overall chest metastasis patterns of both thoracic and extra thoracic malignancies and their possible histologic correlation. Methods: A prospective cross sectional study of 202 patients was done from October 2018-May 2019. A structured questionnaire was used to collect data for analysis. Results: of the total 202 cases there are 25 primary sites and the majorities come from thefollowing sites in the descending order esophagus (63), breast (47), lung (24), bones (14), soft tissues (10), thyroid (9), head and neck (11) and miscellaneous (24). The commonly seen histologic variant is Squamous cell carcinoma (46 cases); majority from the esophagus followed by Adenocarcinoma (26 case); majority from the breast and the lung followed by sarcomas (24 cases) mainly from the bones and soft tissues and other miscellaneous histologic variants account 16cases from different sources. For the rest of cases the histology is not known. The commonest metastatic site is found to be the lung parenchyma and air ways (accounting 120 cases with multinodular pattern being the commonest (67cases). The second is found to be the mediastinum accounting 108 cases mainly involving the lymph nodes (106 cases). The 3the pleura (58 cases) with the pleural nodule being the predominant pattern (24 cases). The last ischest wall metastasis accounting for 53 cases mainly involving the bones (26 cases). There is statistically significant positive correlation seen between the calcific metastasis and sarcomas but no statistically significant correlation between other histologic types and lung metastasis pattern. Conclusion: In both thoracic and extra thoracic malignancies lungparenchymal and air way metastasis is the commonest with multinodular pattern followed by lymphatic spread. The others 2rdsite is are mediastinal, pleural and chest wall metastasis respectively. Calcific metastasis has significant positivecorrelation with sarcomas.
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    Cross Sectional Study of Unsuspected Pulmonary Embolism in Oncology Patients Undergoing Chest Computed Tomography Imaging in Tikur Anbessa Specialized Hospital Addis Abeba University, Addis Abeba ,Ethiopia.
    (Addis Abeba University, 2019-09) Alemayehu Tesfaye; Gissila Azmera; Alwan Amir
    Background:Oncology patients have a fourfold higher risk for developing pulmonary embolism than that of the general population. Acute pulmonary embolism (PE) is a common and often fatal disease. Furthermore, most cases ofPE that eventuallycause fatality are clinically unsuspected and therefore go untreated.Finding of incidental PE in oncologic patients significantly affects management and prognosis of patients.Diagnosis of PE leads to start of therapeutic anticoagulation and prevents embolic recurrence that is associatedwith substantial morbidity and mortality.Although the MDCT protocol for CT pulmonary angiography differs from that used for routine chest CT,modern CT systems, along with high-concentration contrast media, enable detection of pulmonary emboli evenin routine chest CT, increasing the frequencyof detection of clinically unsuspected pulmonary embolism.2 Objective;This study is designed to assess prevalence of incidentalpulmonary embolism in oncologic patients detected by chest computed tomography. Method:Hospital based prospectivecross-sectional study conducted at TASH to address the specific objective during the study period (July, 2018-January 2019 G.C).This study was conducted among oncologic patients being evaluated at TikurAnbessa Specialized Hospital who have chest CT imaging during the study period. Chest CTwas evaluated for the presence of abnormalities.The study population included all oncologic patients having chest CT imaging during the data collection period.Data was collected by evaluating the CT by radiologist. The data was checked for clarity and completeness.Computerized data analysis was conducted by using SPSS version20.0 software. RESULT:The prevalence of incidental PE was 1.7% in this study. A total of 10 patients out of 573 patients had incidental PE. The most common primary malignancy was GIT malignancy (30.9%). The other malignancies werehematologic malignancies among 12.9%, breast cancer in 12.6%, and cancers of the genitourinary tract in 7.7%. the rest of patients had varieties of different cancer types.80% of the patients with PE had multiple PE and 20%had single PE. The most commonly involved part of the lung was RLL which was involved in all cases of incidental PE.Followed by LLL which was involved in 60%. In general, the upper lobes and the RML were involved in 40%of the cases, each. All cases of single PE occurred in the RLL. 3The most frequently involved divisions of the pulmonary were the lobar branches in 80% of the PE cases followed by segmental branches (70%). The main division was involved in 40% of the cases, while the subsegmental division was involved in none of the cases.Limitation of the study-Lack of good pulmonary arterialopacification and motion artifacts which can limit detection of PE.-Lack of properly handled patient’s chart.-Limited sample size. CONCLUSION:The prevalence of incidental PE detected on routine chest CT scan is 1.7% with no detected small artery PE.The risk of incidental PE was higher in older age and advanced malignancy. The diagnosis of incidental PE hassignificantly changed the management in all of these patients.Good pulmonary arterial contrastopacificationis required for diagnosis.
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    Cross –sectional Study of Systemic Mediastinal Vascular Anomalies and Variations in Patients Evaluated at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia from September 2019-November2019.
    (Addis Abeba University, 2020-10) Melkamu Teworos; Gissila Azmera; Alwan Amir
    Objective: This study is designed to assess the magnitude of common incidental variants andanomalies of the systemic mediastinal vasculatures Method: The study was conducted at TASH from September 2019- Nov2019. A hospital-basedretrospective cross-sectional study wasconducted at TASH to address the specific objectiveduring the study period. The study was conducted among patients being evaluated at TikurAnbessa Specialized Hospital who had post-contrast chest CT during the study period. Thesource population were all adult patients with post-contrast chest CT during the data collectionperiod. Data was collected by evaluating chest CT scans from PACS. The data was checked for clarityand completeness. Computerized data analysis was conducted by using SPSS version 25.0 software Result: A total of 422 (N = 422) patients were included in the study out of which aortic branching anatomy was evaluated in 384 patients out of which 220 (57.3%) had normal classic anatomy and164(42.7%) cases had variant anatomy with a common origin of brachiocephalic trunk and leftcommon carotid artery contributing to the majority of these variants (37.3%) and left vertebralartery arising from the aortic arch making up 3.1%. An aberrant right subclavian artery was seenin 2%. There was one case of a right vertebral artery arising directly from the aortic archconstituting 0.3% of the sample. A total of 384(N=384) patients were evaluated for right-sided aortic arch and there were no cases found suggesting a prevalence <0.3%. A total of 384 (N=384)patients were evaluated the for Azygos lobe out of which 3 (0.8%) had Azygos lobe. A totalnumber of 384 (N=384) cases were evaluated for left-sided superior vena cava and there were nocases found suggesting a prevalence <0.3%. Conclusion: Variants of systemic mediastinal vasculature are common .An understanding andanticipation of these entities on post-contrast chest CT enables precise reporting and is essential inpre-procedure planning.
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    A Crossectional Study on Assessment of Chest Radiographic and Chest CT Patterns in Covid-19 PatientsiIn Tikur Anbessa Hospital
    (Addis Ababa University, 2021) Lemma Ashenafi; Alwan Amir
    Introduction: An outbreak of corona virus disease 2019(COVID-19) infection began in December 2019 in Wuhan the capital of central China’s Hubei province (2). On 11 March 2020, the WHO officially characterized the global COVID-19 outbreak as a pandemic (5). In Ethiopia, the first case of COVID-19 was reported on 13 March 2020 in Addis Ababa (3). COVID-19 primarily affects the lung parenchyma and it has high rate of human to human transmission (5). Thoracic radiology evaluation is often key to the evaluation of patients suspected of COVID-19 infection (2). Chest radiograph has lower sensitivity for the detection of COVID-19 lung abnormalities when compared to chest CT which is shown to have reported CT sensitivity of 98% (7). Disease severity and timing of imaging appear to impact on the rates of normal baseline imaging. Objective: The aim of this study is to describe the correlation between chest radiographic and chest CT patterns in patients with RT- PCR confirmed COVID-19 infection at Tikur Anbessa hospital. Method: A retrospective study on RT-PCR confirmed COVID-19 patients who were seen at Tikur Anbessa specialized hospital and had chest x-ray and chest CT. The chest x-ray and chest CT will be reviewed by experienced consultant radiologists and imaging data will be filled separately and images which had differences in the findings will be reviewed again with the consultant radiologists together. Results: This study included 62 COVID-19 patients seen at Tikur Anbessa hospital among which 32() were male aand 29() were female. Patient age ranged from 18 – 86 with mean age of 49 years. Majority of the patients 56(90.3%) were symptomatic most of them 40(70.2%) presented with shortness of breath and 36(63.2%) presented with fever. Most of the patients 39(62.9%) have history of known underlying illness. Among the 62 patients 50(80.6%) of the chest x rays and all the 62 CT images were abnormal. The predominant chest infiltrate was GOO seen in 22(44%) of chest x rays and 29(46.8%) of the chest CT images followed by combination of GGO and consolidation seen in 22(35.5%) chest x rays and 22(35.5%) of the chest CT images. Findings were bilateral in 44(88%) of chest x rays and 61(98.4%) of the chest CT images. Peripheral location was the predominant finding in both chest X ray and chest CT images accounting for 36(72%) of the chest X-rays and 49(79%) of the chest CT images. A combination of lower and middle lung involvement is the most common chest radiographic and chest CT location accounting for 25(50%) of the chest x rays and 21(33.9%) of the chest CT images. The abnormalities were predominantly multifocal accounting for 37(74%) of the chest X-rays and 43(69.4%) of the chest CT images. Conclusion: The predominant chest radiological finding was multi focal ground glass opacity which is bilaterally and peripherally distributed in the lower and middle lungs on both chest X ray and chest CT followed by a combination of ground glass and consolidation.
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    Hospital Based Prospective Cross Sectional Study on Doppler Ultrasound Finding Pattern of Lower Extremities Peripheral Arterial Diseases in Patients Scanned at Chest and Vascular Unit Radiology Department of Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-12) Fikadu Tsegaye; Gissila Azmera; Alwan Amir
    Introduction-Peripheral artery disease (PAD) is an important global health problem and associated with considerably high morbidity and mortality. It is a disease process resulting from obstruction of large peripheral arteries, exclusive of the coronary and intracranial cerebrovascularsystem, commonly due to atherosclerosis. Imaging modalities for evaluating peripheral arterial diseasein the lower extremities includes computed tomography angiography, conventional angiography, andDoppler ultrasonography. Doppler US is the only noninvasive technique that does not require contrastenhancement, preparation of the patient before the study, or radiation exposure [10, 11]. Doppler US is a good method for screening and follow-up, as well as for the definitive diagnosis of peripheral arterial disease Objective- This study generally asses and describe the doppler ultrasound finding pattern of thelower limb peripheral arterial disease with common indication of lower limb peripheral arterial dopplerultrasound in TASH and associated risk factors for the development of PAD. Methods and materials- This is a hospital based prospective study to assess the doppler ultrasound pattern of lower limb peripheral arterial disease on patients for whom unilateral or bilaterallower limb arterial doppler ultrasound done at TASH department of Radiology, Chest and Vascular unit.The ultrasound was done by final year (R3) radiology residents of AAU. Result- There were a total of 78 patients involved in the study of whom 49 are male and the rest 29are female. The age of the patients ranges from 20 to 88 years old with mean age of 54±19. The mostcommon indications for the study are peripheral arterial disease (PAD) followed by intermittent claudication and arterial thrombosis. Regarding the risk factors the top three risk factors identified arediabetics, smoking and hypertension. Of the total patients 56(71.8%) of them have arterial lesions with43(76.8%) of them having multifocal lesions. 39(50%) of patients had intimal thickening and 39(50%)of patients had arterial plaque being 26(66.7%) of the plaque are multifocal. Arterial thrombus wasfound in 16(20.5%) of the patients of whom 10 (62.5%) are male and the rest 6(37.5%) are female.34(43.6%) of patients had arterial stenosis or total occlusion of which 21(61.8%) of them had totalocclusion followed by 20 -49% luminal narrowing and 50-99% luminal narrowing each representing9(26.5%) and 3(8.8%) of the patients with arterial stenosis. Conclusion-In this study we found DM and cigarettes smoking are the significant risk factor forPAD and multifocal intimal thickening, hypoechoic plaque and total arterial occlusion are frequently seen arterial lesions on doppler ultrasound
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    Pattern of Normal and Accessory Fissures of the Lung; Evaluation with High Resolution Computed Tomography in Patients Attending Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-11) Abera Mebratu; Alwan Amir; Gissila Azmera
    Objective: To determine morphological variations of major and minor fissures, to assess frequency of accessory fissures as well as incomplete major and minor fissures in patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa. Methods: This is an institutional based cross sectional prospective observational study where a total of1020 patients whose Chest CT images have no lung pathology included in the study group for evaluation. Then an assessment of the chest CT images on multiplanar reconstructions done to determine frequencyof accessory fissures and incomplete major and minor fissures in both lungs. Results: Out of 1020 patients who have no any lung abnormality on CT images selected within the study period 2% of them have absent right minor fissure making bilobed right lung. The most common accessory fissure in the right lung was inferior accessory fissure comprising 10% of the study group.Azygos fissure happened to occur in 12 patients (1.2%) of the sample under study. On the left lung the most common accessory fissure was the left minor fissure which accounted for 3.5% of the included study group making trilobed left lung. The major fissures on both sides have significant amount ofincompleteness making 45% and 32% on the right and left sides respectively. Classic three right and twoleft lung lobes with complete major and minor fissures and no accessory fissure is found in only 418subjects (41%). Conclusion: Variations of lung fissures assessed based on chest CT with multiplanar reconstructionsshowed no significant deviation from other studies done on large sample size. The degree of incompleteness of the fissures and percentage of accessory fissures are more common on the right lung than the left lung. The uppermost extent of the left major fissure was always higher than the right lung major fissure invariably.
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    A Prospective Study on Diagnostic Yield, Complication Rate and Associated Factors of Computed Tomography (CT) Guided Transthoracic Needle Biopsy in Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2019-10) Girma AbdulKerim; Alwan Amir; Gissila Azmera
    Introduction:Percutaneous image-guided transthoracic needle biopsy is a safe, minimally invasive,accepted, easy and accurate procedure that provides useful diagnostic information and avoids moreinvasive and expensive exploratory surgeries especially in medically treatable or unresectable cases.Computed tomography (CT) guided transthoracic needle biopsy involves the insertion of a needle underthe guidance of a CT scan to a mediastinal, pleural or pulmonary lesion from which a tissue specimen istaken for cytological evaluation. Any solid or cystic lesion between chest wall and mediastinum can bebiopsied percutaneously by a needle provided that it is not accessible by a bronchoscopy. Although it is asafe and minimally invasive procedure, CT guided a transthoracic needle biopsy (TNB) can have somecomplications. Although it is a well-accepted procedure worldwide with determined accuracy andcomplication rate our study was intended to specify this hospital experience, to settle a base for aninstitutional guidelines for selecting fit patients for CT guided transthoracic needle biopsy, for directingways for rapid detection of complications and management if any occurs. Objective:To determine the diagnostic yield, complication rate and associated factors of CT guided transthoracic needle biopsy in TikurAnbessa specialized hospital, Addis Ababa University, Addis Ababa,Ethiopia. Methodology:An institutional-based prospective study was conducted on all patients for whom CTguided TNB was done for mediastinal, pleural, pulmonary or multi-compartmental mass lesions and have pathology result from July 2018 to July 2019 G.C. The collected data were processed and analyzed using IBM SPSS statistics software version 25 and it is presented by statements, figures, graphs, and tables. Result:CT guided transthoracic biopsy was done on 57 males (56.4%) and 44 females (43.6%) whose mean age was 49.12 years. The location of the lesions was lung (72.28%), mediastinal (12.87%), pleural(10.89%), and multi-compartmental (3.96%). Average of 3 pleural punctures were required for adequate lesion access. A minimum of 3 and a maximum of 8 scans (mean 4.8) were taken during the procedureswith a mean DLP of 159.3 mG cm. The mean time required to perform biopsy was 24.8 minutes. The study found that the cooperative patients had statistically significant lower number of scans and short procedure duration than uncooperative patients. The conclusive rate of the procedure was 76.2%.Adenocarcinoma was the most common pathologic result of biopsied lung lesions whereas Thymoma and adenocarcinoma infiltrate were the most common findings in mediastinal and pleural lesions. This study didn’t find statistically significant differences between the conclusive and non-conclusive patient groups in terms of age, sex, lesion characteristics or technical factors. Among the 101 biopsies, 20.8% had complications of which the most common was pneumothorax 12.9% followed by alveolar hemorrhage (5%). Complications had a strong positive correlation with the traversed aerated lung and negativecorrelation with the mean size of the lesion along the planned trajectory. Conclusion and Recommendation:CT-guided percutaneous transthoracic needle biopsy can be performed easily and safely with patient comfort, high conclusive rate, and few associated complications. Lesion size and distance of traversed aerated lung tissue are correlated with complicationsbut no associated factor was found with diagnostic yield. However, it is possible that larger sample size and correlation with the surgical outcome and follow-up imaging could show more subtle trends. The procedure can be done with low dose protocols and shorter duration provided that the patient positionselection and line of trajectory are settled at the pre-procedural time.
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    Retrospective Study of Correlation of Radiologic Diagnosis of Mediastinal Masses with Pathology Findings, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (2017-10) Mohammed Semira; Alwan Amir
    Background : Mediastinum is a site of non-neoplastic and neoplastic lesions, many of which present as mediastinal masses. In the study of the imaging appearance, distribution, and other features of various mediastinal masses comparison with the histopathologic diagnosis is important to make an accurate diagnosis. Objective: To assess the imaging pattern of mediastinal masses with pathology correlation. Method: Hospital based retrospective cross sectional study were conducted at Tikur Anbessa Specialized Hospital [TASH]. All patients who had mediastinal mass and having both imaging and pathology result during the period of January, 2015 to May 2017 were included. Fifty patients were included in the study. Data were entered in Epi-Info version 3.5.1 and analyzed by SPSS version 23.0 software of computer. Descriptive statistics was performed. And sensitivity with 95% confidence intervals (CIs) was calculated for each mediastinal mass and for the overall mediastinal mass. Result: Anterior mediastinal masses formed 56.0% of total masses, followed by multiple compartments 22.0% and posterior mediastinum masses 16.0%. Based on CT findings thymic masses formed the majority, 39.3%, of anterior mediastinal masses. Whereas the pathology finding showed thymic masses and lymphoma formed the majority of anterior mediastinal masses constituting 35.71% each. Based on CT and pathology findings the majority, 75.0% and 62.5%, of the posterior mediastinal mass were neurogenic tumors respectively. The sensitivity of CT in detecting neurogenic tumors lymphoma, thymoma and thymic carcinoma were 80%, 68.75%, 60.0% and 80.0% respectively. The overall CT sensitivity for diagnosis of mediastinal masses were appears 76.74% with 95% CI (64.11, 89.37). Conclusion: The most common location of mediastinal mass was anterior mediastinum. Thymic mass and lymphoma are the most common type of mass in anterior mediastinum. Neurogenic tumors were most prevalent tumors of the posterior compartment. Over all computed tomography has 76.74% sensitivity for diagnosing mediastinal masses in TASH. To increase the sensitivity and diagnostic accuracy; there need to be a feedback mechanism from pathology side for each mediastinal mass CT diagnosis.