Radiology

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    Diagnostic Accuracy of Ultra Sound Reports of Intussusception and Factorsaffecting Treatment out Come Among Pediatricpatients in Tikur Anbassa Hospital, Tah, Addis Ababa, Ethiopia
    (Addis Ababa University, 2002) Birhanu, Addisalem(PhD); Gorfu, Yokabel(PhD); Zewdneh, Daniel(PhD)
    BACKGROUND: Intussusception is one of the main abdominal emergencies in children. Ultrasonography, is widely available, easily performed, does not produce radiation and can be used to screen suspected cases and diagnosis of intussusceptions. OBJECTIVE: To retrospectively evaluate the accuracy of ultrasound investigation reports in the diagnosis of intussusceptions and factors which affect treatment outcome of intussusceptions among pediatric patients in TikurAnbassaHospital, TAH, Addis Ababa, Ethiopia MATERIALS AND METHODS: Between September 2002 and Aug 2004 EC, 47 children were managed for intussusception at TAH and 42 patients underwent screening US for suspected intussusception. The mean age of the patients was 8 months. RESULT: Out of forty seven patients, Forty two underwent screening US and surgery. Thirty eight patients had a positive US result; 34 (89.5%) were true positive and 4(10.5%) were false positive. Four patients had a negative US result; all were false negative. The sensitivity of the ultrasound examination was 89.5%. CONCLUSIONS: It is a concern in our environment causing considerable morbidity and mortality due to late presentation. We conclude that ultrasonography can be used as a rapid, sensitive screening procedure in the diagnosis or exclusion of childhood intussusceptions. The sensitivity of ultrasound examination is shown to decrease in our situation when compared to others, For this to be effective, effort may have to be intensified toward training more specialized personnel. ii
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    A Prospective study in the incidence of immediate complications of image guided FNAC and BIOPSY at Black Lion Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2014-10) Gebrekirstos, Gebreyohannes; Kebede, Tesfaye (MD,SCR,SSBI,Consultant Radiologist, Associate Professor in Radiology)
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    Ultrasound Patterns of Abdominal Lymphoma at Tikur Anbesa Hospital
    (Addis Ababa University, 2014-10) Bekele, Ferehiwot; Atnafu, Asfaw(PhD)
    Lymphoma is a general term for a group of cancers that originate in the lymphatic system and it is the most common hematopoietic malignancy. Overall incidence of lymphoma is increasing globally, with age-adjusted incidence rates for NHL being highest in more developed countries. The incidence is also rising in sub-Saharan Africa where the prevalence of HIV is the highest in this part of the world (1). The lymphomas are divided into two major categories: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma(NHL). Appropriate management of lymphoma begins with an accurate and precise diagnosis. Traditionally, this has necessitated a surgical (either excisional or incisional) biopsy specimen to obtain adequate tissue. Lymphomas have been historically staged by Ann Arbor staging system introduced in 1970. This system, however, was modified in 1989 because of the introduction of CT (Costwald staging classification). Cross-sectional imaging (CT scan, MR imaging, US) is primarily used to detect lymph adenopathy and the pattern of nodal involvement. However, anatomic imagings are limited in accurate lymphoma evaluation as small lymph nodes may harbor malignant cells, whereas large lymph nodes may be benign. Functional imaging, such as positron emission tomography (PET) with fluorodeoxyglucose (FDG), has shown promising results in the diagnosis of lymphoma and complete assessment of the extent of disease. It is also very useful in the follow-up of PET-avid lymphoma (13, 39). This study reviewed articles on imaging patterns of abdominal lymphoma and using qualitative and quantitative data collecting techniques we give the practicing physicians a good knowledge on ultrasound patterns of abdominal lymphoma. And our study results showed lymph nodes in the abdomen and other sites are most common to be involved by lymphoma. According to the result liver involvement outnumbers from other abdominal organs. And pathology result showed NHL type is most common in our study .
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    Prevalence of Incidental Abnormalities on MRI Done For Patients with Other CNS Problems in Private Diagnostic Centers in Addis Ababa
    (Addis Ababa University, 2014-10-27) Demissie, Meskerem; Assefa, Getachew(PhD); Debebe, Tequam(PhD)
    Background The PNS sinuses are air filled cavities which are extensions of the nasal cavities. Various pathological processes affect these structures but inflammatory conditions are the commonest. Even in asymptomatic patients who undergo brain imaging for other indications show one or more incidental abnormalities in their sinuses. Objective of the study To determine the prevalence of incidental PNS abnormalities seen among patients who undergo Brain MRI scanning in of the private diagnostic centers in Addis Ababa. Methods Soft copies of brain MRI studies were collected from a private diagnostic center & the images were jointly examined by the investigator & the advising senior neuroradiologists at the radiology department of AAU. T2W axial images were mainly studied but additional coronal & sagittal images were also examined whenever needed. Result Of the total 115 patients, 66 were males & 49 females. From all, 62.2% showed abnormalities in at least one of their sinuses. Significant paranasal mucosal thickening of more than 3mm was the commonest finding followed by presence of polyps or retention cysts. The most involved sinus groups were the ethmoid & maxillary sinuses.
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    An Audit of Completion of Ultrasound Request form at BLH
    (Addis Ababa University, 2014-11) Berhane, Hailemariam; Kebede, Tesfaye(Associate professor); Teferi, Seife(Assistant Professor)
    Objective: To audit the adequacy of completion of ultrasound request formsreferred to the radiology department from the different wards /OPD of the hospital Design:Cross-sectional study Place and duration of study:Diagnostic Radiology Department of Addis Ababa University of medical faculty, from October 15, 2014 to October 30, 2012. Methods:A total of 218 ultrasound request form in study period were analyzed for completion using a blind ended questioner. The data were cleaned and entered in to SPSS-20 software package. Frequency and percentage were used for this categorical variable. Result:A total of 218 ultrasound requests forms were reviewed. All of them had the names of the patients filled, 218 (100%) and almost all had their father name filled except 5(2.3%). Only 168 (77.7%) of them had their ages filled, and 164 of 218 (75.2%) had their sex filled (Table-1).One hundred and eighty nine (86.7%) had hospital number while, 29(13.3%) did not haveinformation regarding hospital number.Detailed clinical data were filled in 184 (84.4%), and not mentioned at all in 34(15.6%) of them. Although 83.3% (181/218) of them had mentioned the requesting physician name, only 8 (3.7%) and 6 (2.8%) filled the relevant laboratory information and previous data respectively Conclusion: We conclude that radiological investigation forms are still incompletely and inadequately filled. This will have effect on the quality and the overall service provided by the radiologist and may have effect sometimes on clinical decisions and outcomes. There is need to encourage the managing clinician to complete and adequately fill all the required information into the request form and appreciate its importance to patient’s management. This can be achieved by increasing the awareness of referring clinicians through repeated continue medical education in conjunction with the radiologists and the need for a regular clinical-radiological meetings.
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    Impact of Clinical Data on Interpretation of Chest Radiographs
    (Addis Ababa University, 2015-10) zeray, Abrehet; Gisila, Azmera; Miller, Andrea
    BACKGROUND: The inclusion of clinical information may have unrecognized influence in the interpretation of diagnostic testing. OBJECTIVE: The objective of the study was to determine the impact of clinical history on chest radiograph interpretation. DESIGN: Prospective hospital based cross sectional study. METHODS: 10 residents, 4 second year and 6 third year residents evaluated a total of 100 frontal CXRs. Clinical information was withheld during the first interpretation. After one month the radiographs were reviewed with clinical information. The residents reported their finding using a standardized reporting tool containing different clinical parameters (i.e., pattern of infiltrate; alveolar infiltrate, interstitial infiltrate, air bronchograms, hilar adenopathy, pleural effusion etc.). SETTING: Tikur Anbesa teaching and referral Hospital RESULTS: The accuracy improved from fair (k ¼ 0.281, p-value 0.000) to moderate (k ¼0.418 , p- value 0.000) for identification of ‘‘hilar or mediastinal LAP’’, from moderate (k ¼ 0.557 , p- value -0.000 ) to substantial (k ¼ 0.705 , p-value – 0.000) for identification of pneumothorax , from fair (k ¼ 0.340 , p-value-0.000) to moderate (k ¼ 0.425 , p-value -0.000 ) for identification interstitial infiltrate with the addition of clinical history. The sensitivity increased from 23.5 % to 40%, from 44.4 % to 55.6 %, and from 46.2 to 51.3 % for hilar or mediastinal LAP, pneumothorax and interstitial infiltrate respectively with the addition of clinical history. Except for identification of the interstitial infiltrate which were found to be statistically significant, - 6 - for the rest two parameters there was an overlap of the 95 % CIs, suggesting that even though addition of clinical Hx resulted in higher sensitivity, it was not statistically significant. Although there was an increase in kappa values for Identification of ‘‘rib fracture ’’ and ‘‘pleural effusion,’’ and a decrease in the kappa value for identification of ‘‘cardiomegaly ’’, ‘‘alveolar infiltrate ’’, and “air bronchograms’’ with the addition of clinical information, there was substantial overlap of the 95% CIs, suggesting that inclusion of clinical history did not result in a statistically significant change in the reliability of these findings. CONCLUSIONS: The addition of clinical Hx resulted in improvement in the sensitivity of many of the clinical parameters, interstitial infiltrate being statistically significant. The knowledge of clinical Hx also has an impact in interpretation of CXRs for the junior residents as compared to senior residents. So residents should be advised to obtain clinical Hx whenever they read.
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    Accuracy of Ultrasound in Fetal Sex and Weight Determination in the 2nd & 3rd Trimester When Performed By Radiology Residents & Recent Graduates: A Cross Sectional Facility Based Study
    (Addis Ababa University, 2015-10) Hashim, Yasmin; Kebede, Tesfaye(Associate professor)
    Background: Ultrasound is one of the non invasive methods for fetal sex determination and with its introduction visualization of the fetal genitalia has become possible. Although mainly fetal sex determination is done for parental curiosity it has also some clinical implication. Accurate prenatal EFW in late pregnancy and labor is extremely useful in management of labor, aiding in decision making about instrumental delivery, trial of labor after caesarean delivery and elective Cesarean section for patients suspected of having a macrosomic fetus. Objective: Purpose of this study was to assess the accuracy of ultrasound in fetal sex determination in 2nd & 3rd trimester & weight determination in those ≥ 38wks when it is performed by those with lesser experience and exposure Methods: Obstetric ultrasound and ultrasound of the perineal region of the fetus was done on 600 pregnant women to detect the sex of the fetus with gestational age from 16 weeks to term. Completer data and information was available in 55o of the study. There were 20 twins in the study making the overall fetuses in the study 570. For fetal weight accuracy study 235 mothers with gestational age of ≥38weeks were included. Ultrasound results were registered on pre-prepared form at the time of examination. The sex & weight was confirmed at the expected time of delivery through a phone call to the mothers and for some by revising their medical cards. Results: Out of 570 fetuses ultrasound was able to determine the sex for 527 (92.5%); 287 of whom were confirmed female and 240were male. Overall accuracy was 84.92%. Accuracy for females was 91.63% and for males was 92.08%. When the not sure cases are excluded and samples for which actual sex determination was done are analyzed the accuracy was found to be 92%. From the 235 samples with GA of ≥38 weeks the accuracy of ultrasound fetal weight estimation within 10% of actual birth weights was 85.5%. The mean absolute error of estimated fetal weight was 226.67gm. Ultrasound generally underestimated the birth weight. Specifically ultrasound overestimated the fetal weight in those <2500gm and underestimated in those>4000gm. Conclusion: Ultrasound is an accurate method to determine the fetal sex in the second and third trimesters with a sensitivity of 90% and specificity of 93.2% even when it is performed by those with less experience and exposure. In conclusion EFW by ultrasound in term pregnancies using the Hadlock formula was found to have a high accuracy rate when it is performed by those with less experience and exposure. So it can be applicable to make clinical decisions even when it is done by those with less experience. The over estimation of LBW and under estimation of macrosomia found in ultrasound weight estimation should be given due attention
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    Correlations of computerized topographic severity with clinical severity and outcome of head injury patients at Tikur anbessa specialized referral and teaching hospital, Addis Abeba, Ethiopia
    (Addis Ababa University, 2017-08) Dr. Alemnew, Dagnew; Debebe, Tequam (MD,Neuroradiologist)
    Background: Polytrauma due to road traffic accidents (RTA) is the leading cause of head injury in all age groups especially in young adults. More than half of the cases of head trauma are caused by RTA, leading to 70% of all deaths due to brain injury. OBJECTIVE: To correlate the computed tomographic (CT) severity of head injury patients with their clinical severity score (GCS) and outcomes. MATERIALS AND METHODS: An institutional based prospective cross sectional study was conducted among 131head injury patients over a period of 6 months (from March to August 2017). The patients’ levels of consciousness (GCS) were determined and non-contrast head CT scans were performed from vertex to base of the head. The causes for head injury were recorded. The outcomes of patients were also documented from direct telephone communications and chart retrieval and document reviews using patients’ medical record numbers. RESULTS: The age range of patients was 6months to 80 years. The mean age of patients was 30.9 with male to female ratio being 5:1.The most common causes for head injury were RTA(46.6%),fighting(32.1%) and falling down injury(19.1%),The most common CT findings were skull fractures(51.9%),soft tissue swelling(34.4%),brain contusions(32.8%),brain herniation(29.8%),brain edema(29.0%),SDH(22.9),SAH(18.3%),%),EDH(16.0%)and IVH(6.9).There were a total of 6(6.6%) deaths which were resulted from fall down (3cases), RTA (2cases) and fighting (1case). Most patients had Rotterdam CT severity score of 2 and GCS of 13 and above. Loss of consciousness and vomiting were the commonest clinical features in head injury patients brought to emergency department. CONCLUSION: The Rotterdam CT scores of most of the patients in this study was 2.Significant correlation (P-value <0.001) was found between the Rotterdam CT severity scores and clinical severity scores (GCS). The CT severity scores showed inverse correlation with clinical severity scores (GCS) of patients and found to be strong predictor of outcome. The CT severity score was also found to have positive correlation with mechanism of injury (Pvalue=0.044). It was also shown that significant association was found between the outcome of study subjects and Rotterdam CT severity scores (P- value =0.02).The most severe clinical and CT severity scores were found in road traffic accident cases.
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    Cross Sectional Study of the patterns of knee joint abnormalities detected by knee MRI in patients evaluated at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia From April–September 2017.
    (Addis Ababa University, 2017-09) Gizaw, Elias (MD, Radiology Resident); Admassie, Daniel(MD, Professor of Radiology)
    Introduction: The knee joint, the largest joint in the body, has several functions which are essential for human beings to walk, run and jump. Primarily, it enables flexion-extension of the lower limb in the sagittal plane. Joint stability during movement is attained by the shape of the articular surfaces, the collateral and cruciate ligaments, the menisci and tendons and muscles crossing the knee joint. (1) The vulnerability of the knee, the largest joint in the body, to direct trauma makes knee injuries very common throughout life. (2) MRI visualizes most components of the knee joint, including articular cartilage, menisci, intra-articular ligaments, synovium, bone marrow, subchondral cysts, and other periarticular and intra-articular lesions that are not detectable by radiography. (4). The patterns of abnormalities of these different joint components as detected by MRI has been studied in different centers. Such types of studies, to date, have not been done in our country to our knowledge. The aim of this paper is to study frequency and the patterns of these abnormalities in the knee joint detected by knee MRI. Objective: To assess the patterns of abnormalities in the knee joint detected by knee MRI. Methods: Hospital based prospective cross sectional study was conducted on 49 patients who had knee MRI at Tikur Anbessa Specialized Hospital for a period of 7 months from January 1 to August 2016. Patients included here are those who had knee MRI and no history of knee surgery. Results: A total of 49 patients were included in the study out of which 26(53.1%) were male and 23 (46.9%) were female, with a mean age of 43 years (range 17 to 68 years). The three most common pathologies were joint effusion seen in 32(65.3%), bone marrow edema in 22(45.8%) and osteophytes in 22(44.9%). ACL tear was the commonest ligament abnormality occurring in 5 (10.4%) patients. Ten (20.8%) patients had meniscal tear, all involving the medial meniscus with the posterior horn being involved in 8(80%) of these patients. Conclusion: The mean age of our study population was higher than most referenced papers suggestive of possible delay in health seeking. The commonest knee pathologies were similar to other studies. Features of osteoarthritis were seen in higher frequency in our study population. Even though the higher mean age could be the possible cause, further study is recommended to look into the causes. Bone fracture, tendon abnormality and ligament abnormality showed statistically significant association with trauma. These abnormalities which were seen with higher frequency in those with a history of trauma were also observed in higher frequency in the male population.
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    Pilot Study to Assess the AntenatalPoint Prevalence of Neural Tube Defects and Associated Factors in Pregnant Woman Attending ANC in Ghandi Memorial Hospital in Addis Ababa Ethiopia, August 26- September 10of 2017
    (Addis Ababa Universty, 2017-09) Mitiku, Tewodros(MD); Zawdneh, Daniel (MD,Associate Professor of Radiology
    Introduction:NTDs are a heterogeneous group of CNS malformation resulting from faulty development of neural tube during one the three embryonic periods. NTD is the second most common congenital malformation following CHD and the most common form of CNS malformation. It encompasses a broad spectrum of CNS malformation spanning from anencephaly which is incompatible with life to minor occult malformation. NTDs have a global average incidence of 1.6 per 1000 live births, the highest incidence reported in Mexico and England. There is no adequate data on its incidence in Ethiopia but its frequency ranges from 0.77-6.1 per 1000 live births in South Africa 1, 2, 3, 4&5. NTD is a multifactorial process resulting from interplay between genetic and environmental factors. There is an increased risk of NTD after affected siblings and in siblings of affected parents1. There is also an increased risk in infants of mothers with low serum folic acid level, poorly controlled insulin dependent diabetes millets, obesity and maternal intake of anti-epileptic and folic acid antagonist drug especially in the first trimester1, 11 & 12. Objective: to assess the point prevalence and the frequency of different types of NTD using routine obstetric anatomic ultrasound scan as well as factors associated with NTD Methods: A hospital based trans cross sectional study was conducted in Ghandi memorial hospital on 84 pregnant women attending ANC from August 26 to September 10 of 2017. The study has included all pregnant women with a gestational age of 18 weeks and above and live pregnancy. Result: The study has included 84 pregnant women all of whom was singleton intra uterine pregnancies. The study participants had an average age of 27.5 years and literacy rate of 99% .The reported monthly average income was 3300 birr. None of them took preconception folic acid supplementation while 71.4% took during first trimester. Thirty six point four percent took medically prescribed medication during first trimester. Two of the fetuses had ananencephaly type of NTD giving point prevalence of 23.8 NTD per 1000 pregnancies. viii Conclusion: The literacy rate and participants living above the poverty line is much higher than both urban and national average. First trimester; especially, preconception folic acid supplement intake is low in this study but the finding is comparable to similar studies. The point prevalence of NTD is significantly higher than the global and regional averages. All of the studies calculated their incidence as a ratio of live births and did not consider all forms of pregnancy losses and still births. But it is difficult to generalize based on this study findings due to small study population size and facility based study design. Further study is recommended to assess knowledge, attitude and practice of reproductive age women towards folic acid supplement intake. Large population based study is recommended to assess the prevalence and the frequency of different types of NTD.
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    Computed tomography pattern of bone fracture and outcome of road traffic accident in Tikur Anbessa specialized hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2017-10) Bekeele, Sisay (MD, Radiology Resident); Admassie, Daniel(Professor, Consultant Radiologist)
    Back ground Road traffic accident (RTA) is defined as a collision between two or more, between vehicle and pedestrians, between vehicles and fixed animals obstacles. Of all the transportation systems that people use, road transport is the most widely used, complex and dangerous because it is highly associated with the rise in road traffic collisions. Road traffic accidents have become a huge global public health and development problem with highest burden in developing country, especially highest cause of mortality and disability in Africa. Ethiopia, one of developing country in Africa suffering one the most frequent car accidents and mortality. Aim: Aimed at determining the pattern of bone fractures in TASH and assess outcome of RTA. Methods The study is a retrospective cross sectional study involves all patients sustained road traffic accident coming to department of radiology and having CT from February to August. The CT scan will be examine by senior radiology residents and revised by radiologist. The chart of the patient will be revised for pertinent clinical information and to assess the outcome the accident. Results A total of 131RTA victims were included in the study of which 95 (72.5%) were male and majority of them are from urban 81(61.8%). The most affected people were passengers (45%) followed by pedestrians (35.1%) and those found in between 20-29 years of age (33.6%). The fracture occurred were in lower limb (22.3%), spine (21.8%), upper limb (19%), pelvic bone(16.6) and head (15.2%) and the most fractured body region was head and neck(23.2%). Over all fracture of vertebral bone, skull and pelvic bone was the top leading frequently fractures. Majority of patients have either neurologic or movement impairment (61.1%) and others cured (22.1%) and died (7.6%) Conclusions In this study, RTA commonly affects males and those productive age groups (20-49yr). Of all fracture of lower limb was the leading followed by fracture of spine and pelvic bone fractures respectively. With specific bone fracture vertebral bone fracture is the commonest. The outcome of the patient at the time of their discharge or on their follow up, most of them had some degree of neurologic or movement impairments.
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    Computed tomography pattern of bone fracture and outcome of road traffic accident in tikur anbessa specialized hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2017-10) Dr. Bekele, Sisay; Admassie, Daniel (Professor)
    Back ground Road traffic accident (RTA) is defined as a collision between two or more, between vehicle and pedestrians, between vehicles and fixed animals obstacles. Of all the transportation systems that people use, road transport is the most widely used, complex and dangerous because it is highly associated with the rise in road traffic collisions. Road traffic accidents have become a huge global public health and development problem with highest burden in developing country, especially highest cause of mortality and disability in Africa. Ethiopia, one of developing country in Africa suffering one the most frequent car accidents and mortality. Aim: Aimed at determining the pattern of bone fractures in TASH and assess outcome of RTA. Methods The study is a retrospective cross sectional study involves all patients sustained road traffic accident coming to department of radiology and having CT from February to August. The CT scan will be examine by senior radiology residents and revised by radiologist. The chart of the patient will be revised for pertinent clinical information and to assess the outcome the accident. Results A total of 131RTA victims were included in the study of which 95 (72.5%) were male and majority of them are from urban 81(61.8%). The most affected people were passengers (45%) followed by pedestrians (35.1%) and those found in between 20-29 years of age (33.6%). The fracture occurred were in lower limb (22.3%), spine (21.8%), upper limb (19%), pelvic bone(16.6) and head (15.2%) and the most fractured body region was head and neck(23.2%). Over all fracture of vertebral bone, skull and pelvic bone was the top leading frequently fractures. Majority of patients have either neurologic or movement impairment (61.1%) and others cured (22.1%) and died (7.6%) Conclusions In this study, RTA commonly affects males and those productive age groups (20-49yr). Of all fracture of lower limb was the leading followed by fracture of spine and pelvic bone fractures respectively. With specific bone fracture vertebral bone fracture is the commonest. The outcome of the patient at the time of their discharge or on their follow up, most of them had some degree of neurologic or movement impairments.
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    CT imaging features and clinicopathologic patterns of lung cancer at Tikur Anbesa specialized teaching hospital, Addis Ababa university: a descriptive study
    (Addis Ababa University, 2017-10) Gebreyesus, Michael; Gissila, Azmera(MD)
    Background: - Lung cancer is the single most commonly diagnosed cancer and most common cause of cancer deaths worldwide. There are international variations and changing trends in the epidemiology and cell types of lung cancer, which in turn affect the imaging features. CT is the most important imaging modality in lung cancer which is found to have high correlation rate with pathological diagnosis in different studies. In Ethiopia, there is no similar correlative research and this study addresses the deficiency. Objectives: To assess CT pattern of lung cancer with clinic-pathologic correlation at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia from June 2015-June 2017. Methods: Retrospective study was done on a total of 63 patients diagnosed with lung cancer at TASH in a two-year period (from June 2015-June 2017). Results: Mean age at diagnosis was 50.14 years (SD=11.02), with M:F of 1.33:1; 85.2% of females were housewives. Predominant cell type was adenocarcinoma (47.6%). Most common presenting CT feature was mass (77.8%). History was positive for smoking in 25.4% and TB in 42.4%. Majorities (87.3%) were inoperable (stage IIIB-IV) at time of CT imaging and most frequently reported symptom was cough (91.9%). Conclusion: Adenocarcinoma is the most common cell type. Pulmonary mass is the frequently encountered presenting imaging feature. Majority of patients present at advanced stage. We observed a narrow gender gap with M:F of 1.33:1 and majority of the female population are housewives. Smoking is not identified as the major risk factor in our study. With the high incidence of pulmonary tuberculosis in the country and presence of history for tuberculosis in 42.4% of the study population, we assume TB as the most important cofounding problem.
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    Assessment of nurses’ knowledge and attitude towards ionizing radiation during radiodiagnostic imaging and procedures at Tikur Anbessa specialized hospital, Addis Ababa university, Addis ababa, Ethiopia
    (2017-10) Wolde, Helen (MD, Radiology Resident); Teferi, Seife (PhD.Assistant Professor of Medical Physiscs)
    Basic knowledge and attitude towards ionizing radiation and radiation practice during radio-diagnostic imaging and procedure was assessed on nurses working at Tikur Anbessa Specialized Hospital was assessed. The major objective of the study was to assess the knowledge and attitude gap of nurses when dealing with radiation and radiation protection practice during radio-diagnostic examination and procedures. A questionnaire-based, cross-sectional study was conducted inTikur Anbessa Specialized Teaching Hospital from March 2017G.C to August 2017G.C. A convenient sampling method was used where all nurses’ working in departments and unites where radio-diagnostic imaging and procedures are undertaken namely the departments of Radiology, Oncology-Radiotherapy, ICU, NICU, Orthopedic-OR, and Cardiac Catheterization unit were participated. A selfadministered questionnaire forms were distributed to 116 nurses to fill up the questioner forms within two weeks period out of which 111 nurses responded to the questionnaire. The study has shown that participants within the age group of 26 -30 years had the highest compared to those within the age group of 41 to 45years who scored the least frequency. Most of the nurses 97 (87.4%) had BSc as their highest qualification followed by 10(9%) MSc holders. The majority of participants’ have insufficient knowledge suggested by the mean knowledge percent score of 47.9 % and only 24.3% of the participants correctly answered more than 50% of the questions. Moreover Only 32% of nurses practice radiation protection by keeping distance from sources of exposure and shielding. The Majority of nurses 41% keep distance from source of radiation during exposure as a radiation protection method. Finally, Findings of this study revealed that nurses’ with inTikur Anbessa Specialized Hospital working in radiation related areas had insufficient knowledge and low awareness of ionizing radiation, and their attitude towards radiation protection during radio-diagnostic examination is poor and have unsafe practice.
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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) Dr. Mohammed, Semira; Alwan, Amir (MD, Consultant Radiologist)
    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.
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    An audit of completeness of ct scan request forms a retrospective hospital based descriptive cross-sectional study at tikur anbessa specialized hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-12) Kedir, Yousuf (MD); Teferi, Seife (Assistant professor of medical physics)
    Background: Radiologic request forms are the most important, may be the only formal, means of communication tool between the clinicians and the radiologists/radiographers. Many research evidences showed that incompletely filled radiology forms resulted in deteriorating the quality of patient care given by the specific health institution. It is a worldwide practice to do clinical audit in order to improve patient care in a medical institution, hence; including auditing of completeness of radiologic request forms is one approach to improve patient care. The aim of this study was to audit the completeness of CT request forms sent from different units and departments of our institution, TASH. METHODS AND MATERIALS: I scrutinized the CT scan request forms received at Radiology Department, radiology reporting unit, TASH, from 15th July to 15th August 2017. Descriptive study design was applied to assess for the frequency of completeness of the request formsindicated by referring physicians. A nonprobability Quota sampling method was used to select 300 request forms over a period of one month. The patient name, age, address, MRN, ward, clinical background (diagnosis),anatomic location to be imaged and the name and signature of referring clinician were considered as the minimum contents of the request form which were compiled in a structured blind ended questionnaires and analyzed via SPSS version 20and frequency and percentages were obtained. RESULTS: The study generally demonstrated many of the data on the request form were incompletely filled. The patient name, fathers’ name, age, gender,anatomic location to be imaged andMRN were the highest filled data in all the requests with a frequency of 100%, 100%, 100%, 100%, 100% and 296/300 (98.7%) respectively. In contrary, the least filled data were relevant laboratory data, patients’ address, physicians address and previous imaging history which revealed 1/300 (0.3%), 13/300 (4.3%), 15/300 (3.0%) and 52/300 (17.3%) filling rate, respectively. The referring unit was filled in 117 (39%) while the clinical diagnosis was mentioned in 138 (46%) of the cases. Of 300 request analyzed 279 (93%) had referring physicians name and 295 (98.3%) had their signature.CONCLUSION: The completeness of the CT scan request forms was substandard and it should be improved.
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    Diagnostic Value of CT Enhancement Pattern of Focal Liver Masses.
    (Addis Abeba University, 2018) kafani, Mekonnen; Dr.Getachew, Assefa(MD, Associate professor of radiology ); Dr. Getnet, Wondim(MD, Associate professor of radiology.); kebede, Tesfaye(MD, Associate Professor of Radiology)
    Objectives: Objectives of the study were to study the Enhancement Pattern of various hepatic masses using Triphasic CT as diagnostic modality, differentiating different hepatic masses and to compare our findings with that reported in literature Methods:A total of 60 patients were seen in this cross-sectional study done in Department of Radiology,Tikur Anbessa specialized Hospital (TASH) Addis Ababa, Ethiopia from October, 2017 to September, 2018. All patients underwent Triphasic CT examination and diagnosis were made by histopathology/typical imaging findings, follow up, and clinical and lab findings as applicable. Results: Our study included 60 patients with hepatic focal mass masses; most common neoplasm was metastases (38.3%) followed by hepatocellular carcinoma(HCC)which accounted for 31.6 % and hemangioma which accounted for 15% of cases. Peripheral intrahepatic cholangiocarcinoma accounted for 5 % cases. The enhancement patterns of HCC were as follows: 57.8% demonstrate heterogeneous hypervascularenhancement inthe arterial phase and totally hypovascular in the delayed phase, while 36.8% showed homogeneous hypervascular pattern. Almostall of the HCC (100 %) appeared as totally hypovascularmasses in the delayed phase. In the case of hemangiomas, 73.3 % showsGlobular peripheral enhancement in the arterial phase; in the delayed phase, 60 % showed complete centripetal filling in which is iso vascularto vessels. In the arterial phase,60.8 % of metastases were hypovascular. In the delayed phase, all (100%) were hypovascular.Metastases were most commonly hypovascular in all phases (60.8%). Conclusions: Triphasic CT with its high accuracy is helpful in confident diagnosis of a hepatic masses. It has an indispensable role in evaluatingandcharacterizinghepatic masses which helps in guiding appropriate management plan with proper surgical triage.
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    Prospective study of Computer Tomographic pattern of bone metastasis in breast cancer patients, Tikur Anbessa specialized hospital, Addis Ababa University, Addis Ababa, Ethiopia, August 2018 GC.
    (Addis Ababa University, 2018-08) Dr. Dessalegn, Chala; Admassie, Daniel (MD, Consultant Radiologist).
    Introduction Bone metastasis is the most common site to which the breast cancer metastasis. Between 30%and 55% of the patients with breast cancers will develop bone metastasis during the course of the disease. Bone is also representing the first site of metastasis for 26% to 50%of patients with metastatic breast cancer. Imaging is essentials parts of the management of bone metastasis in breast cancer; however no consensus has been reached as to the optimal imaging modality. CT using the bone window offers superior skeletal detail, because of its ability to distinguish among materials of different density. Objective To assess the CT pattern of bone metastasis in breast cancer patients at Tikur Anbessa teaching referral hospital. Method Hospital based prospective cross-sectional study at Tikur Anbessa Specialized Hospital with breast cancer patient who have bone metastasis being evaluated at radiology department and who have CT imaging during the study period. Convenience sampling technique was used. Result A total of 100 breast cancer patients with bone metastasis were included in the study from September 2017 to August 2018 GC. 91 of them are female and 9 of them are male. The minimum age is 21 years and the maximum age is 71 years with mean age of 42.5 years.Ductal carcinoma (87%) is the most common type of breast cancer followed by Adenocarcinoma (5%) and malignant epithelial tumor (5%).Lytic type (51%) of bone lesion is the frequent morphologic type followed by mixed (28%) and sclerotic (21%) respectively. In 87% of the patients had vertebral bone involvement followed by Pelvic bone (34% of patients) and ribs (30% of patients). There are five patients with skull bone involvement. Conclusion Majority of patients are female in our study with female to male ratio of 9:1 which is lower than most studies done at different countries. When seen on computed tomography, lytic lesion is the most common feature of bone lesion followed by mixed (sclerotic and lytic) and sclerotic, which is in line with most of the studies. When we come to the anatomic distribution of the affected bones from breast metastasis, vertebral bone is the most commonly affected bone followed by pelvic bone and ribs.
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    Prevalence of Periventricular-Intraventricular Hemorrhage Diagnosed on Transcranial Ultrasound among Preterm Neonates Admitted to the NICU in Tikur Anbessa Specialized Hospital, Ethiopia
    (Addis Ababa University, 2018-09) Dr. Getachew, Aman; Zewdneh, Daniel (MD.,MHA, Associate Professor of Pediatric Radiology)
    Objective: To determine the incidence of PIVH among preterm neonates admitted to TASH NICU using .TCUS. Method: A hospital-based cross-sectional study was conducted at Tikur Anbessa Specialized Hospital among preterm neonates admitted to the NICU in TASH from November, 2017 to July, 2018. The study population comprised all preterm neonates born 36 weeks and earlier and admitted to NICU in TASH for whom focused trans cranial ultrasound (TCUS) was done. Data were collected from November, 2017 to July, 2018 using structured data collection instrument and it was analyzed by using SPSS 20.0 software, then summarization and comparison of data was done. Results: In our study, the prevalence of PIVH in preterm infants was 20.7% in the first seven days of postnatal life. Grade I PIVH was the most frequent (42.86%) followed by Grade III PIVH (25.71%), Grade IV (27.5%) and Grade II PIVH (22.86%) respectively. Grade II was the least prevalent. Independent variables significantly associated with presence of PIVH were birth weight (P = 0.001, CI 95%), gestational age (P = 0.001, CI 95%). Other associations were Low 1st minute APGAR (P = 0.021, CI 95%), Prenatal steroid administration (P = 0.215, CI 95%), mode of delivery (P = 0.01, CI 95%) and neonatal sepsis (P = 0.023, CI 95%), Conclusion: The study found lower overall prevalence of PIVH compared to reports of other studies in Africa and globally, while the frequency of severe PIVH was relatively very high. Variables significantly associated with IVH were birth weight and gestational age. The other associations were Low 1st min. APGAR, mode of delivery and presence of neonatal sepsis. The findings of the study are in keeping with findings of studies from other African and global studies.
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    Cross-sectional Study on Patterns of Brain MRI Findings in Patients with Epilepsy Seen in the Neuro Radiology Unit at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
    (Addis Ababa UniversIty, 2018-10) Dr. Befekadu, Milkias; Saleh, Amal (MD, Consultant Neuroradiologist)
    Background: Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. It can result from inherited (genetic) or acquired factors or a combination of both. Important causes include infections, head trauma, vascular malformations, brain tumors and stroke. MRI can diagnose these wide varieties of pathologic lesions routinely and noninvasively. Objective: The objective of this study is to assess the patterns of brain MRI findings in patients with epilepsy. Method: A cross-sectional study was conducted at Tikur Anbessa Specialized Hospital(TASH) among patients with epilepsy evaluated at neuroradiology unit from August 2016 to December 2017.All patients who fulfill the International League Against Epilepsy (ILEA) criteria of epilepsy and who had brain imaging done on a 1.5T MRI machine with standard epilepsy protocol were included in this study. Data were collected by using structured data collection format, analyzed using SPSS version 20.0 software and results were displayed using descriptive statistics. Results: A total of 378 patients had brain MRI done at the radiology unit for the clinical indication of seizure during the study period. Among whom 132 patients who had at least one epileptic seizure, who had their brain MRI done on standard epilepsy protocol and whose charts were retrievable were included in this study. Out of the included patients 79(59.8%) were male, 50 (40.2%) were female, 59 (44.7%) were in the under 10 age group and more than two thirds of all patients were aged less than 20 years. The commonest type of seizure reported in this study was generalized tonic clonic seizure (GTC) accounting for 98 (74.2%) of the cases and 50(37.9%) of the patients had their first seizure between the age of 1-10. Abnormalities were detected on the brain MRI in about half 64 (48.5%) of the cases. The commonest brain abnormality detected in this study was gliosis/brain parenchymal volume loss which was seen in 29 (45.3%) of the cases. The other abnormalities seen include mesial temporal sclerosis 8(12.5%) and brain tumor 8(12.5%). The commonest cause of gliotic change identified was perinatal injury 12(41.4%) and 18(62%) of the gliotic lesions were seen among children aged less than 10 years. Conclusion: In this study, young people aged less than 20years were more affected by epilepsy where GTC was the commonest seizure type. Gliosis or brain parenchymal volume loss predominantly caused by perinatal injury was the commonest type of brain abnormality. The other lesions identified included mesial temporal sclerosis, brain tumors, infections and cortical malformations.