Radiology

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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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    Assesement of Prevalence,Types and Associated Risk Factors of Neutral Tube Defects in Pregnant Women Visiting Health Centers in Addis Abebe.
    (Addis Ababa University, 2019-09) Legesse, Aga; Zewdineh, Daniel(Associate Professor of Radiology); Gorfu, Yocabel(Assistant Professor of Radiology)
    Introduction:Central nervous system (CNS) defects are the second most common congenital anomalies after congenital heart diseases. Neural tube defects (NTD’s) are amongst the major CNS defects with significant public health burden and long term morbidity and functional impairment. Central nervous system (CNS) defects are the second most common congenital anomalies after congenital heart diseases. Neural tube defects (NTD’s) are amongst the major CNS defects with significant public health burden and long term morbidity and functional impairment. Many literatures recommend offering screening for NTDs to all pregnant women. Amniotic fluid AFP (AF-AFP) and amniotic fluid acetylcholinesterease (AChE) are the primary biochemical tests performed on amniotic fluid for detection of open neural tube defects. The other modality used for screening of these defects is prenatal ultrasound scan. Method:This hospital based cross sectional prospective study tried to show the utility of ultrasound and the prevalence and pattern of occurrence of these defects.About total of 956 pregnant mothers who came to the hospital were evaluated with ultrasound scan. Results:We found a total of 6 open NTD’s out of this group. There were 2 anencephaly, 1 Chiari II, 1encephalocele and 1 had both anencephaly and spinabifida. Only 55 % if the respondents took IFA supplement during pregnancy and of those who took the supplement 43% took it for a maximum of 1 week. Of the parameters we found TCD has a strong correlation with the calculated mean gestational age. Conclusion and recommendation:The above findings reflect a high incidence of these defects. The low coverage of folic acid supplement as well as poorer socioeconomic factors all would contribute to the observed burden of the disease. Comprehensive screening and preventive strategies must be designed. Further studies and decisions policy maker level are necessary to improve the current figures.
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    Assessment of Appropriateness of head CT SCAN done at Tikur Anbessa Specialized Hospital,Radiology Department,Adiss Abeba ,Ethiopia,2019G.C.
    (Addis Ababa University, 2019-09) Demeke, Etsehiwot; Mekonnen, Abebe(MD, Consultant Neuroradiologist)
    Background: The use of advanced diagnostic imaging modalities is significantly increasing throughout the world. Overutilization of these modalities is straining the health care system and exposing patients to medical and economical sequel. There are various evidence-based guidelines to determine the appropriateness of a certain imaging modality. One such guideline is the American College of Radiology Appropriateness Criteria (ACR –AC). In our institution, there is no clear data showing how many of these investigations are truly indicated. Objective: The main aim of this study is to objectively determine the magnitude of inappropriate head CT scans done at Tikur Anbessa Specialized Hospital (TASH), Radiology Department and to assess the factors associated with inappropriate scans. Methodology: A hospital-based retrospective cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) among patients getting head CT examinations at the department of radiology in the period of August 2018- November 2018. All head CT scans done in the study duration, with complete requests and available medical records were included in this study. Data was collected from the CT requests and the Medical records as well as the radiology reports. Appropriateness of each scan was assessed using the ACR-AC and finally, data was analyzed using SPSS version 25.0 software and results were displayed using descriptive, univariate, bivariate and multivariate regression models. Results: Of the 443 Head CT scans assessed, the majority were done for male patients (61.6%) and the mean age of patients scanned is 35.185 with minimum age 1 month and a maximum of 90years and standard deviation of 20.84. 17.2% were done for children younger than 14yrs of age. 63.9% of the scans were non-contrast head CTs and 64.3% were initial imagings with no prior study for similar indication. This study showed that there is a significantly large number of inappropriate head CT scans being done (11.7%). The most frequent indications for requesting inappropriate head CT included Headache, seizure and head trauma. The Central triage, EOPD sand pediatric departments requested the largest number of inappropriate head CT scans. Residents requested the majority of inappropriate scans. Inappropriate head CT scans were associated with young age, use of IV contrast agent, qualification of requesting physician and an incidental outcome. Scans done for cerebrovascular diseases were more likely to be appropriate. Conclusion: This study showed a high magnitude of inappropriate head CT scans and it should serve as a gateway for future studies to evaluate the appropriateness of all other imaging modalities in the department and motivate implementation of control mechanisms aimed at appropriate utilization of medical imaging. One such mechanism we recommend is preauthorization by radiologists. Medical students, physicians as well as radiology residents and radiologists need to be aware of the ACR appropriateness criteria and incorporate it into their daily practice to provide better quality care for patients. It should also be planned to prepare a local customized imaging appropriateness guideline taking the financial status of the country into consideration; as the ACR-AC assumes an ideal setup and moreover, doesn’t address most clinical indications.
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    Assessment of Diagnostic Performance of Saline Sonourethrography in the Evaluation of Male Anterior Urethral stricture in Black Lion Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-10) Feleke, Endale; Getachew, Assefa ( Body imaging subspecialist and associate professor of Radiology)
    Introduction Purpose of this study was to evaluate the efficacy of saline Sonourethrography (SUG) in detection and evaluation of male anterior urethral strictures compared with retrograde urethrography (RUG). Anterior male urethral stricture disease is a major health problem representing a significant part of the workload of the radiologist and urologist. Its management remains a challenge to both the urologist and the patients. The appropriate choice of management of anterior urethral stricture depends largely on a reasonable, safe and high diagnostic yield of preoperative imaging methods. Methods Hospital based prospective cross-sectional study was used at Tikur Anbessa specialized hospital from October 2020 – September 2021. The study participants were all patients on work up for clinically suspected anterior urethral stricture that came to urology department & radiology department at TASH. There were a total of 44 patients involved in this study. Data was collected directly by interviewing the patients and as well as by reviewing Salinesonourethrography and retrograde urethrography imaging’s done for the patients using a structured questionnaire. The data was analyzed using SPSS software and results were presented using text, tables and graphs. The results of both methods (Salinesonourethrography and Retrograde urethrography) were compared. Retrograde Urethrography was considered as the gold standard for this comparison. Result In 68.18% of the patients (30 patients) anterior urethral stricture was identified by retrograde urethrography. Most of the patients with anterior urethral stricture were in the age group of 41-60 years (41.9%). The two most common presenting symptoms were weak stream and dysuria each comprising 38.7% and 32.3% respectively. The most common site of stricture was bulbar urethra and the most frequent length of stricture was short segment stricture. Moderate degree of Spongiofibrosis was the mostly identified degree of Spongiofibrosis. The sensitivity and specificity of SSU were 86.66% and 92.85% respectively and the PPV and NPV were 96.29% and 76.47% respectively.
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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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    Assessment of pediatric adenoid size and adenoid-to nasopharyngeal ratio using conventional CT at tikur anbesa specialized hospital (tash), addis abeba, Ethiopia (Prospective cross sectional study).
    (Addis Abeba University, 2019-09) Gebrewahd, Teferi; Zewdneh, Daniel (Assoc Prof in Diagnostic Radiology); Gorfu, Yocabelfu (Asst Prof. in Diagnostic Radiology)
    Background information: Many studies have been developed revealing normal measurements of adenoid size and adenoid to nasopharyngeal Ratio (ANR). The lateral radiograph is a common investigative modality. However, the literature is diverse and controversial. Lateral x-rays undertaken for purposes other than suspected upper airway way obstruction at Tikur Anbessa Specialized Hospital (TASH) are assumed to be inadequate for the sample size needed for this study. Moreover, the risk of radiation exposure makes the use of lateral x–ray requests solely for this study unethical. Therefore a cross-sectional imaging study was done. Objective: To determine the accurate size of the mean adenoidal size and ANR Methodology: A quantitative prospective cross-sectional study was conducted in 114 patients aged from 4-12 years (divided into three age groups), who underwent CT of the neck or head & neck at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Subjects who had symptoms of upper airway obstruction or sleep-disordered breathing were excluded objectively using Obstructive Sleep Apnea score (OSA). Linear measurements of adenoid size and nasopharyngeal depth were done along a reconstructed sagittal section and the ANR was calculated according to the Fujioka method. Results: We studied 114 children aged 4-12 years who were divided into three sub-groups namely group I (4-6 yrs), II (7-9 yrs) and III (10-12yrs). We calculated the mean adenoid thickness, mean nasopharyngeal depth and calculated the mean ANR of each groups. The statistically analyzed mean ANRs were 0.416, 0.397 and 0.395 for Group I, II, and III respectively with the highest value of 0.66 detected in group I. The mean adenoid size were measured to be 8.34, 8.41, and 9.42 for the age groups I, II and III respectively. We found that both the mean adenoid size and the ANR did not show significant differences between each groups but there was a progressive increase of the nasopharyngeal depth as the age progress across the different groups. Conclusion: Adenoid to nasopharyngeal ratio (ANR) was the most consistent radiologic parameter when subjectively compared with previous x-ray based studies. Therefore we strongly recommend the use of ANR rather than the mere use of the adenoid size or the nasopharyngeal space depth particularly when evaluating the degree of nasopharyngeal obstruction by enlarged adenoids. However radiologists and responsible physicians should use lateral x-rays cautiously as plain films may overestimate or underestimate the adenoid shadow and nasopharyngeal space depth due to superimposition of adjacent structures.
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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; Dr.Alwan, Amir(MD, Consultant Radiologist); Dr.Gissila, Azmera(MD, Consultant Radiologist)
    Assessment of the distribution and the morphologic patterns of bronchiectasis on computed tomography at Tikur Anbessa specialized hospital, Addis Ababa University. 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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    Assessment of the sensitivity of ct scout radiograph in detecting ureterolithasis on non contrast computed tomography as gold standard, Tikur Anbessa specialized hospital, Addis Ababa,Ethiopia
    (Addis Ababa University, 2018-10) Dr. Mohammed, Alelgne; Getenet, Wondim (MD, Body Imaging, Consultant Radiologist)
    Introduction: Imaging plays an important role in the management of patients with urinary stone disease including initial diagnosis, treatment planning and follow up after medical therapy or urologic interventions. There is high variability in determining the choice of imaging protocols to observe progression of ureteral calculi for follow up. Noncontract computerized tomography for kidney ureter bladder (NCCT or CT KUB) scan has become widely accepted as gold standard and imaging study of choice for examining patients with acute flank pain. Scout view is always included as an essential part of NCCT. Some have proposed using scout view in management of ureteric calculi owing to its reduced radiation dose. Therefore, our study aim was to assess the sensitivity of CT scout radiography for detecting ureteral stones in patients with ureterolithiasis diagnosed on NCCT as a standard reference. Methodology: Institutional based cross-sectional prospective study was conducted over an 11month (between September 30, 2017, and August 7, 2018) study period in Radiology department of TASH. A total of 86 patients who has undergone NCCT KUB were assessed for initial eligibility. Out of these, 58 were enrolled in this study which had ureteric calculi. Location of the stone, size, density characteristic of the stone was determined from the NCCT KUB. Moreover, the visibility of that stone on scout radiograph was documented by a radiologist who was blinded for NCCT findings. The sensitivity, positive and negative predictive value of the scout films were calculated in reference to NCCT. Before statistical analysis, data was first checked manually for completeness and then coded and entered in to SPSS and analyzed using SPSS version 21.0. Level of significance (p < 0.05) and CI (95%) was employed. Results were presented in graphs, charts and texts. Results: A total of seventy-six calculi were analyzed from fifty-eight patients who had ureteric calculi. Of the 76 total ureteric calculi stones, 37(48.7%) were definitely visible on the scout radiograph, 34(44.7%) were definitely not visible, and 5 (6.6%) were indeterminate, which giving a sensitivity of 48.7 %. On the basis of stone location, the sensitivity of the scout view for stone detection was as follows: proximal ureter, 56%; mid ureter, 37%; distal ureter, 50%; and ureterovesical junction, 37%. On the basis of stone size category, the sensitivity of the scout view for stone detection was as follows: < 4mm, 33%; 4-8 mm, 48%; and >8 mm, 52% as well the mean size of stones visible on the scout view was 8.36 mm. Mean HU visible on scout was 779 HU in the range 344-1601HU. Conclusion: In our study, 48.7% of ureteral stones were visible on the often overlooked routine CT scout radiograph. Therefore, the CT scout view should be encouraged and reported routinely in conjunction with CT KUB as a baseline for treatment follow up. It may avoid the need for obtaining a conventional radiograph at the time of diagnosis. So, we will postulate, it is good practice to report if the calculus is visible on the scanogram of the study to establish if a plain KUB radiograph is sufficient for follow up purposes rather than a higher radiation CT study.
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    Attitude, practice, and barriers in Academic research among Radiology residents in Ethiopia,a cross sectional survey
    (Addis Abeba University, 2021-09) Dandena, Abdi; Dr.Kebede, Tesfaye(Body imaging subspecialist)
    Background: Radiology has become one of the most sought out residency program in the country attracting highly talented qualified candidates from all over the country.the objective of the study was to determine the attitude, practice and barriersof radiology residents towards academic research Method:A descriptive cross sectional survey was conducted across all five institutions currently giving radiology residency programs in the country the survey was carried out from 12/16/2020 to 12/12/2021. Using a questionaries’ that were distributed to the residents online using google docs. Results:.There were at total of 120 radiology residents participated in the study. 93(77.5%) of the participants were male while the rest 27 (22.5%) were female. With the mean age of the participants was 30 years of age. Out of the 120 residents only 6 (5%) of them have published a research paper and from the residents with previous publication only three had more than one publication. 92.6% of the respondents were found to have a positive attitude towards academic research. Some of the major barrier to research identified by the study were the lack of time due to heavy workload which was an issue for 99(85.3%) of the residents, followed by lack of Training course 78(67.2%), inadequate Mentor Support 63(54.3%), inadequate financial support 60(51.7%). Conclusions: The study has showed that the overall attitude of radiology residents across the country towards academic research was positive but the practice of the residents in various academic research activities was found to be low.The authors recommend that all the stakeholders in radiology post graduate education to encourage residents in their academic pursuits by providing the necessary time and resources needed to perform quality research
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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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    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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    Barium Enema – Pathology correlation in Hirschsprung’s disease at TASH & Menelik II Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-10) Kebede, Abenezer; Zewdneh, Daniel (MD, Professor of Radiology); Gorfu, Yocabel (MD, Ass. Professor of Radiology); Sissay, Samuel (MD, Consultant Radiologist)
    Background: Hirschsprung’s disease is a common cause of pediatric intestinal obstruction. It’s a developmental disorder characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the distal intestine resulting in functional obstruction. Barium enema is a simple and primary study for the evaluation of clinically suspected Hirschsprung’s disease. Aim:To review the diagnostic performance of barium enema examinations for the investigation of Hirschsprung’s disease. Methods: Institution based prospective cross-sectional study at Tikur Anbessa Specialized - & Menelik II Hospitals was done with clinically HD suspected patients who have a barium enema & biopsy during the study period, September 2020 to August 2021. Convenience sampling technique was used. Results: A total of 28 cases were evaluated during the study period all having a barium enema & biopsy result, of whom 18 were males & 10 were females. The minimum & maximum ages at presentation were 10 days & 10 years respectively with the median age being 11 months. Constipation was the most commonly present clinical symptom followed by abdominal distension & delayed meconium passage which was found in 50% of the participants. The overall sensitivity, specificity & accuracy of barium enema was 95%, 71.4 %, & 88.8 % respectively. Sensitivity, specificity, PPV, and NPV were 90%, 71.4 %, 90% and 71.4 % respectively for recto-sigmoid index in barium enema. Sensitivity, specificity, PPV, and NPV were 85 %, 85.7%, 94.4% and 66.7 % respectively for transitional zone. Sensitivity, specificity, PPV, and NPV were 75%, 100%, 100% and 58.3 % respectively for irregular contraction detected in barium enema. Sensitivity, specificity, PPV, and NPV were 35%, 100%, 100% and 35 % respectively for mucosal irregularity detected in barium enema. Conclusion: The accuracy of barium enema for the diagnosis of HSD was 88.8 % & hence barium enema can be used as a reliable primary diagnostic modality for HSD. Irregular contraction & mucosal irregularity were the most specific findings whereas inverted recto sigmoid index & transition zone had a comparably higher sensitivity.
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    Brain Imaging Evaluation of Ventriculoperitoneal Shunting and Complication at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-10) Ahmed, Akrem Duri; Dr. S, Amal (MD, Ass. Prof. Of radiology, Neuroradiologist, Department of Radiology); Dr.G, Tesfayea (MD, Neuroradiology fellow Department of Radiology)
    Background: Hydrocephalus is an abnormal accumulation of CSF in the central nervous system by different pathologic causes. Abnormal CSF accumulation causes a rise of intracranial pressure and results in catastrophic complications unless treated. The management focused on reliving raised intracranial pressure using different methods and one of the commonly used methods is a ventriculoperitoneal shunt. Our study direction was to assess brain image evaluation of ventriculoperitoneal shunt using different imaging. Methods: A retrospective cross-sectional study was conducted, on all patients who had a ventriculoperitoneal shunt, and brain imaging was reviewed from 15 Jun 2017 to 2 Mar 2021 G.C. Data Review of medical records and all the images in the study population during the study period was carried out. Information on socio-demographic characters, indication for shunting, imaging finding, and related complication were reviewed, using data collected by using structured questionnaires and image analysis. Data were compiled and analyzed using SPSS 23.0 computer software and presented using tables, graphs, and figures. Result: In 60 patients we study the age of the participants ranges from 1 month to 55 years, with a mean of 20.8, and a median of 19. The sex distribution showed 22(36.1%) females and 38(63.9%) were males. Post-op CT images done in the study period were 45(75%), and shunt tip grading analysis showed grade two shunt tip of 28(46.7%) and grade one in 19(31.6%). Fiftyfour (90%) causes of Hydrocephalus were neoplasm, three (5%) congenital, and one (1.6%) meningitis. Complications we identified in our study were 12(20%) intracranial hemorrhage, four (6.7%) ventriculitis, and five (8.3%) pneumocephalus. Conclusion: Our study showed, most patients had no imaging evaluation after VPS procedure, and common imaging used where pre-contrast CT. A common indication for VPS insertion was neoplasm. Complications related to VPS in our study are commonly caused by intracranial hemorrhage.
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    Cervical spine MRI patterns in patients with neck pain at Tikur Anbessa specialized hospital, Addis Ababa University, Addis Ababa, Ethiopia
    (Addis Ababa University, 2018-10) Dr. Endale, Tewodros; Bekele, Ferehiwot (MD, Consultant Radiologist)
    Background:Neck pain is a common health problem throughout the world causing significant individual disability and economic burden on health care facility. Many factors are mentioned as a cause or association in relation to neck pain of which degenerative and posttraumatic cause are the main ones. There are many studies done in the world dedicated to patterns of cervical spine MRI findings in patients with neck pain but none in Ethiopia despite its impact on health care and economic burden stated worldwide. Objective:To assesscervical spine MRI patterns in patients presented with neck pain with or without radiculopathy. Methods: A retrospective record based descriptive study was carried out at Tikur Anbessa Specialized Hospital department of radiology.All patients with neck pain with or without radiculopathy who had cervical spine MRI evaluation between Jun 2017 and March 2018were included in the study.Cervical spine MR images were acquired using Philips Medical Systems Achieva 16 channels1.5 T strength MR scanner using standard neck and brain receiving coils. Images were acquired in sagittal plane in T1 weighted (TR/TE in ms of 400/7.8) and in sagittal plane in T2 weighted (TR/TE in ms of 3000/120) turbo spin echo (TSE) with 3 mm slice thickness, slice gap of 3.3 mm and FOV of 213mm x 213 mm. Axial plane in T2 weighted 3D (TR/TE in ms of 1600/100)turbo spin echo (TSE) with3 mm slice thickness, slice gap of 1.5 mm and FOV of 140 mm x 140 mm. Sagittal plane Short Tau Inversion Recovery (STIR) was acquired (TR/TE in ms of 2500/60) with3 mm slice thickness, slice gap of 3.3 mm and FOV of 213 mm x 213 mm. Record review and data collection using structured format was done between February to August 2018. Data was analyzed using SPSS 20.0 software and frequencies, mean, standard deviation, percentages and cross tabulation were determined and summarized. Results:A total of 160 patients who had cervical spine MRI evaluation for an indication of neck painduring the period under review were included in this study of which 82(51.3%) patients had manifestations of radiculopathy. There were 71(44.4%) male and 89(55.6%) female patients. The mean age was 46.3 ± 13.3years with a range of 18-85 years.Degenerative cervical spine findingssuch as intervertebral disc degeneration in the form of desiccation/dehydration, intervertebral disc space loss of height and disc osteophyte complex with resultant neural foramina and/or spinal canal stenoses were the most common imaging findings seen in 127(79.4%) patients with increasing prevalence with age. Non degenerative imaging findings such as neoplasm and infection were seen in 10(6.3%) patients only. A total of 23(14.4%) patients had normal cervical spine MRI evaluation. Conclusion: Degenerative cervical spine findings were the most common MRI patterns seen in symptomatic patients in this study showing increasing prevalence with age. Cervical spine MRI in patients with neck pain with or without radiculopathy can strongly suggest underlying serious abnormalities as demonstrated in our study, such as infections or neoplasms, which could definitely affect patient management plan.
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    Comparison of diagnostic efficacy of ultrasound and CT scan in patients with blunt abdominal trauma t Tikur Anbesa comprehensive specialized hospital and AaBET hospital, Addis Aabeba, Ethiopia
    (Addis Ababa University, 2018-10) Dr. Woldu, Dori; Getachew, Assefa (Associate Professor of Radiology)
    Background: Traumatic injuries are a significant public health issue worldwide. Abdomen has ben reported to be the third most common region of injury after head and extremities. Imaging plays a key role in the advanced care of trauma patients. US is a recommended initial imaging modality in the evaluation of blunt abdominal trauma but CT is considered the most accurate imaging method. Objective: to compare the diagnostic efficacy of ultrasound and CT scan in patients with blunt abdominal trauma Tikur Anbesa comprehensive specialized hospital and AaBET hospital. Methods: An institution based prospective cross-sectional study was conducted at tikur Anbesa Comprehensive specialized hospital and AaBet hospital using ultrasound (Sonoscape SSI-8000) and CT scan (GE 64-row detector volumetric scanner) was conducted for one-year period from patients who fulfill the inclusion criteria in the study. Data collection of 47 patients was done using a well-designed data collection forms by interview of patients or attendants who presented for ultrasound, review of patient’s medical record chart and review of diagnostic images. Data was then entered using EpiData 3.1, cleaned and analyzed using IBM SPSS version 25 software according to the study objectives. Results: Total of 47 patients were studied, of which 34 (72.3%) of patients were male and 13 (27.7%) were females with male to female ratio of 2.62:1. The age ranged from 3 months to 69 years with mean of 30.36 year and majority of the study population, 72.4%, were adults aged 18-40 years. The commonest mechanism of injury was road traffic accident taking more than half, 28(59.6%) followed by falling down accidents 11 (23.r%). Hemoperitoneum is the most common finding seen in blunt abdominal trauma patients. The sensitivity and specificity of ultrasound is 76.9% and 90.5% in detecting hemoperitoneum with 8 false negative (23.1%) and 2 false positive (9.1%). Overall 22 organ injuries were detected in 47 patients with CT with sensitivity specificity, Positive and Negative predictive value of 50%, 100% and 69.4% respectively. Conclusion: The present study supports the view that US and CT have complementary rols in the diagnosis of blunt abdominal trauma. Although US can be used as an initial screening method for blunt abdominal trauma to detect presence of free fluid, CT is till the imaging modality of choice for detecting intra-abdominal injuries in stable patients because about a quarter of the patients with blunt abdominal injuries in stable patients because about a quarter of the patients with blunt abdominal trauma may be missed on ultrasound.
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    Computed Tomography and X-Ray Patterns of Pelvic Fracture in Tikur Anbessa Specialized Hospital in Adults, Addis Abeba University, Addis Abeba ,Ethiopia.
    (Addis Abeba University, 2019-07) Dr.Hagos, Haile; Prf.Admassie, Daniel(Consultant Radiologist); Dr.Gezahegn, Hiwot(Radiologist); Dr.Zenebe, Moges (Radiologist)
    Background Trauma is a public health burden resulting in increased morbidity, mortality and disability for the survivors. Musculoskeletal injury results in dramatic, destructing and life-threatening injuries.Of these pelvic fracture accounts approximately to 3% of the overall injuries and is one of the major causes of morbidity and mortality.Classification of pelvic fracture is useful in describing injury and also helps in guiding both the initial treatment and definitive fixation. But pelvic fractures have presented a great challenge to orthopedic surgeons and radiologists over the years in that multiple classification system exists to attempt to standardize care and no consensus exists in the classification method of such fractures. The classification scheme of Young and Burgess and Tiles described the severity of injury by the mechanistic process involved and by grading the stability of the injury respectively. However, the most current classification method is that developed by the AO and OTA and is a composite of these two earlier methods. In addition, an understanding of the mechanism of injury that leads to pelvic fractures is useful to guide treatment and understand patterns of injury and cause of mortality. Objective The objective of the study is determining the CT and X-ray pattern of pelvic fracture in TASH. Method The study is a hospital based retrospective cross sectional study done on 80 patients who have pelvic ring fracture who have CT scan and Pelvic X-ray (AP, Inlet and outlet views) in the department of radiology. The CT scan was examined by senior radiology residents and revised by radiologist, with these finding the Tiles classification of pelvic ring fracture was assessed by the principal investigator initially by X-ray alone and later by CT scan alone blindly. vii Result A total of 80 patients with pelvic ring fracture were included in the study of which 58 (72.5%) were males and 22 (27.5%) were females. Road terrific accident was the major cause of pelvic fracture accounting for 76.3% of cases followed by fall from a height. Of those involved in RTA the most affected people were both passengers and pedestrians (30%) each followed by drivers(16.3%).The most commonly affected age group was those found in between 15-25 years of age (43.8%) and followed by those in between 26-35 years (35%). The most common pattern of pelvic ring fracture was Tiles B2 (25%) followed by C1 (22.5%) and B3 (20%). Over all Tiles B accounts 45% and Tiles C accounts 38.8%. Conclusion In this study trauma commonly affects males and RTA is the most common type of trauma causing pelvic ring fracture affecting males in the productive age groups between 15-35 years. Tiles B pattern of pelvic ring fracture is the most common pattern followed by Tiles C pattern. Further study is recommended in the value of CT and X-ray in the evaluation of pelvic fracture.
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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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    Computed Tomography Patterns of Cervical Spine Injury among Traumatic Patient Who Underwent Computed Tomography for Cervical Spine at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-11) Feleke, Israel; Dr. Debebe, Tequam (MD, Associate Professor of radiology); Dr.Mekonnen, Abebe(MD, Assistant Professor of Radiology)
    ABSTRACT Introduction- Cervical spine injury was defined as a fracture or subluxation of any of cervical vertebrae which are frequently seen in association mostly with injuries secondary to blunt trauma (motor vehicle accidents, falls, sports injuries). The overall impact of SCI on the individual, and also on society at large, therefore depends on a range of factors. However there is shortage information regarding computed tomography pattern of cervical spine injury. Objective: The study was aimed to assess computed tomography pattern of cervical spine injury among traumatic patients who underwent computed tomography for cervical spine injury from March 2019 to March 2020 in Tikur Ambesa Specialized Hospital. Methods: Institutional based retrospective cross sectional study was conducted. The sample size for the study was 209 patient record. A structured data extraction sheet was used for data collection. The collected data was checked for completeness, edited, coded and entered into Epi Data version 3.1 and exported to SPSS version 20.00 for analysis. Descriptive analyses was done by computing proportions and summary statistics. The information was presented by using table and figures. Result: 209 patient recording was included making response rate of 98.1%. Out of 209 included patient record 164(78.5%) were male. Incidence of cervical spine fracture was 27 (12.9 %%). Incidence of cervical spine fracture is significantly more in male patients when compared to females patients (7:2). The maximum number 13, (48.1%) of fracture is observed in the 16-30 age group. Road traffic accident was the most common mode of trauma 116(55.5%) cases. Conclusion: This study showed numbers of cervical spine fracture cases in the one year. This data demonstrated that most victims in our study are young’s. A male predominance was observed, and car accident were the most frequent trauma mechanism leading to cervical spine fracture. Budget: The total budget which was employed for this study is around 28,000.00 ETB.
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    Computed Tomography Patterns of Sinonasal Disease at Tikur Anbessa Specialized Hospital ,Addis Ababa University, Addis Ababa, Ethiopia: Institutional based Retrospective Descriptive Cross-sectional Study from November 2019 –July 2021.
    (Addis Abeba University, 2021-10) Jegnie, Misganaw; Prof. Assefa, Getachew(Consultant Neuroradiologist); Dr.Endale, Tewodros(Radiologist,Neuroradiology fellow)
    Background: Sinonasal disease affects a wide range of population including broad spectrum of diseases both inflammatory conditions, congenital and neoplastic. Since their clinical assessment is fraught by the surrounding bony structures; diagnostic radiology is of paramount importance. This study is aimed at assessing the CT patterns of sinonasal pathologies which is the first study to the best of our knowledge at Tikur Anbessa Specialized Hospital and in Ethiopia. Objective: To assess computerized tomography patterns of sinonasal pathologies and patterns of histopathologic findings at Tikur Anbessa Specialized Hospital. Methods: Institutional based retrospective cross-sectional study was carried out at Tikur Anbessa Specialized Hospital department of radiology. A non-probability convenience sampling technique was employed to include all patients imaged at radiology department for sinonasal diseases during the study period. Data was collected from medical record books and imaging archive system to see the imaging reports of patients’ images from November 2019 – July 2021, using structured data extraction template. The date was collected from June to August 2021. Data was entered and analyzed using SPSS 26 statistical software. Ethical clearance was obtained from Ethical Review Committee of the Department of Radiology at Addis Ababa University. Result: A total of 102 patients were included during the study period of which 64(62.7% were males and 38(37.3%) were females with age range of 1 day up to 83 yrs. The mean age was 30.7 + 20.9 years and median age 27.5 years. The most common presentations were nasal discharge 52(50.9 %), and nasal blockage accounting 42(41.2%) Inflammatory etiology is the most common finding accounting 47.1% (N=48) of the cases and malignant masses is the second most common category which accounted 28(27.4 %) of the cases. From those having histology the majority are malignant 25(71.4% N=35). Conclusion: In this study malignant sinonasal pathologies are common next to inflammatory causes. All choanal atresia cases were bilateral. Further prospective study with large number of participants is recommended as this institutional based retrospective study in tertiary center may not represent the general population.