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Item Pediatrics Ultrasound-Guided Tissue Sampling in a Resource-Limited Setting: Initial Experience from Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia: A Retrospective Cross- Sectional Study from July 2022-June 2024(Addis Ababa University, 2024-06-01) Amanuel Aboye; Samuel Sisay; Leul AdaneUltrasound guided tissue biopsy is a minimally invasive, increasingly preferred tool for evaluation of pediatric pathologies due to its decreased complications and ease of accessibility in resource limited settings. However, the diagnostic yield and safety of these procedures in Ethiopian pediatric patients are not well known. We conducted a retrospective cross-sectional study to review the records of pediatric patients who underwent ultrasound guided tissue sampling from July 2022 to June 2024 at TASH. We collected data on demographic characteristics, type of procedure, diagnostic yield, and complications. A total of 102 ultrasound guided tissue samples were performed, CNB accounted for 69.6%. The overall diagnostic yield was 93.1%. CNB had significantly higher diagnostic yield when compared to FNAC; the odds of obtaining a diagnostic yield were 10 times better for CNB(p<0.003). One bleeding complication (0.97%) requiring blood transfusion was recorded. Our results are consistent with other international studies and a previous Ethiopian study which reported diagnostic yield of 92.7% for image guided procedures in a different demographic. Conclusion: USG guided tissue sampling is safe and highly effective diagnostic tool for the pediatric population at Tikur Anbessa Specialized Hospital (TASH) with high diagnostic yield and minimal complications. Our results support the wider adoption and standardization of ultrasound guided procedures in similar resource limited settings in EthiopiaItem Evaluation of Focal Breast Lesions Using Ultrasound Elastography with Fnac and /Or Histopathology Correlation Among Patients Visiting Breast Ultrasound and Mammography Unit Radiology Department of Tikur Anbesa Specialized Hospital(Addis Ababa University, 2025-07-01) Bereket Engedasew; Daniel Admassie; Daniel Zewdneh; Ferdosa AhmedBackground: Breast cancer is one of the most common causes of illness and death in Ethiopia and worldwide. In Ethiopia, diagnosis has usually relied on clinical palpation, mammography, and B-mode ultrasonography (US). Biopsy is still the best method for a definitive diagnosis. Recently, elastography has emerged as a useful tool alongside B-mode US. It improves specificity and helps in the early detection of breast cancer. By determining the need for biopsy procedures, elastography reduces both false-positive and unnecessary outcomes. However, it is still largely unexplored in Ethiopian clinical practice. This study aimed to examine the impact of ultrasound elastography on characterizing breast lesions and reducing unnecessary biopsies in our context. Methodology: From January 1 to April 30, 2025, we conducted a prospective analytical cross-sectional study at Tikur Anbessa Specialized Hospital (TASH) to evaluate focal breast and post mastectomy chest wall lesions using ultrasound elastography. We correlated the results with fine needle aspiration cytology (FNAC) or core needle biopsy (CNB). We used structured checklists based on the ACR BI-RADS guidelines to collect data. A single radiologist trained in breast elastography acquired the images. The data was analyzed using IBM SPSS version 25. Result: In this study100 patients were included and among this 72% had malignant lesions, 26% had benign lesions, and 2% showed atypical findings. The most common malignant lesion was invasive carcinoma and most common benign lesion was fibroadenoma. ROC analysis revealed that the BI-RADS classification alone had excellent sensitivity at 98.6% but poor specificity at 10.7%. Including elasticity scoring and strain ratio significantly improved diagnostic accuracy. Elasticity scoring had a sensitivity of 96% and a specificity of 68%. The strain ratio achieved 97.2% sensitivity and 57.2% specificity. When all three methods were used together, parallel testing resulted in perfect sensitivity and negative predictive value at 100%, but very low specificity at 4.3%. The serial testing method provided more balanced outcome, with 91.3% sensitivity, 87.7% specificity, and an overall accuracy of 91%. This suggests serial testing method has superior clinical value in reducing false positives. Conclusion: These findings shows that the clinical importance of combining the BI-RADS category, elasticity score, and strain ratio during ultrasound diagnosis of breast lesions. The results support using multiparametric ultrasound techniques in routine practice to improve diagnostic accuracy, decrease unnecessary biopsies, and optimize patient management. Regular uses of elastography, especially in resource-limited areas help resolve diagnostic challenges.Item A Cross-Sectional Study on the Prevalence of Burnout and Associated Factor Among Radiologists in Ethiopia June 2025(Addis Ababa University, 2025-06-01) Benyam Goa; Assefa Getachew; Tequam DebebeBackground: Burnout is a syndrome among health professionals, especially physicians who experience intense occupational stress. It is characterized by emotional exhaustion, a feeling of depersonalization, and a sense of ineffective/low personal accomplishment. Higher rates of burnout are often seen across all medical specialties globally negatively influences clinical outcomes. The issue of burnout do not spare the radiology department. Although burnout among radiologists has received growing attention globally, there is a lack of data specifically addressing among Ethiopian Radiologist, the purpose of this study is to evaluate burnout among radiologists in Ethiopia. Objectives: To determine the prevalence and associated factors of burnout among Ethiopian Radiologist working in Ethiopia, 2025. Methods: A cross-sectional study was conducted between January27, 2025 to May27, 2025. Anonymized Google form based 47-item questionnaire including included the standard Maslach burnout inventor-Health Sciences survey (MBI-HSS) was disseminated to radiologists through Telegram group of Radiology society of Ethiopia (RSE). R software 4.5.1 was used for data analysis., Bivariate, and multivariable logistic regression as well as descriptive statistics were analyzed. Result: Among 410 radiologists, 204 completed the survey and were enrolled in the study. The majority of the respondents (79.4%) were males. The age range was 30 to 65 years old, with a mean of 35.5 years and a standard deviation of 7.1. The overall prevalence meeting all three MBI criteria was 26 % (n=53). However, 76.96% (n=157) reported high emotional exhaustion, and 58% (n=119) of respondents reported moderate to high depersonalization, while 52.9% (n=108) maintained a high sense of personal accomplishment. Female radiologist were much more likely of experiencing burnout than males (AOR = 0.31; p = 0.038); a daily caseload of >50 cases greatly increased odds compared to 10-20 cases (AOR = 0.03; p = 0.009); engagement in other income generating activities had 89% reduced odd of burnout (AOR = 0.11; p = 0.001), and each additional year of practice lowered odds by 30% (AOR = 0.70; p = 0.005). Recommended preventive strategies by radiologists included improving working environment, increase income and hiring additional radiologists to reduce workload and stress. Conclusion: In this baseline study assessing burnout among Ethiopian radiologist, 26% met full MBI criteria (elevated EE, increased DP and diminished PA). However, individual subscales revealed alarmingly high rates of EE and DP. High daily caseloads and female gender emerged as significant V risk factors, whereas engagement in other income generating activities and greater year of practice were protective against burnout.Item Evaluation of Image Quality and Mean Glandular Dose for Patients Undergoing Mammography X-Ray Examination at Tikur Anbessa Specialized Hospital, Ethiopia(Addis Ababa University, 2025-07-01) Abdulmejid Suleyman; Seife Teferi; Ferdosa AhmedBackground: Breast cancer is the most commonly diagnosed cancer and the most common cause of cancer related death in women. Mammography is the imaging modality of choice for early breast cancer detection at curable stage. But acquiring good quality mammograms are challenging to obtain because of poor contrast between normal and pathologic breast tissues. Furthermore, inappropriate mammographic technique can lead to unnecessary high radiation dose to the breast tissue and poor image quality resulting in incorrect diagnoses and high number of unnecessary biopsies. The mammography unit at Addis Ababa University, Tikur Anbessa Specialized Hospital, may produce poor-quality mammography images with the highest breast doses. Hence, the objective of this study was to assess the image quality and breast doses in all mammography practices at Tikur Anbessa Specialized Hospital. Methods: The sample size was determined based on the International Commission for Radiation Protection (ICRP) recommendations for conducting such studies. According to the ICRP, patient dose surveys should include at least 50 patients. Technical parameters for each patient, such as peak kilovoltage, compressed breast thickness, and milliampere seconds for each patient was recorded by data collectors. Remaining data on phantom image quality was gathered using various exposure modes and tube potentials. Furthermore, a variety of criteria are used to assess the clinical image quality of each mammogram, including the ability to clearly see the nipple and pectoralis muscle among others. The collected and cleaned data were entered into SPSS (version 27) and analyzed. P-value < 0.05 was considered statistically significant. Results: The average calculated mean glandular dose for the craniocaudal (CC) view was 1.153 mGy ranging between 0.436-1.929 mGy. The average calculated mean glandular dose for the mediolateral oblique (MLO) view was 1.217 mGy ranging between 0.457- 2.210 mGy. The average clinical image quality for CC and MLO was 78 and 80 % respectively. The phantom image quality turned out to be 4 fibers,3 simulated specks of calcifications, and 3 masses. Conclusion: The study concluded that the mammography unit at Tikur Anbesssa Specialized Hospital has kept the radiation exposure below the level recommended by the American College of Radiology (<3mGy) while achieving good image quality. Additionally, it validated the close comparison between computed mean glandular dose (MGD) and machine recorded MGD, indicating that machine recorded MGD can be used to follow radiation exposure, saving time and resources.Item Imaging Features of Neuroblastoma at Initial Presentation Associated with Metastatic Spread and Poor Clinical Outcome: A Cross-Sectional Study(Addis Ababa University, 2024-12-01) Leul Adane; Daniel ZewdnehBackground: Neuroblastoma (NB) is a tumor of the sympathetic nervous system which represents one of the most common malignancies in early childhood; initial imaging gives important information on the diagnosis of NB. Objective: This study aimed to assess imaging features of NB associated with metastatic disease at presentation and poor clinical outcome in a resource limiting setting. Methods: A hospital-based cross-sectional study was conducted. Computed Tomography (CT) images were reviewed and imaging appearances were evaluated in all patients with pathology confirmed cases of neuroblastoma in Tikur Anbessa Specialized Hospital (TASH) radiology department from January 2023-December 2024. Using Statistical Package for Social Sciences version 27 (SPSS) software program, data was analyzed. Association between imaging features variables like location, size and IDRFs with disease prognostic factor (metastasis) and clinical outcome were analyzed using Fisher’s exact test. Results: Among 42 participants, 22 were male (52.4%). The participants' age ranged from 1 to 120 months; a median age is 33 months. Twenty-four patients (57.1%) had tumor originating from the adrenal gland, followed by non-adrenal retroperitoneal in 13 (31%). Thirty-five cases (83.3 %) had a tumor size greater than 4 cm in longest diameter. Thirty-three cases (78.6%) had at least one image defined risk factor and intra-abdominal vascular encasement is seen in 27 cases (64.3%). Twenty-two cases (52.4%) had a metastatic disease at presentation and the most common single site of metastasis was bone in 8 patients (36.4%), followed by liver in 6 patients (27.3%). Nineteen cases (45.2%) had a metastatic NB. 6(14%) had improvement on follow up, 11(26%) were on palliative treatment, 5(12%) were lost on follow up and status unknown, and 20 (48%) patients died. 4 A statistically significant association was found between the primary tumor location and tumor size with tumor metastasis at initial presentation with a two-sided Fisher’s exact sig P value of 0.045 and 0.027 respectively. There is an association between metastatic disease at presentation and clinical outcome (P-value of 0.006). Conclusion: NB presents as a large intra-abdominal solid mass with calcification and roughly half of them having metastasis at initial presentation. Adrenal tumor origin and large tumors have more propensities to have metastatic disease at presentation. Metastatic spread at initial presentation has a poor clinical outcome.Item Assessment of Diagnostic Accuracy of Preoperative CT Staging of Oesophageal Cancer in Patients Undergoing Surgery with Surgical and Histopathology Correlation at TASH, TASH Affiliated Hospitals(Addis Ababa University, 2025-02-01) Hanna Damtew; Azmera Gissila; Amir Alwan; Yimaj AbdulwahabBackground: Esophageal Cancer Is a Malignancy of the Esophagus that Arises from Neoplastic Changes in the Epithelial Lining. Computed Tomography (CT) Is Recommended as an Initial Imaging Modality, Primarily to Evaluate Respectability and Detect Distant Metastasis as well us Guides Treatment Options. The Purpose of the Study Is to Assess Diagnostic Accuracy of Preoperative CT Staging of Esophageal Cancer in Patients Undergoing Surgery. Material and Methods: After Ethical Clearance Hospital Based Prospective Cross-Sectional Study were Conducted on CT Scan Reports of 121 Patients who Undergoes Surgery. Diagnostic Accuracy Measured by Comparing with Histopathological Staging. Result: Accuracy, Sensitivity, and Specificity of CT For T3 and T4 Diseases are 50%, 65%, 28% and 67.8 %, 50%, 69.4% Respectively. Diagnostic Accuracy, Sensitivity, And Specificity of CT For the Presence of Nodal Ds Is 62% ,59% And 63% Respectively the Sensitivity of CT For Detecting Tumor-Free Nodes Was High (84.3%) Conclusion: Preoperative CT Has a High Positive Predictive Value for Correctly Identifying Truly Operable Stages. High Sensitivity for Correct Identification of Tumor Free Nodes. Low Diagnostic Accuracy in Correct Prediction of T3 and T2 Stages. Low Diagnostic Accuracy in Identification of Tumor Positive Nodes. Only 23.1.0% Of Patients Had Correct Preoperative T and N Staging Assessment.Item Assessment of Thoracic Aorta Diameters Using Contrast Enhanced Chest Computed Tomography in Ethiopian Adults at Tikur Anbessa Specialized Hospital: An Institution-Based Cross-Sectional Study.(Addis Ababa University, 2025-02-07) Hawi Farris; Azmera Gissila; Amir Alwan; Yimaj AbduBackground: The diameter of the thoracic aorta (TA) is a crucial factor in assessing cardiovas cular health, as deviations from normal ranges can indicate underlying pathological conditions, such as aortic dilatation and aneurysm. Although substantial research has been conducted worldwide to determine normative data for TA diameters, there is a notable lack of such data for Ethiopian populations. The accuracy, speed, reproducibility, simplicity, and 3D capability of Computed Tomography (CT) have made it the gold standard for evaluating the TA. Objective: To assess the diameter of the TA at multiple anatomical levels and identify factors correlated with its diameter in adult Ethiopians who visited the Radiology Department at Tikur Anbessa Specialized Hospital between September 1 and November 30, 2024. Methodology: An institution-based prospective cross-sectional study was conducted using a consecutive sampling method. Data were collected from consecutive eligible adults who came for contrast-enhanced CT scans during the study period, using interviewer-administered struc tured questionnaires. The data were cleaned and analyzed using SPSS version 27. Descriptive statistics, including frequency, percentages, means, and ratios, as well as the independent Stu dent's t-test, Mann-Whitney U test, and Pearson correlation, were used for statistical analysis. The p-value threshold was set at 0.05. Results: A total of 386 study participants were included, of whom 244 (63.2%) were females and 142 (36.8%) were males. The mean age was 46.04 ± 15.39 years, with a range of 18 to 86 years. The thoracic aorta showed smooth tapering from the ascending to the descending aorta. The diameters (mean ± SD) at the level of the sinus of Valsalva, STJ, mid-ATA, distal ATA, arch, proximal DTA, mid-DTA, and distal DTA were 35.29 ± 2.60 mm, 27.10 ± 2.71 mm, 33.72 ± 3.35 mm, 32.35 ± 3.29 mm, 29.42 ± 2.82 mm, 26.66 ± 2.89 mm, 23.42 ± 2.49 mm, and 21.80 ± 2.40 mm, respectively. The thoracic aorta diameter at all levels had a statistically significant correlation with age, weight, BSA, and hypertension (p<0.05). Conclusion: This study evaluated the mean diameter of the thoracic aorta at various levels in Ethiopian adults at TASH, providing a normal reference range. It found a statistically significant association of the TA diameter at all levels with age, weight, BSA, and hypertension.Item Prevalence and types of Biliary and Pancreatic Duct Anatomic Variation in Patient Undergoing Magnetic Resonance Cholangiopancreatography (MRCP) study in TASH, and Diagnostic Center in Addis Ababa Ethiopia: a Retrospective Study from February of 2022 up to February of 2025(Addis Ababa University, 2025-06-01) Temis Gudeta; Asefa K; Semira A; AgaHowever the scales used to measure satisfaction level was based on scales validated and used in other countries. Hence a need to understand more patients experience based on a mental health service scale (MHSSS) scale, validated and tested in Ethiopia makes this study sound helpful [45].Patient’s responses to their experiences of using services are under-researched inthe context of mental healthcare in low income countries.Therefore, the purpose of this study is to explore the factors underlying psychiatric patients’ satisfaction with the health-care system and the extent to which satisfaction reflects their experience of care with the validated MHSSS (mental health service satisfaction scale) tool in Ethiopia, written in Amharic and English version as a measure of satisfaction among consumers of mental healthcare. Background: Knowing the normal branching pattern and anatomic variations of the pancreatic and biliary duct is extremity important for both radiologist and hepatobiliary surgeons. These anatomic variations may have no significant clinical importance per se but has important clinical implication in hepatobiliary surgery, endoscopic and image guided intervention. Knowing branching pattern of biliary duct help radiologist in deciding best approach in obstructed biliary duct intervention. Knowing the cystic duct anatomic variation preoperatively makes laparoscopic surgeon not to cause iatrogenic biliary duct injury. Liver resection surgery is also currently increasingly done for focal liver disease and knowing the biliary drainage system avoid complication including biliary cirrhosis or biliary leak. Finally, knowledge of this anatomic variant has important clinical implication in selecting potential living liver donors for successful harvesting and to minimize post op complication (even if liver transplant not yet started in our setup). MRCP study is the least invasive and one of the most reliable imaging modalities for evaluation of biliary and pancreatic duct. Currently, there is no study done on the prevalence and types of anatomic branching variation of the pancreatic-biliary duct in Ethiopia using MRCP or other imaging modalities. Objectives: To study the prevalence and types of the anatomic branching variations of pancreatic biliary duct in Ethiopia using MRCP at TASH and private diagnostic center, Addis Ababa, Ethiopia. Methodology: A retrospective cross-sectional study will be conducted at TASH and selected private diagnostic center in Addis Ababa. The study will be conducted on patients who had undergone MRCP study for clinically suspected biliary and pancreatic pathology from October 2022 to October 2025. A structured research tool will be used to collect all the necessary data from participants and MRCP study will be evaluated by the investigator with from expert radiologist with experience in the field. Participant will be selected by selected by simple random sampling method. Data will be entered and analyzed using SPSS version 28 software.Work plan and budget: The working budget will be covered by Addis Ababa University, College of Health Sciences, and School of Graduate Studies. The study period will be from September 30, 2025 to February 30, 2025. The total estimated cost of the study is 25200.00 ETB.Item Title: Mammographic Breast Density Pattern and Its Association with Breast Cancer Among Women Sent for Mammography in TASH And MCM Hospitals, Addis Ababa, Ethiopia(Addis Ababa University, 2025-05-01) Yenewub Muluken; Daniel Z; Firdosa MD; Mesfin MBackground:Mammography Is the Most Effective Imaging Method for Detecting Breast Cancer. It Is a Specialized X-Ray That Uses the Attenuation Difference in Breast Tissue of the Fibroglandular and Fibrofatty Components. Breast Density, Which Represents the Ratio of Fibroglandular and Fatty Tissue, Could Be Assessed Both Quantitatively and Qualitatively. Qualitative Assessment Based on the BIRADS Category Developed by ACR Is the Most Commonly Used Method to Assess Breast Density. Breast Density Category Is Described As A-Almost Entirely Fatty, B-Scattered Fibroglandular, C-Heterogeneously Dense Fibroglandular, And D-Extremely Dense. High Breast Density Is Defined as Either Category C Or D, Which Accounts for Around 50% In The US. Breast Density Distribution Is Variable Among Different Geographic Regions, Ethnic Groups, Age, Body Habitus, And Other Factors. High Breast Density Is a Strong, Established Risk Factor for Breast Cancer, Evidenced in Many Global Studies. This Study Aims to Assess Patterns of Mammographic Breast Density; It Will Be a Baseline for Further Study as There Is No Similar Local Data. Methods And Materials: A Retrospective Descriptive Study Which Included 272 Women with Either Screening or Diagnostic Mammography from Two Teaching Hospitals, Tikur Anbesa Specialized Hospital/TASH/ And Myung Yung Christian Medical College/MCM/, From Addis Ababa, Ethiopia. A Total Of 272 Cases, 141 From TASH And 131 From MCM, Were Included. The Data Was Collected from the Electronic PAC System Retrospectively from July 2023 to May 2025, Subsequently Downloaded and Revised by the Principal Investigator. For Those Patients with a Suspicious Mass, Either Biopsy or FNAC Was Performed for and Those with Available Results Were Included in the Study. Breast Density Was Categorized Based on the 5th Edition. Finally, The Data Was Entered, Cleaned, Checked for Appropriateness, Processed, And Analyzed Using SPSS V27. Result:Among The 272 Women Included in The Study, The Age Range Was 36-77 Years, With A Median Age Of 48years, 67.3% Of These Were Within the Range Of 41-60 Years. BIRADS B Was the Most Common Density Pattern, Which Accounted For 48.5%, Followed by BIRADS A, Which Accounted For 23.9%. So, The Low-Density (BIRAD A And B) Pattern Was the Predominant Pattern, 72.4%. BIRADS D Was the Least Common and Accounted For 4%. Age Showed Significant Correlation with Breast Density, With A Chi Square of X2=92.2, P Value 0.05, So These Correlations Were Not Statistically Significant. But We Cannot Conclude the Absence of Correlation as the Sample Size Is by Far Too Small. Conclusion:In Conclusion, Scattered Fibroglandular Density -BIRADS B Is the Most Common Pattern, Followed by Almost Entirely Fatty Density -BIRADS A. Breast Density Showed an Inverse Correlation with Age.Item Chest Ct Patterns of Pulmonary Sequelae Following Tuberculosis in Patients at the Chest Unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia A Retrospective Cross Sectional Study(Addis Ababa University, 2025-05-01) Yonas Mulat; Amir A; Azmera; Yimaj ABackground: Being One of the Most Important Infectious Diseases in the World; Tuberculosis (TB) Has A Major Impact on Both Socioeconomic Development and Public Health. Globally, The Prevalence of PTLD Is Increasing, Paralleling with the Growing Burden TB. However, Little Attention Has Been Given to the Diagnosis and Management of Post-Tuberculosis Lung Disease (PTLD). This is in Contrary to TB Control Efforts, Which Have Focused on the Prompt Diagnosis and Efficient Treatment of Active Cases, Producing Encouraging Results Over the Past Three Decades. The Long-Term Effects of PTLD Are Becoming More Noticeable as TB Control Initiatives Advance and More People Survive the Illness, Necessitating the Urgent Need to Comprehend and Treat This Condition. This Study Aims to Characterize the CT Imaging Pattern of PTLD And Associated Clinical Features to Better Understand the Disease Entity and Recommended Further Management Plan in Ethiopian Setting. Methods And Materials:A Retrospective Cross-Sectional Study Was Done On 150 Patients with a Prior Documented History of Pulmonary Tuberculosis (TB) Treatment and Who Have Undergone Chest CT Scans. Chest CT Images Were Evaluated Including Relevant Clinical and Demographic Data. Data Was Collected Using a Structured Check List and Data Processing and Analysis Was Conducted Using SPSS Software. Result: In Our Study of Chest CT Of 150 Post TB Patients, Commonest Radiological Sequelae Identified Were Fibrotic Changes (84.7%), Bronchiectasis (74.0%), And Pleural Thickening (19.3%). Parenchymal Distraction Was Noted In 18.0% Of Patients and Cavitation In 11.3% Of Patients. 82% Of Patients with Cavity Have Imaging Evidence of Aspergilloma. Common Presenting Clinical Symptoms Include Cough (81.3%), Dyspnea (56.0%), And Hemoptysis (21.3%). 87.3% Of Our Patients Has No Imaging Evidence of Active TB, And Out Of 19/150 Of Our Patients (12.6%) With Imaging Evidence of Possible Active TB Infection, only 3/19 Patients (15.7%) Has Microbiologic Evidence for Active Tb Infection. Statically Significant Association Identified Between Aspergilloma and Hemoptysis. Conclusion: This Study Highlights the Importance of Imaging and Follows Up in Post TB Patients for Early Diagnosis of PTLD And Differentiation from Active TB Infection to Reduce Morbidity and Avoid Unnecessary Repeated Anti-TB Drug Treatment in Ethiopian Setting, A High TB Burden Country. Hemoptysis Is Identified as a Great Clinical Predictor for Aspergilloma, And High Fungal Super Infection Burden Also Alerts for Tailored National Intervention and Multidisciplinary Approach in Managing PTLD In Ethiopia.Item Role of MRCP in Biliary Obstruction: Comparison with ERCP/Surgery in Addis Ababa, Ethiopia (2025)(Addis Ababa University, 2025) Habtamu Tilahun; Tesfaye Kebede; Assefa GetachewBackground;-A fast growing noninvasive technique for Imaging assessing the hillary tree and pancreatic ducts is magnetic resonance cholangiopancreatography (MRCP). The effectiveness of MRCP to provide maximum intensity projection(MIP) images that closely resemble those produced by endoscopic retrograde cholagiopancetigraphy (ERCP) without the need for intravenous or oral contrast agents is one of its main advantages . It uses heavily T2 weighted imaging technique or sequences which result in the generation of bright signals from slow moving or static fluids like the bile fluid or secretion from the pancreas making these structures bright and the rest of the background will appear darker.(2) Objectives;-To evaluate the diagnostic performance of MRCP in patients suspected biliary obstruction by assessing imaging features , determining etiologic causes,and comparing its diagnostic accuracy with ERCP and surgical findings Methods;-A total of 112 patients from black lion hospital, lancet general hospital and MC comprehensive specialized hospital were included for this retrospective cross-sectional diagnostic accuracy study . There MRCP images were retrieved from PACs system and then interpreted by the body imaging subspecialist and fellow. Their surgical findings or ERCP findings were retrieved from the operational notes and their medical history were recovered from their hospital medical recording systems . Data was entered to epi info and then analysed with SPSS. Results;-MRCP demonstrated high diagnostic performance, with an overall accuracy of approximately 91.1%, sensitivity of 94.7%, and specificity of 72.2%. The most common cause of biliary obstruction was CBD stones contributing for 43.5 % of cases followed by benign strictures and of no etiology cases .MRCP showed excellent diagnostic performance for CBD stones, with sensitivity exceeding 90% and specificity around 94%. A notable finding in this study was that 16.1% of patients demonstrated biliary dilatation without an identifiable obstructing etiology. Conclusion and recommendation;-MRCP is a highly sensitive and accurate non-invasive imaging modality for evaluating biliary obstruction. It performs exceptionally well in detecting biliary dilatation and CBD stones and is highly reliable in excluding malignancy. However, limitations remain in detecting small stones and subtle lesions and in accurately characterizing stricturesItem Retrospective Analysis of Brain MRI Findings in Patients with Clinical Diagnosis of Trigeminal Neuralgia in Tikur Anbessa Specialized Hospital and MyungSung Christian Medical Center(Addis Ababa University, 2025) Kebron Atnaw; Abebe MekonnenBackground: Trigeminal neuralgia (TN) is a debilitating facial pain disorder most commonly caused by neurovascular compression (NVC) of the trigeminal nerve, as well as secondary and idiopathic causes. Magnetic resonance imaging (MRI) plays a central role in identifying etiologies and guiding management, particularly in distinguishing clinically relevant neurovascular conflict from incidental contact. Objective: To describe MRI patterns in patients with clinically diagnosed trigeminal neuralgia and to compare neurovascular relationships between symptomatic and asymptomatic side. Methods: A retrospective multicenter cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) and Myung Sung Christian Medical Center (MCM), Ethiopia, including patients aged ≥18 years with a clinical diagnosis of TN who underwent MRI between January 2024 and December 2025. MRI scans were reviewed for neurovascular contact or conflict, secondary structural causes, and incidental findings. Paired comparisons between symptomatic and asymptomatic sides were performed using Mc Nemar’s test. Results: Thirty-four patients were included (mean age 53.2 ± 17.7 years), with equal gender distribution. Trigeminal neuralgia was predominantly unilateral (97.1%), more frequently affecting the right side (60.6%). Neurovascular compression was identified in 25 patients (73.5%), constituting the most common etiology. Secondary causes were found in 5 patients (14.7%), including multiple sclerosis and tumors, while 4 patients (11.8%) had normal MRI findings consistent with idiopathic TN. Neurovascular contact or conflict was significantly more frequent on the symptomatic side compared with the asymptomatic side (p < 0.001), and true neurovascular conflict was strongly associated with symptoms (p = 0.012). The superior cerebellar artery was the most commonly implicated vessel 21 (84%). Most patients were managed medically, while microvascular decompression was performed in 6 patients (17.6%) with MRI-confirmed NVC. Conclusion: MRI is a valuable tool in evaluating trigeminal neuralgia, demonstrating a high prevalence of neurovascular compression, particularly on the symptomatic side. Differentiating neurovascular conflict from simple contact is essential for etiological classification and surgical decision-making. Routine use of standardized high-resolution MRI protocols is recommended to optimize diagnosis and management of trigeminal neuralgia, especially in resource-limited settings.Item Sonographic Estimation of Normal Palatine to Nsillar Size in under 18-year-old Patients who VisitTASH: ADDIS-ABABA, ETHIOPIA(Addis Ababa University, 2023-11) Tamir Raja; Gorfu Yocabel; Omer FathiaBackground Currently,therei snostandardnormaltonsillarmeasurementusingultrasound whichcanbeusedforcomparisonwithanabnormalpalatinetonsilinclinical practice. Objectives Inthisstudyweaimtoestimatenormalpalatinetonsilsizeusingultrasoundin childrenwhohavenotonsillarrelateddi seaseinTASH,AddisAbaba,Ethiopia. Methods Aprospectivecross-sectionalstudywasconductedatTASH.Thestudywas conductedonpatientsunderageof18yearswhovisitthehospitalforcomplaints unrelatedtotonsillardi seasesfromMay26-September30,2023.Astructured researchtoolwasusedtocollectallthenecessarydatafrom participants selectedbyconveniencesampling.DatawasenteredandanalyzedusingSPSS version27software. Results Atotalof265patientswereenrolledinthestudyintheagerangeof0–18years. Themeanpalatinetonsillarvolume±SDfortherightpalatinetonsilwas0. 97cm3 cantcorrelati ±0.55anditwas0.97cm3±0.56forthelefttonsil.Wedidnotidentifyany signifi onbetweenPTvaluesandsexaswellasthesideofpalatine tonsilmeasured.WedetectedasignificantpositivecorrelationbetweenPT valuesandheight,weightandBMI.Heighthavingstrongestcorrelati onandBMI theleast. Conclusion Thesenormaltonsillarsi tonsill zesontranscervicalultrasoundcanbeusedtodiagnose arpathologies.Palati netonsilsizecorrelateswi thage,height,weight,and BMI;however,nocorrelati onispresentforsexandside. Keywords:palatinetonsil,transcutaneousultrasound,tonsi liItem Role of Imaging in Cervical Cancer Diagnosis & Staging, a Retrospective Descriptive Study, from September of 2022 up to February of 2023 in Tikur-Anbessa Specialized Hospital, Addis Ababa, Ethiopia.(Addis Ababa University, 2023-11) Yusuf Fami ; K Tesfaye; Asefa; SemiraBackground & Objectives: - In many developing countries cervical cancer is not only the mostfrequently occurring cancer among middle-aged women, but also a leading cause of death, partlydue to poor access to medical care and the unavailability of routine screening in many of these countries. Staging of cervical carcinoma is done clinically using International Federation of Obstetrics and Gynecology (FIGO) guidelines. Computed tomography (CT) provides someinformation about the overall size of the cervix, but is inferior to MRI in staging of the primary cervical tumor due to its limited soft-tissue resolution. The study aims to determine the staging and imaging of cervical cancer at first diagnosis. Despite advancements in imaging technologyand staging guidelines, cervical cancer diagnosis and staging remain a challenge. Accurate imaging techniques and proper staging at diagnosis are essential for effective treatment planning and improved outcomes. Methods: - A quantitative retrospective descriptive statistic study was utilized to analyze thedata collected from a 115 medical records of newly diagnosed cervical cancer patients, theirdisease stage at first diagnosis and the imaging modalities used in these patients in Tikur-Anbessa Specialized Hospital form September 2022 up to February of 2023. Results: - It was found that 61 [53%] of patients had advanced clinical staging (stage IIIA–IVB)at the time of their cervical cancer confirmation, indicating a delayed diagnosis. Imaging results showed that the advanced disease stage reached 85 [73.9%] based on CT scans, which performedwell in identifying distant disease spread. It was also found that there was a significantdiscrepancy in disease staging between clinical and CT based disease staging, with 63 [54.8%]disagreement rateInterpretation and Conclusions: - The staggering prevalence of advanced-disease stage ofcervical cancer during initial presentation of patients has rendered surgical intervention futile and has impeded the definitive disease staging objective of our study. This stark reality highlights thepressing need for early detection and intervention strategies to improve the prognosis andsurvival of our cervical cancer patients.Item Idiopathic Interstitial Pneumonia Patterns and Correlation with Spirometry Studies in Tikur Anbessa specialized Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2024-01-23) Alemu Natnael; Azemera GissilaBackground: Idiopathic interstitial pneumonias are widespread interstitial lung diseases with no known cause. The diseases are characterized by a steady decline in dyspnea and lung function. Objective: To assess the patterns of interstitial idiopathic pneumonias and investigate the correlation between the extent of lung involvement on High-Resolution Computed Tomography (HRCT) with spirometric findings in Tikur Anbessa Specialized Hospital(TASH) chest clinic, covering the period from February 2020 to February 2023. Methods: An institutional-based retrospective, descriptive cross-sectional study design was used. All cases with a diagnosis of IIPs who have HRCT and spirometry within a 3-month window were included in this study. Finally, Pearson correlation test was used with less than 0.05 significance 2-tailed value taken as a cut-off. Then the information is presented using simple frequencies, summary measures, tables and figures. Result: There were 54 patients diagnosed with IIPs. The overall median age of the patients was 53.9 ± 15.4. NSIP was the commonest interstitial lung disease diagnosed. Ground glass opacity was the most dominant HRCT feature identified. Pearson correlation tests (p < 0.05) to examine the correlation between lung involvement and spirometry parameters, as well as pulse oximetry-measured oxygen saturation. All spirometry parameters (FVC, FEV1, PEF, FEF 25-75%) and oxygen saturation demonstrated a significant negative correlation with lung involvement. The strongest correlations were observed with FVC (r = -0.827) and FEV1 (r = -0.789), both with p < 0.001. Oxygen saturation showed a moderate correlation (r = -0.49, p < 0.001), while PEF and FEF 25-75% exhibited weak correlations (r = 0.39, p = 0.003, and r = -0.38, p = 0.005, respectively). Conclusion and recommendations: There was a significant negative correlation between FVC and FEV1 and extent of lung involvement identified by HRCT in idiopathic interstitial pneumonias(IIPs). Suggesting a pivotal role of pulmonary function tests (PFTs), specifically FVC, in monitoring IIP progression, supported by HRCT for diagnostic clarity. To enhance IIPs patient care, routine PFTs, particularly FVC, are recommended for monitoringItem Carotid Body Tumor: Comparison of Radiological and Surgical Findings(Addis Ababa University, 2024-02-17) Metti Kuma; Abebe MekonenThe title of this study is Carotid Body Tumor: Comparison of Radiological and Surgical Findings. Its objective is to conduct a comparison of carotid body tumor radiological imaging (CT and MRI) finding to intra-operative findings. The methodology used in the study is hospital based cross sectional descriptive study. Patients with CBT operated at TASH and Minilik II hospital during Oct 1, 2022, to Nov 30, 2023, were included. The radiological images (CT/MRI) were revised by two neuroradiologist and one neuroradiology fellow. Using structured questioner, data was collected through Kobo. Data transferred to SPSS and analyzed. Descriptive methods with ordinal regression analysis done. 23 patients are included in the study. The result shows that 91% of the cases are female. Patients are in 20-67years of age. Mean age is 44years. All patients presented with neck mass. 26% also had headache while 9% had earache. On radiological imaging, 13% were Shamblin group I lesions while group II and III make up 43.5% each. Imaging and surgical Shamblin classification agreed in 65% of the cases. Tumor volume has significant relation with surgical Shamblin grouping and blood loss (p=0.03 and 0.04 respectively). No significant relation seen among surgical Shamblin grouping with loss of tumor adventitia interface and presence of tuft of vessels. In conclusion, in conjunction with imaging Shambling grouping, tumor volume can be related with surgical Shamblin.Item Urinary Bladder Cancer :Value of Ct and Mri in Differntiating Non Muscle Invasive Blader Cancer From Muscle Invasive Bladder Cancer with Histopathologically Staged Tumors(Addis Ababa University, 2024-12-19) Mahlet Kifle; Tesfaye KebedeBladder cancer ranks as the tenth most prevalent cancer globally, representing 2% of all malignant urinary tract tumors. Diagnosis entails utilizing Cystoscopy first, followed by TURBT and histology. Imaging is primarily valuable for determining the stage. CT imaging is useful for assessing larger, higher-staged tumors and for metastatic evaluation. Meanwhile, MRI has the potential to provide value in evaluating local and regional staging, as well as assessing muscular invasion in bladder cancer, which is crucial for prognosis and treatment decisions.Item Hypoxic Ischemic Encephalopathy; Late Magnetic Resonance Imaging Findings Correlated with Clinical Findings, at Yehuleshet Specialty Clinic, December 2023, Addis Ababa, Ethiopia.(Addis Ababa University, 2023-12) Amin Ilili; Debebe Tequam; Saleh Amal; Mekonen Abebe; Endale TewdrosIntroduction: Neonatal Hypoxic Ischemic Encephalopathy is a brain injury that occurswhen oxygen or blood flow to the brain is reduced or stopped before, during, or shortly afterbirth. Birth asphyxia is the main contributor to both long-term neurodevelopmental problems andinfant mortality in low- and middle-income nations. MRI examination can assist in elucidating the type of injury, the timing of injury, the pattern of pathological evolution, and changes inbrain metabolism over time. Objectives: To explore the late Brain MRI patterns and associated clinical findings of childrenwho had clinical diagnosis of perinatal asphyxia in Addis Ababa, Ethiopia. Methodology: The study is conducted in pediatric neurology clinic with MRI facility in Addis Ababa, Ethiopia. A total of 797 pediatric patient’s charts were identifiedwho had Brain MRI imaging evaluation. Of these, 70 cases with clinical diagnosis of perinatalasphyxia were included. Using a structured questioner, demographic data, pre and perinatalhistory of patients was collected. The MRI reports were reviewed by the principal investigator in a systematic pattern. Result: The age at time of MRI evaluation ranges from 2 months to 14 years. Gestational age was assessed of which 74.3% are term and 25.7% are preterm. 42.9% of our patients received antenatal care (ANC) during gestation and 55.7% were delivered at a healthcare facility GlobalDevelopmental Delay (GDD), observed in 61.4% of the cases followed by Seizures occurring in21.4% of patients. 62.5% of preterm infants had periventricular leukomalacia on MRI as compared with those full-term (10.8%) infants, (P-value<0.001). And, (64.9%) of term infants had Subcortical/ deep watershed border zone hyperintensities on MRI as compared to with preterm (12.5%) infants. MRI findings suggestive of chronic injury, thinning of corpus callosum and cerebral cortical atrophy were seen 31.35 & 40% and 31.3% 37.3% respectively in preterm and term infants. Conclusion: The study reveals high magnitude of perinatal asphyxia (8.8%) among pediatric Neurology clinic visits. Brain MRI imaging showed abnormality in majority of cases with specific dominant patterns seen being periventricular leukomalacia and subcortical/deep watershed hyperintensities for preterm and term infants respectively indicating that brain MRI should be used as primary diagnostic work up for these patients.Item Radiological-Pathological Correlation 0f ACR-TIRADS Ultrasound Classification 0f Thyroid Nodules With Fine Needle Aspiration Cytology Results At Tikur Anbessa Specialized Hospital: Prospective Study From April 2023- November 2023(Addis Ababa University, 2023-11) Badege Misganaw; Debebe Tequam; Assefa Getachew; Kebede Asfaw; Mulugeta Mesfin; Tamirat DagnachewBackground:Ultrasound based risk stratification is a widely used method currently helping to guidemanagement in patients with thyroid nodules; which are common and mostly benign. The use ofthese risk stratification methods has helped reduce unnecessary FNAC rates, therefore, reducing the burden both on patients and the health care system. This study aims to determine theeffectiveness of ultrasound-based risk stratification by correlating ultrasound findings andpathologic diagnosis at TikurAnbessa specialized hospital (TASH). Methodology:This was a hospital based prospective radiologic pathologic correlation study in patients referredfor ultrasound guided FNAC based on their American College of Radiology Thyroid Imaging,Reporting and Data System (ACR-TIRADS) score at TikurAnbessa Specialized Referral and Teaching Hospital, radiology department, during the time period of April-September 2023 toassess accuracy of ACR-TIRADS in ultrasound based thyroid nodule risk stratification in ourhospital.Sixty two patients with thyroid nodules were subjected to ultrasound and USG guided FNAC.Each was assigned a TIRADS and Bethesda category. The outcomes were contrasted in order toassess the ultrasound's sensitivity, specificity, and positive predictive value (PPV) in terms ofdistinguishing benign from malignant nodules. RESULT: Twenty-six of the sixty-two nodules that were analyzed classified into TIRADS 3, andthirteen and twenty-three, respectively, into TIRADS 4 and 5. On FNAC, 36 were found to beBethesda 2 & 5, 7, 1 and 8 to Bethesda 3, 4, 5 and 6 respectively. The sensitivity, specificity andPPV of ultrasound were found to be 93.75, 54.35, and 41.67 % respectively.Item CT Patterns of Clinically Suspected Stroke Patients, a Retrospective Descriptive Study, from January of 2023 up to December of 2023 in Tikur-Anbessa Specialized Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2023-12) Gelashe Zerihun; Woldeyohannes Abebe; Saleh Amal; Endale Tewodros; Gizaw Tesfaye