Conformity Assessment of Lead Aprons Used in Conventional Radiology: A Multi-Centre Survey in Togo

Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead aprons are supposed to play in radiation protection, we propose to assess their conformity in medical imaging departments in public and religious hospitals in Togo. Materials and method: A multi-centre survey conducted from 26 November to 06 December 2021 in the radiology departments of public and religious health facilities in Togo. All aprons in use were included. The evaluation criteria were physical (visual), quantitative (radiographic) and qualitative (dosimetric). Results: We had registred 43 aprons among wich 27 (62.79%) leaded aprons were labelled non-compliant and 16 (37.21%) were labelled compliant. Of the aprons judged to be non-compliant, 70.37% were more than 10 years old and 96.30% showed defects on the radiographic images. The most common defects were vampire marks (18.64%), multiple folds (16.96%), cracks (16.96%), multiple cracks (15.25%), tears (8.47%), absence of lead (5.08%), holes (3.39%) and lead corrosion (1.69%). Defective aprons (62.96%) had at least two defects. The defects were of thoraco-abdomino-pelvic (74.07%), thoracic (14.82%) and abdomino-pelvic (11.11%) topography. For indirect exposure at 50 and 70 kilovolts, all the aprons had an attenuation factor greater than 90%. After dosimetric measurement, 13.95% of aprons had attenuation factors below 90% for indirect exposure at 100 kilovolts. Conclusion: The compliance of the leaded decks is trifactorial (physical, radiographic and dosimetric). However, there is no significant difference in X-ray attenuation capacity between defective and normal decks.

Quantitative Assessment of Liver Fibrosis by Elastography in Patients with Chronic Liver Disease: A Cross-Sectional Study in Lomé (Togo)

Aim: To describe the two-dimensional elastographic profile according to the Shearwave (2D-SWE) technique in patients with chronic liver disease in Lom. Materials and method: Cross-sectional, descriptive study conducted over seven month at the Autel dElie Clinic in Lom, from January to August 2022, on adult patients with chronic liver disease who underwent abdominal ultrasound coupled with two-dimensional elastography. Results: The sample size was 54 patients. The mean age of the patients was 33 12 years, with extremes of 18 and 66 years. Patients aged 30 years or less accounted for 48.1% (n = 26). All patients (n = 54) had at least one transaminase assay with a mean of 69.3 78.3 IU/l (AST) and 59.3 82.8 IU/l (ALT). There was no statistically significant association between the biological parameters and the presence of fibrosis. Viral liver disease was the main cause, accounting for 81.5% (n = 44) of cases, with no significant association with the degree of fibrosis. Ultrasound revealed a dysmorphic liver (57.4%;n = 31) and portal hypertension (18.5%, n = 10). Fibrosis stages F1, F2 and F4 accounted for (48.1%, n = 26), (24.1%, n = 13) and (13%, n = 7) of cases respectively. Liver dysmorphia was significantly associated with the presence of fibrosis (p = 0.012) and portal hypertension was significantly associated with the degree of fibrosis (p = 0.0063). Conclusion: Assessment of liver fibrosis in patients with chronic liver disease using 2D-SWE elastography is essential for patient follow-up.

Breast Cancer: Knowledge, Attitudes on Risk Factors and Means of Screening by Medical Students from Lomé, Togo

Background: Breast cancer is the leading cause of cancer-related death in women around the world. The objective of this study was to assess knowledge and attitudes about breast cancer screening among students in the Faculty of Health Sciences at the University of Lomé. Methods: This was a prospective descriptive transversal study conducted among students enrolled in the Faculty of Health Sciences (FSS) of the University of Lomé (UL) in the 2019 school year account 2020. The purpose of this study was to assess the knowledge and attitudes of medical students about breast cancer screening. Results: In total, the questionnaire was completed by 934 students, for a response rate of 57.1%. The most frequently mentioned risk factors were the presence of a family history of breast cancer (n = 799, 85.55%) and the use of oral or injectable contraceptives (n = 606, 64.88%). There is a statistically significant link between the participants’ knowledge of the self-examination and clinical examination of the breasts and certain socio-demographic characteristics, namely age (OR = 0.2, 95% CI [0.11 - 0.75], p-value < 0.0001), the level of study (OR = 1.5, 95% CI [0.55 - 2.46], p-value = 0.0054), the follow-up of a course on breast cancer (OR = 2.63, 95% CI [0.32 - 4.33], p-value = 0.009) and the effectiveness of an internship in a gynecology-obstetrics department (OR = 0.77, 95% CI [0.49 - 2.56], p-value < 0.0001). Similarly, there is a statistically significant link between participants’ knowledge of mammography and certain socio-demographic characteristics, namely age (OR = 0.75, 95% CI [0.50 - 0.84], p-value = 0.0005), the level of study (OR = 1.92, 95% CI [1.11 - 3.46], p-value < 0.0001), the follow-up of a course or training on breast cancer (OR = 2.44, 95% CI [0.08 - 3.91], p-value < 0.0001) and the effectiveness of an internship in a gynecology-obstetrics department (OR = 0.62, 95% CI [0.33 - 0.85], p-value < 0.0001). Conclusion: Knowledge and attitudes related to breast cancer screening have been found to be generally satisfactory to medical students. Active measures are needed to develop educational programs for health personnel, which could enable them to disseminate knowledge and positively influence patient attitudes.

Bone Metastases Indicative of Post Viral Hepatitis C Hepatocarcinoma: About Two Observations

Background: Hepatocarcinoma is the most common primary malignant tumor of the liver with rare bone metastases, electively residing in the vertebrae, ribs and sternum. They remain exceptionally revealing. Cases reports: We report two cases of bone metastases indicative of hepatocellular carcinoma in patients with viral hepatitis C. Through these two observations, we describe the various clinical, paraclinical and therapeutic aspects of this condition whose prognosis is poor. Conclusion: Although unusual, osteolytic bone metastases may be indicative of hepatocellular carcinoma, the diagnosis must be made in the event of any tumor bone involvement in a patient with chronic liver disease, particularly viral.

Knowledge and Practices of Dentists, Oral and Maxillofacial Surgeons of Cone Beam Computed Tomography (CBCT) and the Dentascanner in a Low Income Country: Case of Togo

Background: In dental-maxillofacial imaging, 3D sectional imaging progressively replaces conventional 2D imaging in developed countries. They are based specially on Computed tomography (CT-Scan), with the Dentascan application and cone beam computed tomography (CBCT). In developing countries those technics are newly introduced. Aim: This study aimed at studying the knowledge and practices of dentist and oral and maxillofacial surgeons on sectional imaging such as Dentascan and Cone Beam Computed Tomography (CBCT). Materials and Methods: We conducted an anonymous survey among dentists and oral maxillofacial surgeons in Togo over one month. Results: The response rate was 78.79% (27/33). They were mainly male sex (sex ratio of 2.25 men for one woman). They were aged between 27 and 71 years old with an average of 49.69 years old. The majority (61.54%) had a professional experience over 20 years. The majority of respondents (65.38%) believed their level of knowledge about dental x-Ray was poor. Half of them (50%) confirmed that they had never asked for a Dentascan, and 15.38% asked from time to time for it and only two (7.69%) asked often for this test. 96.15% confirm they have no knowledge of the Dentascan. Regarding the CBCT, 84.62% didn’t ask for it because this technique did not exist in Togo before. 69.20% of respondents confessed to be interested in continuing training on sectional imaging. Conclusion: This study shows that sectional imaging is very little used by oral and dental practitioners in Togo because of the ignorance of the new techniques and the absence of the CBCT. It is therefore necessary to promote the teaching of the new technique of sectional imaging in the training syllabus of oral and dental specialists and to initiate continuing medical training.

Mechanical Confining of Sinonasal Anatomic Variants by Computer Tomography in Togo

Objective: Determine the frequency of the sinonasal mechanical anatomic variants by CT Scan. Patients and method: Six-month retrospective study concerning sinus CT scans in the registers of Teaching Hospitals’ Imaging Services of Lomé and Kara (TOGO). It involves patients without distinction of sex, of over 15 years without anomaly that can lead to a modification of the normal anatomical configuration of the paranasal sinuses’ cavities. The analysis has been made by only one radiologist. Results: The frequency of mechanical sinonasal anatomic variants stood at 91.87%. The narrowing of the middle nasal turbinate was the variant mostly observed (55.03%), dominated by the deviation of the nasal septum whose frequency was 25.48%. The narrowing of the infundibulum represented 10.80% of population. They were more represented by the Haller cell which displayed a frequency of 3.60%. The variants venturing to narrow the upper nasal turbinate, represented only by extra turbinates, involved 1.02% of the population. The other variants of mechanical sinonasal anatomic variants represented 25.02%. They were dominated by the maxillary sinus septa (11.2%). Our study showed a feminine predominance which is statistically important for Haller cells (p = 0.037) and the ethmoidbulla hypertrophy (p = 0.0036). Conclusion: The anatomic variants of mechanical sinonasal are very frequent in Togo.

Biometrics of the Cervical Spinal Canal and Cord by Computer Tomography in Togo

Studies on the canal dimensions of the cervical spinal are rare in Africa. The aim of this study is to provide normal values of the cervical spinal canal and spinal cord dimensions of adult people in Togo. It was about a twelve-year prospective study conducted in the main Hospitals of Campus Teaching Hospital. This study involved people of more than 18 years who neither presented any clinical sign nor rachis defect. The distances measured were antero-posterior 1 (APD1) and inter-pedicular (IPD) of the cervical spinal canal, the antero-posterior 2 (APD2) and the transverse (TD) diameters of the cervical spinal cord, followed with APD2/APD1 (R1) and TD/IPD (R2) research reports. The mean age was 38 +/- 9.34 years old. The average of APD1 of the cervical spinal canal stood at 15.41 ± 0.55 mm, with a minimum of 10.48 ± 0.57 mm and a maximum of 25.00 ± 2.60 mm. The IPD average stood at 23.27 ± 1.67 mm with a minimal average of 13.68 ± 1.46 mm and a maximal average of 33.68 ± 1.46 mm. The average of DAP2 was 11.66 ± 0.66 mm, with a minimum of 10.7 ± 0.66 mm and a maximum of 12.77 ± 0.66 mm. The DT average stood at 15.55 ± 1.54 mm, with a minimal average of 14.03 ± 2.43 mm and a maximal average of 17.63 ± 1.82 mm. The ratio R1 (APD2/APD1) average was 0.80 ± 0.04, with a minimum of 0.76 ± 0.06 and a maximum of 0.85 ± 0.07. The ratio R2 (TD/IPD) average stood at 0.69 ± 0.14, with a minimum of 0.5 ± 0.12 and a maximum of 0.84 ± 0.08. The cervical spinal canal and the cervical spinal cord diameters in Togo are not significantly different from those described above.

Echo-Mammographic and Anatomo-Pathological Aspects of Male Breast Cancer in Togo

Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lomé. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.

Giant Breast Hamartoma: A Case Report in Togo

We report the case of a 50-year-old patient, who was explored in mammography, ultrasound and CT for a large painful mass of the right breast that had been evolving for 30 years and gradually increasing in size. There was a typical “sausage slice” appearance with clear center macrocalcifications on the mammogram;an aspect of “breast in the breast” on ultrasound. The scanner had made it possible to specify the dimensions of the mass, which measured 21.4 cm in height;18.6 cm wide and 9.5 cm thick. Histology after exeresis noted the adenolipofibromatous nature of the mass.