Imaging Findings in Chest Computed Tomography: Initial Experience in a Developing Country

Background:?High resolution chest computed tomography (HRCT) is an established imaging modality that accurately assesses disease processes that are non-specific on conventional chest radiography. Chest Computed Tomography (CT) has proven invaluable in the evaluation of various diseases of the chest providing precise diagnosis that have great impact on the course of management. In this study, our aim is to evaluate the spectrum of radiological findings in all patients that had chest CTs at a tertiary health Institution in a developing Country. Method: This is a 6-year retrospective study of all patients that had Chest CT from 2009 till 2015. All patient data were retrieved and their Chest CT images reviewed and radiological findings and diagnosis documented. Results: Age range of patients was 1 - 84 years with a mean of 52.36 ± 22.9 years. Ten patients were children (12%). There were more males 53 (63.1%) than females 31 (36.9%) in the study. Referral for imaging was predominantly from internal medicine 33 (47.1%) and Surgery 27 (38.6%) departments. Most of the patients, 53 (63.1%) did not have previous chest radiographs. Consolidative changes were the most common parenchymal finding (77.4%). Few mediastinal masses were found in the study population. CT angiography constituted only 10.7% of all chest CTs done in adults. Conclusion: Few chest CT evaluations are performed compared to CTs of other parts of the body done in the same period. Chest CT is generally under-utilized even in a tertiary institution. There is a need to educate chest physicians on the role and advantages of CT use for the management of their patients.

Giant Ascending Aortic Aneurysm: Are There Peculiarities in the Developing World?

Aim: To highlight the imaging features and the peculiarities associated with a giant ascending aortic aneurysm in a typical developing world setting. Presentation of Case: A 78-year-old known hypertensive and asthmatic woman of 25 and 10 years duration respectively. She had an untreated degenerative aortic valve lesion and moderate aortic regurgitation. This case study showed the complex interplay of background untreated aortic valve disease, aortic insufficiency, chronic hypertension, chronic airway obstructive disease and ageing in a case of giant aneurysm of the entire ascending aorta. It also emphasizes the role of imaging in diagnosis and follows up of ascending aortic aneurysm particularly where prevention is key to prevent the high mortality associated with Thoracic aneurysymal rupture. Conclusion: Timely institution of appropriate treatment of aortic valve disease, prevention and adequate control of hypertension is key to prevent the development and the grave prognosis of ascending aortic aneurysm, particularly in the developing world where appropriate medical facilities, expertise and treatment are scarce.