Contribution of Bone Scintigraphy in the Diagnosis of a Case of SAPHO in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar, Senegal)

Introduction: The acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is a syndrome combining osteoarticular and cutaneous manifestations. It occurs mainly between the ages of 30 and 50. Sternocostoclavicular hyperostosis is one of the main distinguishing features. We report a case of SAPHO in Dakar diagnosed by bone scintigraphy. Observation: 28-year-old Senegalese women presented with left shoulder pain and relative functional impotence for over 2 years. Examination revealed right sternoclavicular hyperostosis and left shoulder pain on palpation. Questioning revealed a history of acne and hyperostosis of the right first toe. Bone scintigraphy, performed after injection of 630 MBq of 99mTc-HMDP, revealed: hyperfixation of the bilateral (right++) manubrio-sternal and sternoclavicular junction, producing the classic bull’s horn image;hyperfixation of the left shoulder with an inflammatory appearance;hyperfixation of the sacroiliac joints suggestive of bilateral sacroiliitis;hyperfixation of the right first toe;two mandibular hyper fixations probably related to dental damage. This scintigraphic appearance in one was strongly suggestive of SAPHO syndrome. Conclusion: SAPHO syndrome, related to spondyloarthropathy, associates cutaneous and osteoarticular signs. It is characterized by frequent delays in diagnosis due to poor recognition. Soy is an invaluable diagnostic tool, enabling us to assess the extent of the disease and its evolution.

Place of Bone Scintigraphy in the Assessment of Extension and Follow-Up of Breast Cancer in Senegal: Study of 165 Cases in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar)

Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to metastases, with 73% of metastases occurring in the bone. In oncology, metastable technetium 99-labelled methylene bisphosphonate bone scintigraphy (BS) remains the standard examination for detecting and assessing the extent of bone metastases. The aim of this study was to assess the role of BS in the evaluation and follow-up of breast cancer in Senegal. Methodology: This was a retrospective study of breast cancer patients who underwent bone scintigraphy with 99mTc-HMDP in the nuclear medicine department of Idrissa Pouye General Hospital (IPGHO), from July 2009 to June 2022. Results: We enrolled 165 patients, mean age 46.79 years (27 - 87 years). BS was performed in 94.37% of cases for post-therapeutic monitoring and in 5.63% for pre-therapeutic assessment. Results were contributory in 131 patients (92.25%), of whom 72 cases (50.70%) were normal and 59 cases (41.55%) positive or presenting bone metastases;and non-contributory or doubtful in 11 cases (7.75%). Secondary bone locations were multiple in 57 cases (96.61%) and single or solitary in 2 cases (3.39%). The scintigraphic appearance of bone metastases was hyper-fixative in 58 cases (98.31%) and mixed in 1 case (1.69%). Bone lesions were quantified using the Soloway’s grading classification. Conclusion: BS with 99mTc-labelled bisphosphonates remains the examination of choice for skeletal exploration, in the detection and extension of bone metastases in breast cancer. Performance has been enhanced by the development of SPECT coupled with CT (SPECT-CT).

Chest Radiography: General Practitioners’ Compliance with Recommendations

Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.

Bithalamic Ischemic Stroke in Sickle Cell Patient at the Kamenge University Hospital in Burundi: Case Report

Aim: To describe the clinical and radiological diagnostic for a sickle cell patient who got a bithalamic vasculature accident. Observation: This was a 4-year-old female child admitted to the pediatric ward for convulsive seizures in a feverish context. The physical examination did not find signs of meningeal irritation. The effective workup including thick gout, lumbar puncture, complete blood count, and C reactive protein was normal. An electrocencephalogram was not performed due to lack of availability of the device. Based on clinical data and the fact that Burundi is an area of high malaria prevalence, antimalarial and anticonvulsant treatment has been started. An alteration of consciousness (the Glasgow score of 7) had motivated a CT scan. Bithalamic hypodensities in favor of a vascular accident have been demonstrated. Etiological investigation revealed homozygous sickle cell disease ss during hemoglobin electrophoresis. The final evolution has been characterized by a return to normal consciousness. Conclusion: The complexity of the clinical picture following occlusion of Percherons artery makes it difficult to diagnose. Sickle cell disease may favour the occurrence of ischaemic lesions. Cerebral imaging enables the diagnosis to be made with certainty and avoids delays in treatment.

Relevance of Medical Imaging in the Pre-Therapeutic Evaluation of Acute Intestinal Obstruction at CIMED

Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytical study involving 96 patients collected at the radiology and medical imaging department of CIMED, from January 2022 to January 2023. Result: The age of our patients varied between 11 and 86 years with an average age of 36 years. There was a male predominance of 64.6% compared to 35.4% for women, i.e. a sex ratio of 1.82. The notion of previous surgery was found in 61.5% of our patients. Pain was present in all patients. Radiography of the ASP was performed in 89.6% of patients. It showed hydro-aerial levels in 96.5% of patients. Abdominopelvic CT was performed in 12 patients and made it possible to make the diagnosis of occlusion in all patients. The results of the positive diagnosis were concordant with those intraoperatively in 92% of cases. 8% of our patients, compared to the treatment, spontaneously resumed their transit, 91% benefited from surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients or 83.3%, poor with death in 16 patients or 16.7% of cases. Conclusion: Acute intestinal obstruction remains a serious pathology for which ASP radiography often remains the only radiological examination performed urgently. However, abdominopelvic CT seems widely indicated thanks to its contribution both for the positive diagnosis and for the serious and etiological diagnoses. However, this imaging technique is largely underused in our practice due to its high cost and lack of availability.

Atlas of Elbow Soft Tissue Pathologies Using Magnetic Resonance Imaging at the Saint Camille Hospital in Ouagadougou and the Polyclinique Notre Dame de la Paix (Burkina Faso)

Introduction: The elbow is a superficial joint, particularly exposed to direct impact, forced movement, and overstrain. Our work aimed to study magnetic resonance imaging (MRI) pathologies of the soft tissues of the elbow through illustrative cases. Methodology: This was a retrospective and prospective cross-sectional study covering a period of one year, from June 2020 to June 2021, at the Saint Camille Hospital in Ouagadougou and the Polyclinique Notre Dame de la Paix. Results: In general, this study found that the pathologies diagnosed on MRI were lateral epicondylitis, subcutaneous type V elbow lipoma and liposarcoma, anteromedial cortical fracture of the radial cup, cortical detachment fracture of the lateral epicondylitis, medial epicondylitis, villonodular articular synovitis, simple dermo-hypodermatitis, sequellar fibrosis of the ulnar nerve, Workman's syndrome (median and ulnar nerves) and osteoarthritis of the elbow. Lateral epicondylitis was the most frequent pathology, and most patients consulted for elbow pain predominantly associated with pressure on the epicondyle, with relative functional impotence and, occasionally, elbow swelling. Conclusion: MRI, as a complement to ultrasound and radiography, remains the most informative examination for exploring soft-tissue pathologies of the elbow.

Ultrasound of the Rotator Cuff in Non-Fractured Shoulder Trauma: 30 Cases at the Yalgado Ouedraogo University Hospital of Ouagadougou (Burkina Faso)

Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou. Methodology: This was a prospective descriptive cross-sectional study running from August 1 to November 30, 2017, in the medical imaging department of CHUYO. The study population consisted of patients received in the department for ultrasound in the context of non-fracture shoulder trauma. Results: We collected 20 cases (66.67%) of rotator cuff lesions out of 30 non-fracture shoulder injuries. The mean age of the patients was 27.6 years. Road traffic accidents accounted for 60% of injuries, sports accidents for 30%, and domestic accidents for 10%. Ultrasound lesions were mainly tendon ruptures (36.67%) and tendinitis (23.33%). Ruptures were non-transfixing in 90.90% of cases. The supraspinatus was the most affected (81.81%). Conclusion: Ultrasound can help diagnose rotator cuff injuries, particularly in non-fractured shoulder trauma.

Image Non-Uniformity Correction in 3T Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging: Comparison among Different Software Versions

Background: Non-uniformity in signal intensity occurs commonly in magnetic resonance (MR) imaging, which may pose substantial problems when using a 3T scanner. Therefore, image non-uniformity correction is usually applied. Purpose: To compare the correction effects of the phased-array uniformity enhancement (PURE), a calibration-based image non-uniformity correction method, among three different software versions in 3T Gd-EOB-DTPA-enhanced MR imaging. Material and Methods: Hepatobiliary-phase images of a total of 120 patients who underwent Gd-EOB-DTPA-enhanced MR imaging on the same 3T scanner were analyzed retrospectively. Forty patients each were examined using three software versions (DV25, DV25.1, and DV26). The effects of PURE were compared by visual assessment, histogram analysis of liver signal intensity, evaluation of the spatial distribution of correction effects, and evaluation of quantitative indices of liver parenchymal enhancement. Results: The visual assessment indicated the highest uniformity of PURE-corrected images for DV26, followed by DV25 and DV25.1. Histogram analysis of corrected images demonstrated significantly larger variations in liver signal for DV25.1 than for the other two versions. Although PURE caused a relative increase in pixel values for central and lateral regions, such effects were weaker for DV25.1 than for the other two versions. In the evaluation of quantitative indices of liver parenchymal enhancement, the liver-to-muscle ratio (LMR) was significantly higher for the corrected images than for the uncorrected images, but the liver-to-spleen ratio (LSR) showed no significant differences. For corrected images, the LMR was significantly higher for DV25 and DV26 than for DV25.1, but the LSR showed no significant differences among the three versions. Conclusion: There were differences in the effects of PURE among the three software versions in 3T Gd-EOB-DTPA-enhanced MR imaging. Even if the non-uniformity correction method has the same brand name, correction effects may differ depending on the software version, and these differences may affect visual and quantitative evaluations.

A Huge Metastatic Liver of a Neuroendocrin Tumor Explored by SPECT/CT with 99mTc-Tektrotyd: A Case Report

Background: Colorectal neuroendocrine tumors are rare and have a heterogeneous clinical representation and variable prognosis. High grade neuroendocrine tumors (NETs) are characterized by destructive and aggressive growth, followed by rapid spread. For this purpose, SPECT/CT with 99mTc-Tektrotyd is very useful for imaging and staging of NETs. Case Report: A 50-year-old man with a huge metastatic liver from an unknown neuroendocrine tumor (NET). SPECT/CT with 99mTc-Tektrotyd was performed in this patient, it showed a huge metastatic hepatomegaly compressing neighboring organs with bone metastases, and also revealed the primary colon tumor. Discussion and Conclusion: In recent decades, the incidence and prevalence of neuroendocrine tumors (NETs), especially those of the colorectal segments, have been increasing. 99mTc-EDDA/HYNIC-TOC (Tektrotyd?) was introduced into the market and its use has been approved for scintigraphic imaging of patients with NETs and other SSTR-positive tumors. It provides in vivo metabolic data related to the over-expression of Somatostatin Receptors (SSTRs) and also predicts response to peptide receptor radionuclide therapy (PRRT).

Cancer Occurrence and Associated Factors to Malignancy in BIRADS-3 Lesions in Yaoundé: The Need to Be More Proactive for Patients above 40, Non-Compliant with Imaging Follow-Up and Presenting with Nipple Discharge

Background and objectives: Breast Imaging Reporting and Data System in Category 3 (BIRADS-3) includes probably benign lesions which need a short-term imaging follow-up. However, in our context, the lesions graded BIRADS-3 remain insufficiently evaluated. We therefore conducted this study to assess the cancer occurrence and associated factors in BIRADS-3 lesions during the follow-up in order to propose an adaptation of the management for lesions in this category in our setting. Patients and methods: A retrospective longitudinal study of patients with lesions initially classified as BIRADS-3 and who realised each at least one additional imaging check-up between January 2014 and December 2022 in five Yaoundé hospitals. All clinical and imaging data were analysed using SPSS® 21.0 software with a significant p-value Results: Patients were aged 13 to 73 (33.0 ± 13.4) years, with a history of breast mass (315 cases;79.7%), breast pain (25 patients;6.3%), nipple discharge (20 patients;5.1%) or past family history of breast cancer (25 cases;6.3%). The most common baseline abnormalities were mammogram opacities (64.8%) and microcalcifications (48.6%), whereas initial breast ultrasound showed solid masses (77.0%) and cystic lesions (11.1%). Compliance with imaging appointment periods was low with only 23.9% of all patients performing an imaging control at the scheduled moment. During the follow-up, 115 patients (29.1%) were upgraded to BIRADS-4 and histology performed revealed 43 cancers (10.9% of overall initial BIRADS-3 sample). The presence of malignancies was associated to age above 40 years (p = 0.0001) and to the presence of nipple discharge (p = 0.0375). Conclusion: The frequency of malignancies among initial BIRADS-3 lesions in our series is higher than that described in the guidelines. This study highlights the need to be more proactive in the management of BIRADS-3 lesions in our setting as the compliance with follow-up is low. So, biopsy should be considered as an alternative to long-term follow-up for patients above 40, non-compliant with imaging check-ups and presenting with nipple discharge.

Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.

A Breast Density Classification System for Mammography Considering Reliability Issues in Deep Learning

In a convolutional neural network (CNN) classification model for diagnosing medical images, transparency and interpretability of the model’s behavior are crucial in addition to high classification accuracy, and it is highly important to explicitly demonstrate them. In this study, we constructed an interpretable CNN-based model for breast density classification using spectral information from mammograms. We evaluated whether the model’s prediction scores provided reliable probability values using a reliability diagram and visualized the basis for the final prediction. In constructing the classification model, we modified ResNet50 and introduced algorithms for extracting and inputting image spectra, visualizing network behavior, and quantifying prediction ambiguity. From the experimental results, our proposed model demonstrated not only high classification accuracy but also higher reliability and interpretability compared to the conventional CNN models that use pixel information from images. Furthermore, our proposed model can detect misclassified data and indicate explicit basis for prediction. The results demonstrated the effectiveness and usefulness of our proposed model from the perspective of credibility and transparency.

The Epidemiological, Clinical and Radiological (Echography, Mammography) Characteristics of Breast Pathologies at the Diagnostic Imaging Center (C.I.D) “Teriya” in Bamako

Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was a retrospective descriptive study, carried out over a period of 3 years (from January 2018 to December 2020) at the Diagnostic Imaging Center (C.I.D) “TERIYA” in BAMAKO. It concerned all patients who came for a mammogram/ultrasound examination of the breast. All women admitted for mammogram or breast ultrasound who were diagnosed with a breast injury during the study period were included. Incomplete records and radiological checks were not included. The variables analyzed were age, sex, clinical data, and ultrasound and mammography aspects. The devices used are: a Voluson 730 PRO ultrasound machine and a G 600T type mammography machine. Results: At the end of our study, we collected 254 breast pathologies on a number of 382 women, i.e. a frequency of 66.49%. The average age of our patients was 41 years old. The dominant clinical data were mastodynia (41.88%) and mammary nodule (21.70%). On imaging (mammo-ultrasound) the lesions predominated on the left in 36% of cases, bilateral in 28% of cases and in the upper-outer quadrants in 31.5% of cases. Tumor pathologies represented 66.54% of which 45.27% were benign mainly composed of fibro-adenoma (20.88%) and cyst (18.50%), 11.8% of suspected cases and 9.45% of cancers. Non-tumor pathologies represented 33.46%, mainly mastitis (16.14%), galactophoric dilations (11.02%) and abscesses (5.51%). These pathologies were classified in 50.3% in ACR2, 17.75% in ACR3 and 4, and in 14.20% in ACR5. Lymphadenopathy was present in 73.21% of cases.

Unusual Head Trauma: About Three Observations at the Chu Pr Bocar Sidy Sall (BSS) of Kati

Introduction: Penetrating head injuries are often due to human-to-human violence, mainly by firearms, those by stab are rare. CT is the exam of choice in the assessment of emergency lesions. We report three observations, all victims of knife assault during the brawl in order to clarify the contribution of DTM in the care. Observations: 1) Mr. I S, 21-year-old, student, was admitted with the hillside implanted in the skull. There were traces of blood on his face and clothes. There was no neurological deficit on examination. The CT scan performed showed the knife penetrating the vault of the skull at the left parietal level, up to 5 cm in the cerebral parenchyma with a minimal subdural and intracerebral hematoma;2) Mr. S C, 43-year-old, farmer, admitted with a large left fronto-temporo-parietal wound, bleeding and right hemiplegia. The CT scan performed showed a frontal linear fracture (with fronto-ethmoid hemosinus) and left temporoparietal with a parietal intraparenchymal hematoma and homolateral frontoparietal subdural hematoma;3) Mr. S B: 40 years old, driver, admitted with a parietal wound. The CT scan performed objectified a left parietal cortical hematoma in relation to a metallic foreign body (3000 HU) corresponding to the distal end of the knife penetrating the vault of the skull. They all underwent emergency surgery and received antibiotics and preventive serotherapy. The postoperative follow-up was simple, the follow-ups are without neurological sequelae. Conclusion: Head trauma by knife is rare, it results from inter-human violence. The lesion diagnosis is computed tomography. The prognosis depends on the severity.

Interest of SPECT/CT in Detection of Sentinel Lymph Node in Breast Cancer

Aim: Assess the role of hybrid modality SPECT/CT versus planar scintigraphy in sentinel lymph node (SLN) identification in patients with breast cancer. Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 23 women with breast cancer (mean age 59.5 years with range 25 - 82 years) with invasive breast cancer (T0, T1 and T2), without clinical evidence of axillary lymph node metastases (N0) and no remote metastases (M0), radiocolloid was injected in four subareolar sites. Planar and SPECT/CT images were separately interpreted. Results: SLNs were detected on lymphoscintigraphy in all patients (100%), taking into consideration both techniques (planar and SPECT-CT images). Planar images identified 45 SLNs in 23 women, with a mean of 1.95 per patient, whereas 56 SLNs were detected on SPECT/CT, increasing this mean to 2.43 per patient. Drainage to internal mammary lymph nodes was seen in 4 patients (17.39%). However, two foci of uptake were identified on planar image as hot SLN in two patients (8.69%);while they have been found as a false positive non-nodal site of uptake on SPECT/CT. Conclusion: SPECT/CT is more focused than planar scintigraphy in the detection of SLN in patients with breast cancer. It detects some lymph nodes not visible on planar images, excludes false positive uptake and exactly locates axillary and non-axillary SLNs.

Varicocele and Spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. Sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of the pampiniform plexus and the sperm abnormalities mentioned above. It should be recognized that varicocelectomy has allowed a significant improvement in the quality of sperm with the obtaining of a certain number of natural pregnancies and those resulting from medically assisted procreation.

Quality Assuring a Ring Vortex Flow Phantom in Real-Time

Introduction: The ring vortex phantom is a novel, cost-effective prototype which generates complex and well-characterised reference flows in the form of the ring vortex. Although its reproducibility has been demonstrated, with ring speeds routinely behaving within 10% tolerances at speeds of approximately 10 - 70 cm/s, a form of real-time QA of the device at the time of imaging is needed to confirm correct function on demand in any environment. Methods: The technology described here achieves real-time QA, comprising a linear encoder, laser-photodiode array, and Doppler probe, measuring piston motion, ring speed and intra-ring velocity respectively. This instrumentation does not interfere with imaging system QA, but allows QA to be performed on both the ring vortex and the device in real-time. Results: The encoder reports the reliability of the piston velocity profile, whilst ring speed is measured by laser behaviour. Incorporation of a calibrated Doppler probe offers a consistency check that confirms behaviour of the central axial flow. For purposes of gold-standard measurement, all elements can be related to previous Laser PIV acquisitions with the same device settings. Conclusion: Consequently, ring vortex production within tolerances is confirmed by this instrumentation, delivering accurate QA in real-time. This implementation offers a phantom QA procedure that exceeds anything seen in the literature, providing the technology to enhance quantitative assessment of flow imaging modalities.

Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 127 women, i.e. 84.7%. The sub-endometrial flow was found in 128 women or 85.3%. Conclusion: The Knowledge of the status of the endometrium is essential and has an impact on the outcome of embryo transfers. The thinner (7 and <15). Doppler factors also play an important role.

Ultrasound Diagnosis of Primary Epiploic Appendagitis: A Case Report

A rare differential diagnosis for severe abdominal pain is acute epiploic appendagitis. Its symptoms resemble those of acute diverticulitis, acute appendicitis, or omental infarction quite a bit. The primary imaging method used for diagnosis is computed tomography (CT). We are describing the case of a 27-year-old guy who underwent an abdominal ultrasonography after complaining of severe left lower quadrant abdominal pain. It identified an oval and non-compressible hyperechoic mass in the left iliac fossa. The mass was surrounded by a hypoechoic rim and there was no color Doppler signal. In the absence of CT, radiologists must be able to diagnose acute epiploic appendagitis on ultrasound in order to avoid unnecessary hospital admission, pricey laboratory tests, antibiotic treatment, and unnecessary surgery. In this instance, the patient was spared from ionization exposure from a potential CT scan and other invasive treatments including surgery with associated costs because of the reliable ultrasound diagnosis of epiploic appendagitis. After receiving conservative medical treatment, the patient was placed under surveillance and then discharged.

Epidemio-Clinical and Uretrocystographic Profile of Pathologies of the Lower Urinary Tract at the Chu Pr Bss of Kati

Introduction: Pathologies of the lower urinary tract are common in urology composed of various conditions, responsible for urinary disorders. Despite the new methods, exploration in Africa is mainly based on retrograde urethrocystography (UCR). The main objective was to determine the importance of UCR in the diagnosis of pathologies of the lower urinary tract. Materials and Methods: This was a retrospective and descriptive study covering a period of 5 years (July 2016-June 2021). It involved all patients admitted to the ward for retrograde urethrocystography during the period. A remote-controlled table of the GE PRESTILIX 1600× type was used for the examinations. Results: At the end of our study we collected 100 cases of pathologies of the lower urinary tract out of a total of 112 RCUs performed or 89.28%. Pathologies of the lower urinary tract accounted for 78% of the UCRs in the department. The age group of (61 - 70) was the most affected with extremes from 1 year to 101 years. Non-specific urination disorders were the most common indications (43%), followed by acute urine retention (18%). Acquired urethral pathology was the most common (89%), followed by bladder neck disease 5% and posterior urethral valve with 4%, Bladder struggle was the most common associated sign (54%) with post-urination residue in 97% of patients. Conclusion: Pathologies of the lower urinary tract are relatively common in our region, dominated by urethral narrowings. Retrograde urethrocystography remains the reference examination in our control for the diagnosis of obstructive pathologies of the lower urinary tract while specifying the seat of the obstacle.