Citation: Nkubli FB, Nzotta CC, Nwobi NI, Moi SA, Adejoh T, Luntsi G, et al. A survey of structural design of diagnostic x-ray imaging facilities and compliance to shielding design goals in a limited resource setting. J Glob Radiol. 2017;3(1):Article 6.

Abstract

Background: MRI plays a vital role in diagnosis of diseases. Objectives:To determine the pattern of imaging requests and findings from MRI scans of patients in the bauchi State Hospital. Methods:A prospective cross-sectional study of MRI request forms and findings of 138 patients was conducted from August 2016 to January 2017. MRI scans were performed using a 0.35T Neusoft MRI scanner and reported by a group of consultant radiologists. Data were analysed using descriptive statistics with the computer software SPSS version 22 (IbM, New York, USA). Results:This study revealed that majority of the MRI requests were for lumbosacral spine examinations (n=84, 60.9%), followed closely by MRI of the brain (n=42, 30.4%) and thirdly shoulder and abdomen examinations with a frequency of 4.3% each. Out of 138 MRI scans studied, intervertebral disc prolapse (n=60, 43.5%) was the commonest finding from MRI scans of patients, the second most prevalent finding was L4-L5 degenerative disc disease (n=12, 8.7%). Intramuscular lipoma and basal ganglia edema had a prevalence of 4.3%. Conclusion:The commonest requests were MRI lumbosacral and, in terms of findings, we found intervertebral disc prolapse, L4-L5 degenerative disc disease, basal ganglia edema and intramuscular lipoma as the major findings from MRI scans in bauchi.

Background:The ultrasound machines used in our locality are programmed with software of non-indigenous normative values; furthermore, as pregnancy advances the accuracy of most biometric parameters in predicting GA varies due to racial morphological difference and error increases, hence the need for this study.Purpose: To determine local (black race) sonographic FTL normative values and to compare the values with that of the Caucasian population. Material and Methods:Women with a singleton pregnancy that was conceived naturally and who met the individual inclusion criteria were recruited consecutively. The Helsinki declaration of 1975 was considered. A prospective cross-sectional study was conducted in the Federal Medical Center Azare, Bauchi. The study in-volved 253 women from 16 to 38 weeks of gestation. A 2D ultrasound scan was used to measure the FTL (that is from the root of the neck to the diaphragm) at the level of the four-chamber view.Results: Normal values of the FTL were developed and showed a linear and statistically significant correlation with the weeks of gestation (r2= 0.81, P≤0.001). The FTL has a growth rate of 0.182 cm per week. Conclusion:There is no statistically significant difference between the FTL of the population under study (black population) and that of the Caucasian population. Hence, the use of Caucasian FTL on black race is a valid estimate of GA. And the GA predictive equation is; y = 3.61x + 11.95. Where y = gestational age in weeks and x= thoracic length.

Diagnostic Reference Levels (DRLs) for digital mammography and image quality evaluation are important optimization tools in medical imaging. High quality mammograms are essential to the successful early detection of breast cancer. The objective of the study is to establish DRLs for digital mammography and to assess image quality of the mammograms for optimization. DRLs were established using thermoluminescent dosimeter (TLD) chips to estimate the mean glandular dose for both cranio-caudal and medio-lateral oblique projections. The TLD chips were calibrated. The DRLs were set at the 75th percentile of the distribution of the median value of mean glandular dose. Image quality was assessed using European Commission guideline for mammographic image quality assessment. Results for DRLs were 0.53 mGy for cranio-caudal and also 0.53 mGy for medio-lateral oblique. Image quality evaluation showed criteria scores for cranio-caudal and medio-lateral oblique projections as 76 % and 61.2 % respectively. The mammograms scored the highest and lowest score of 100 % and 44 % on criteria 2 and criteria 6 (absence of skin fold) respectively for cranio-caudal projections while for the mediolateral oblique projections, criteria 1 (all breast tissue clearly shown) and criteria 5 (inframammary angle clearly demonstrated) have the highest and lowest score of 96 % and 8 % respectively. The study showed that the DRLs in this study was lower than the established values in other regions of Nigeria and international established values. Image quality was within acceptable level. DRLs for digital mammography and image quality evaluation are important optimization tool that should be adopted by every radiology department with mammography unit.

Background: The practical implementation of Diagnostic Reference Level in paediatric imaging is a complex task due to their unique individuality in terms of high sensitivity to radiation, varying body sizes and presenting pathology. Hence, good knowledge of medical technology, skill to perform patient dosimetry and to analyze mage quality is required. Purpose: To provide a guide on the methodological requirements for the establishment of Paediatric Diagnostic Reference Levels (PiDRLs) based on the revised and updated guidelines from the current ICRP publication 135 on Diagnostic Reference Levels (DRLs). Materials and method: An extensive review of the ICRP report Publication 135 on Diagnostic Reference levels in medical imaging with a focus on paediatric imaging and other related studies were undertaken. Results: The ICRP report 135 updates and refines the recommendations of 2001. It highlights that the application of DRLs in paediatrics alone is not sufficient for the optimization of protection. Image quality must be evaluated. Quantities used for DRLs should be appropriate to the imaging modality being evaluated, assess the amount of ionizing radiation applied to perform a medical imaging task, and be measured directly. For interventional procedures, the complexity of the procedure may be considered in setting DRLs. DRLs shall not be used for individual patients or as trigger (alert or alarm) levels for individual patients. Appropriate weight bands (generally with 5 or 10 kg intervals) are recommended for establishing paediatric DRLs and should be promoted. Conclusion: The amount of radiation used for examinations of children can vary tremendously due to great variation in patient size and weight from neonates to adult-sized adolescents. This variation in patient radiation dose is appropriate. However, variation in patient doses due to inappropriate technique or failure to child-size the imaging protocol is not appropriate. This forms the basis of the new ICRP guideline and should form the basis of developing PiDRLs.

PurposeDiagnostic Reference Level (DRL) is a practical tool for radiation dose optimization, yet it does not indicate the patient size or image quality. The Acceptable Quality Dose (AQD) introduced to address the limitations of the DRLs and it is based on image quality, radiation dose, and patient weight. The aim of this study is to establish the AQD for adult patients' undergoing Computed Tomography (CT) examinations (Head, chest, abdomen).MethodsThis study is conducted in the four main hospitals at the Ministry of Health and Prevention. Patient information and exposure parameters were extracted. All the acceptable images are scored for their quality assessments. Data is classified as seven weight groups, <50, 50–59, 60–69, 70–79, 80–89, 90–99, and ≥100 kg. The mean ± SD, median, and 75th are calculated for the CTDIvol and DLP for each weight group per examination.ResultsOut of 392, 358 CT examinations are scored with acceptable quality. The median CTDIvol values for the weight groups are obtained as 24.6, 25.4, 25.4, 25.0, 26.0, 27.0, and 29.0 mGy. Moreover, median DLP values are obtained as 576.7, 601.0, 616.5, 636.1, 654.0, 650.0, 780.0, and 622.5 mGy.cm, respectively, for head CT without Contrast Media (CM). Similar calculation for head CT with (CM), chest without CM, abdomen without CM, and chest and abdomen (with and without CM) CTs are presented.ConclusionImages with bad, unacceptable and higher than necessary qualities contribute to increasing patient dose and increasing the DRLs. The AQD for the selected examinations were lower than the proposed DRLs in the United Arab Emirates. The integration of image quality and patients size in the assessment of the AQD values provide effective model to compare radiation dose indices within facility and compare with others. The obtained results may be useful in terms of improving dose and the diagnostic quality in the national and international levels.

Studies have shown that knee alignment parameters differ among races. However, to our knowledge, radiographic frontal plane knee alignment has not been studied in normal northern Nigerian adults. The objective of this study was therefore to determine the frontal plane knee alignment in normal northern Nigerian adults. This study recruited a total of 59 consented subjects (44 males, 15 females). The entire subjects are without any history of lower extremity deformity. Anteroposterior radiographs of both knees with the patella positioned straight ahead were obtained from each participant while standing in a relaxed bipedal stance and placing equal weight on each limb. Alignment was assessed by measuring the tibiofemoral angle (TFA), distal femoral angle (DFA) and proximal tibial angle (PTA). The angles were measured with the aid of a universal plastic goniometre and a plastic ruler. Descriptive statistics of the alignment parameters, independent and paired t-test were computed. In the male population, the mean (standard deviation) obtained were 179.06 (3.87)o for the TFA, 85.94 (3.03 o for the DFA and 89.27 (3.26)o for the PTA. In the female population, the values were 179.53 (3.38)o for the TFA, 86.40 (2.97)o for the DFA and 89.27 (2.15)o for the PTA. No significant mean difference was observed between genders in all the parameters. The TFA does not show any significant difference between the right and left angle regardless of gender. However, significant mean differences were observed in the DFA and PTA of males and combined population. No significant difference was observed in the DFA and PTA of females. Accordingly, northern Nigerian adults may have varus knee alignment compared to other races. Thus, this pre-existing varus alignment should be taken into consideration during clinical examination, preoperative planning and postoperative evaluations of knee deformities in this population.