Anterior cruciate ligament (ACL) rupture is one of the most frequently encountered traumatic ligamentous lesions of the knee. Several intrinsic and extrinsic factors are linked to this lesion. Anatomical factors increase the anterior translation of the knee and thus promote the stretching and rupture of the anterior cruciate ligament. Objectives: To determine the anatomical risk factors favouring ACL rupture by comparing morphometric parameters of patients with knee ACL rupture to patients without ACL rupture, as well as the intercondylar notch index and the tibial slopes of the two groups and describing the ruptured ACLs and associated signs. Materials and Methods: We conducted a case-control descriptive analytical study in imaging centres of the General Henri Mondor of Aurillac Hospital Centre in France (CHM) and the Jordan Medical Centre of Yaoundé in Cameroon (CMJ). MRI exam protocols included T1 SE, T2 SE, proton density and Fat Sat sequences, with slices in all three planes. Morphometry knee variables measured in our study were: intercondylar notch index and the tibial slopes. These measurements were obtained from images stored in DICOM format and post processing software OsiriX MD ® for CMJ patients and Explore ® for CHM patients. Results: The study included 92 individuals, 38 in the case group and 54 in the control group. The mean age was 36.6 years for both groups; 35.5 years for the cases and 37.4 years for the controls. The sex ratio was 1.87 men for 1 woman in
CT-scan is the most irradiating tool in diagnostic radiology. For 5% -10% of diagnostic X-ray procedures, it is responsible for 34% of irradiation according to UNSCEAR. Patients radiation protection must therefore be increased during CT-scan procedures. This requires the rigorous application of optimization principle which imposes to have "diagnostic reference levels". Objective: The aim of this study was to determine the diagnostic reference levels (DRLs) of the four most frequent CT-scans examinations of adults in Cameroon. Material and Method: It was a cross-sectional pilot study carried out from April to September 2015 in five health facilities using CT-scan in Cameroon. The studied variables were: patients age and sex, type of CT-scan examination (cerebral, chest, abdomino-pelvic, lumbar spine), Used of IV contrast (IV−/ IV+), acquisition length, time of tube rotation, voltage (kV), mAs, pitch, thickness of slices, CTDIvol and DLP. For each type of examination, at least 30 patients were included per center, consecutively on the randomly predetermined days. The DRL for each type of examination was defined as the 75th percentile of its PDL and CTDIvol. Results: Of the 696 examinations, 41.2% were cerebral, 26.9% abdomino-pelvic, 17.7% lumbar spine and 14.2% chest. •cm] respectively for cerebral, lumbar spine, abdominopelvic and chest CT-scans. Taking in consideration the number of detectors, the 75th percentile of the Dose-Length product decreased with the increase number of detectors for cerebral examinations but was the highest with 16 MDCT for the abdominopelvic, lumbar spine and chest CT-scans. For the chest and lumbar spine examinations, there was a significant increase in patient-dose with the increase in the number of detectors. Conclusion: Our DRLs values lie between the norms of some European countries and those of some African countries. There is remarquable variation in dose for the commonest CTscans examinations in Cameroon, requiring then an optimization process from these determined DRLs and establishment of national DRLs. Special attention to optimization should be paid when using 16 MDCT.
Background: Urethral stricture is a disabling condition that remains prevalent due to the upsurge of sexually transmitted infections and traumatic lesions of the urethra during trauma of the pelvis in humans. Objective: Describe the epidemiological, clinical and radiological presentations of male urethral strictures. Method: It was a cross-sectional and descriptive study during a one-year period from January to December 2017 including all male patients presenting for a urethrocystography examination, at the Ngaoundere Radiology and Medical Imaging Center who agreed to participate. The urethrocystography technique depended on patient's condition and was either retrograde, anterograde, or following intravenous urography. The examinations were performed with GE X-ray equipment using Kodak Dry View CRs. The interpretation was performed by a radiologist with at least five years of experience. The variables studied were age, clinic, history, uretrocystography technique and results. The data were collected using a previously established data sheet and processed with Sphinx Plus2 V5 and Microsoft Excel 2010 software. Results: 39 patients were enrolled in this study; the average age of our patients was 43.8 years with extremes of 4 and 76 years. The 50-60 age group (30.7%) was the most affected. Infection (53.9%) and trauma (23.1%) were the most common etiologies; dysuria (38.5%) and diminution of urinary flow (30.8%) were the most patient's complaint. Retrograde urethrocystography (66.7%) was the most performed technic. Minimal bleeding in 46.2% of patients was the most common incident during urethrocystography; 76.9% of patients had a difficult urination and 7.7% an impassable urethral meatus. After interpretation, 84.6% of patients had urethral stenosis, which How to cite this paper: Guena, M.N.,
Objective: Bleeding during the first trimester of pregnancy is common and can be a sign of complication that often necessitates obstetric ultrasound for the assessment of the haemorrhage, and of fetal well being. The aim of this study was to determine the causes of first trimester bleeding on obstetrical ultrasound in our area. Method: It was a cross-sectional descriptive study during a six-month period from May to October 2017. All women who referred to the Regional center of medical imaging of Ngaoundere who agreed to participate in the study with first trimester bleeding were evaluated with clinical history and ultrasonography (US). Ultrasonographic exam was done via transabdominal or endovaginal approaches using GE LOGIQ 7 scanner brand. Microsoft Office Excel 2010 and SPHINX V 4.0 were used for data analysis. Results: A total of 121 of pregnant women who presented vaginal bleeding during the first trimester were enrolled into the study. These Ultrasound examinations represented 37.93% of all obstetric ultrasounds in the first trimester. The patients in this study ranged in age from 16 to 47 years with an average of 30 years. 50 (41.32%) were pregnant for the first time and 24 (19.83%) were primiparous. Mean gestational age was 9 weeks with the extremes of 5 and 12 weeks. 97 (80.2%) reported spontaneous bleeding while in 24 (18.8%) bleeding was mostly caused by sexual intercourse 11 (45.8%). Pelvic pain 91 (75.2%) was the most associated sign. 36 (29.8%) patients were diagnosed as threatened abortions. 27 (22.3%) were diagnosed with incomplete abortions. 4 (3.3%) cases showed an ectopic gestation. 9 (7.4%) cases showed complete abortions. Concordance between clinical diagnosis and ultrasound results was 84%. Conclusions: Bleeding in the first trimester of pregnancy is common in our area. Ultrasonography occupies a prominent place in the etiological diagnosis of bleeding in the first trimester of pregnancy;
Objectives: Osteoarticular pathology has benefited greatly from MRI. This modality was only recently introduced in our country and its implantation is still rare. The objective of this study was to evaluate the practice of MRI of osteoarticular system in Douala General Hospital. Method: It was a cross-sectional descriptive study during a five-month period from May to September 2017 involving all patients referred to the Imaging Department of the Douala General Hospital for osteoarticular MRI. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using axial, sagittal and coronal slices in T1-weighted, T2-weighted proton density. T1 gadolinium or water-fat saturation (WFS) slices were obtained after injection of a contrast agent (Dotarem). Collected data were analyzed using SPSS v20 and Microsoft Excel 2010 softwares. Results: 34 patients were enrolled in this study; osteoarticular MRI accounted for 12% of the activity behind MRI of the spine (40.4%) and the brain (42.5%). The mean age of patients was 37.6 ± 13.1 years with extremes between 6 and 61 years. There was male predominance with a sex ratio of 1.83. Trauma (44.2%) and pain (42.1%) were the most common indications. MRI of the lower limb (85.3%) and more particularly of the knee (68.9%) was more frequently performed than that of the upper limb (14.7%). Orthopedic surgeons (38.2%) and rheumatologists (26.5%) were the main referral physician. 73.5% of request's forms did not conform to the eight compliance criteria according to the recommendations of French National Agency for Accreditation and Health Evaluation. Most of the examinations (94.1%) were performed without the injection of contrast agent (Dotarem). 97% of MRI was pathological. Traumatic pathologies (39.4%
Uterine rupture is defined as the occurrence of communication between the abdominal and uterine cavity and may be complete or incomplete depending on the degree of involvement of the different layers of the uterus and surrounding organs. It is a rare complication whose consequences often involve the maternal and fetal prognosis. The majority of uterine rupture occurs on the scarred uterus, its incidence in France is estimated according to the series between 1/1000 and 1/2000 births, it represents 30% of causes of maternal death in the developing countries. The authors report here a case of uterine rupture outside of labor at 33 weeks of age in 32 years old woman, gravida 9 para 8, with no history of uterine surgery discovered during obstetric ultrasound for abdominal pain. During the interrogation, she was alarge multipara and had a child of 15 months. The abdominal ultrasound showed a right lateral corporeal rupture with hemoperitoneum of medium sized and a dead fetus. The emergency laparotomy revealed a right lateral uterine wound approximately 15 cm long with intra-abdominal placenta and a haemoperitoneum of medium sized of about 600 cc and a bladder lesion. After opening the amniotic sac, there was extraction of a dead fetus. The uterine and bladder lesions were repaired followed by bilateral tubal ligation. The patient received 500 cc of whole blood during and 500 cc after the procedure. The postoperative follow-up was simple. This case contributes to the knowledge of this rare and atypical event, and emphasizes the importance of maintaining a suspicion.
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