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Introduction : Pulmonary CT angiography is among the most challenging protocols to execute, with significant inter-center variability in image acquisition protocols and iodinated contrast media injection. This study aimed to ascertain whether the use of iodinated contrast media (ICM) and acquisition protocols are optimized during pulmonary CT angiography procedures. Materials and methods : This multicentric cross-sectional study, descriptive and analytical with a prospective data collection was conducted in three radiology departments in Togo. It encompassed all pulmonary CT angiography examinations carried out from March 1st to June 30th, 2023. Results : In total, 89 patients, of which 52 were females (58.43%), were registered. The average age was 59.97±14.34 years. The average volume of injected ICM was 67.08±14.21 ml. The mean iodine dose was 0.31±0.07 gI/Kg. Catheters of 20 G (44.94%) and 18 G (43.82%) were most frequently used. The mean injection rate was 4.22±0.64 ml/s. The bolus test technique was the most employed (75.28%). The average acquisition delay was 17.77±12.26 seconds, while the average acquisition duration was 10.56±2.56 seconds. The average dose-length product (DLP) was 390.09±236.69 mGy.cm, and the average volumetric computed tomography dose index (CTDI_vol) was 12.31±11.69 mGy. Vascular enhancement was insufficient in 7.87% of cases. No statistically significant difference was found on the rate of insufficient enhancement and optimization factors. Similarly, there was no enhancement difference between bolus test and bolus tracking techniques. Conclusion : The vast majority of examinations allowed for optimal opacification of the pulmonary arteries. However, the optimization measures for the use of iodinated contrast media are not consistently applied.

Objective(s): to assess the knowledge and perception of nuclear medicine by radiologists in French-speaking sub-Saharan Africa. Methods: cross-sectional study conducted from April 8 to June 7 2020 including radiologists practicing in French-speaking sub-Saharan African countries. Data were collected electronically via a google form. Results: Of the 142 radiologists surveyed, 45.8% had already completed an internship in Europe, 3.52% in a nuclear medicine department and 72.54% had a nuclear medicine department in their country of practice. Among these radiologists, 21.13% knew the three main techniques of nuclear medicine and only 9.15% knew that nuclear medicine allows functional, metabolic and molecular studies. On average, 56.8% were aware of clinical indications for the main fields of nuclear medicine. In 47.18% of cases, they thought that scintigraphic imaging was more irradiating than radiological imaging, 71.1% knew about hybrid imaging techniques, 43.66% had read a scientific article on nuclear medicine, 4.93% had attended a nuclear medicine conference and 28.9% had recommended a scintigraphic imaging examination in their report. Half of them would like to see nuclear medicine and radiology merged into a single specialty and 95.77% considered it essential to create a nuclear medicine department in their country. Conclusion: The level of knowledge of radiologists in French-speaking sub-Saharan Africa about nuclear medicine was, on the whole, unsatisfactory with a generally encouraging perception.

Background. There is great variability between centers regarding contrast injection protocols. They should only be injected if they can provide useful information for diagnosis with the necessary and sufficient quantity of iodine. We wanted to know through this study if the use of iodinated contrast media is optimised in abdominal CT scans performed for cancer assessment in Lomé. Materials and Methods. It was a cross-sectional, descriptive, and analytical study with a prospective collection over a period of 6 months in three CT units in Lomé. It involved abdominal CT scans performed for oncological evaluation. Data were reported as the mean ± standard deviation. The Pearson correlation coefficient, ANOVA, chi-square, and the Fisher test were used. Results. A total of 218 examinations were recorded. The female sex represented 56.88% of the patients. The mean age was 50.92 ± 15.78 years. The mean weight was 70.46 ± 15.23 kg. The mean BMI was 24.91 ± 5.32 kg/m2. The examinations were performed with a voltage of 120 kV in 195 cases (89.45%). The mean dose of injected iodine was 0.42 ± 0.09 gI/kg with a dose of 0.40 gI/kg at 80 kV and 0.45 gI/kg at 130 kV. The mean injection rate was 2.90 ± 0.34 mL/s. The mean injected volume was 83.19 ± 7.29 mL. The mean duration of the injection was 30.60 ± 7.39 s. The mean iodine delivery rate was 0.98 ± 0.17 gI/s. There was no saline injection in 152 cases (69.72%). Liver contrast enhancement was satisfactory in 94.5% of cases. There was a strong negative linear correlation between the dose of injected iodine and weight. Conclusions. Optimization guidelines for the use of iodinated contrast media are not always applied. Therefore, monitoring and benchmarking programmes for iodinated contrast injection protocols that involve all radiology personnel should be implemented.

Abstract Background Primary squamous cell carcinoma of the endometrium is an extremely rare tumor with poorly understood pathogenesis. Case presentation We report a case of a 28-year-old Togolese woman who had consulted for vaginal bleeding and pelvic pain. Ultrasound showed thickening of the lining of the endometrium, and biopsy curettage was done. Anatomopathological examination was noteworthy for a proliferation of squamous cells often connected by union bridges arranged in tumor lobules with dyskeratotic maturation. Immunohistochemistry showed epithelial membrane antigen positivity, anti-pancytokeratin 1 markers of tumor cells positivity, chromogranin A negativity, actin negativity, S100 negativity, estrogen receptor negativity, and progesterone receptor negativity. In situ hybridization had objectified human papillomavirus genotypes 16/18. The diagnosis of primary squamous cell carcinoma of the endometrium associated with human papilloma virus was retained. A hysterectomy was performed, and the tumor was classified pT1N0M0. Conclusion The pathogenesis of this endometrial cancer is complex, and its association with human papillomavirus does not explain its genesis.

The association of breast cancer and abscess is rare in daily practice. The authors report a short series of 3 cases of cancer of the breast in nonlactating women presented as breast abscess, reviewing aspects in radiology (ultrasound and mammography), correlating them with the histopathology findings and the bacteriological profile of the isolated germs.

Neuroendocrine carcinoma (NEC) of the breast is a rare disease and has been scarcely reported by African authors. The authors report a case of breast NEC in a 13-year-old African girl initially diagnosed as an atypical adenofibroma by ultrasonography. Ultrasound-guided biopsy and conventional histological examination indicated two potential diagnoses: primary malignant non-Hodgkin’s lymphoma and undifferentiated carcinoma. According to immunohistochemistry performed on paraffin blocks in France, infiltrating ductal carcinoma with a strong neuroendocrine component was confirmed by CD56, CD57, and chromogranin A markers.

We report a case of poorly differentiated squamous cell carcinoma of the vulva induced by human papillomavirus in a 23-year-old woman, in whom we experienced diagnostic difficulties.

Le fibromatosis colli (FC) est pseudotumeur rare du muscle sterno-cléido-mastoïdien (SCM), à l'origine d'un torticolis dit congénital chez le nouveau-né ou le nourrisson. Le mécanisme étio-pathogénique de sa survenue est sujet à controverse. Son diagnostic fait appel à l'échographie qui permet de mettre en évidence un épaississement caractéristique du muscle. Nous rapportons deux cas diagnostiqués par l'échographie avec pour un cas une notion de malposition intra-utérine et pour l'autre cas une absence totale de malposition et de traumatisme obstétrical qui pourtant est évoqué comme élément du mécanisme de survenue du FC.

Le but de notre étude était de déterminer la fréquence des fractures de membres liées à l'exercice de la fonction militaire au sein des Forces de Défense et de Sécurité en milieu africain en vue de ressortir l'impact des différentes circonstances de survenue. Nous avons entrepris une étude rétrospective descriptive allant du 1er janvier 2004 au 31 décembre 2013. Elle a concerné les agents des forces de défense et de sécurité traités pour des fractures de membres au cours de notre période d'étude. Sept cent quatre (704) cas de fractures de membres ont été dénombrées. La moyenne d'âge des patients était de 30,57 ans avec des extrêmes de 19 et 55 ans et une nette prédominance masculine (95,71%). L'Armée de Terre (51,05%) et la Gendarmerie Nationale (38,86%) étaient les plus représentées. Les hommes du rang étaient majoritaires (43,08%), suivis des sous-officiers (32,59%). La fréquence annuelle des fractures de membres en rapport avec la profession militaire était de 63 cas. Les fractures de jambe étaient les lésions les plus recensées (32,96 %). Les Formations et les stages militaires ont été les circonstances de survenue les plus rencontrées (42,60 %), suivies des accidents de la circulation (39,43%). La perte des journées de service liée à ces lésions était estimée à 14009 jours par an. Les fractures de jambes occupent le premier rang des fractures de membres en rapport avec l'exercice de la profession militaire. Les formations-stages militaires et les accidents de la voie publique en sont les deux grandes circonstances de survenue.

La cysticercose a une prévalence élevée dans les pays sub-sahariens et son diagnostic reste difficile. Cette étude a pour but de déterminer la valeur diagnostique de la tomodensitométrie dans la cysticercose cérébrale. Recrutement des patients ayant bénéficié d'une tomodensitométrie cérébrale dans l'une des circonstances suivantes: épilepsie, hypertension intracrânienne, syndrome pyramidal, détérioration mentale, ataxie locomotrice ou une diminution de l'acuité visuelle. Les critères de Del Brutto et al. avaient permis de retenir le diagnostic positif de cysticercose cérébrale. Pendant la période, 4193 patients avaient été inclus à l'étude, dont 140 cas de cysticercose cérébrale (3,3%). L'âge moyen des patients de cysticercose cérébrale était de 36 , 14 ans, avec des extrêmes de 17 ans et 59 ans. La sensibilité et la spécificité de la tomodensitométrie dans la cysticercose cérébrale sont respectivement de 96,4% et 98,3%. La valeur prédictive positive et la valeur prédictive négative de la tomodensitométrie sont respectivement de 65,9% et 99,8%. Les aspects tomodensitométriques chez les vrais positifs sont dominés par des lésions associées, 72 cas (53,3%), suivies d'une hypodensité nodulaire arrondie unique ou multiple sans prise de contraste iodée, 17cas (12,6%). La TDM est une technique d'imagerie qui a une sensibilité et une spécificité élevées dans le diagnostic de la cysticercose cérébrale. Cependant, les autres critères de diagnostic restent utiles du fait de l'existence de nombreux cas de faux positifs à la tomodensitométrie.

The chest wall tuberculosis abscesses is rare. We present a case of a 27-year-old immunocompetent male who presented chest wall abscesses. Imaging (chest radiographic, ultrasound, and computed tomography) and Ziehl-Neelsen staining demonstrated chest wall tuberculosis abscesses.

The goal of this study was to assess risk for CIN after CT Scan during an emergency and to identify risk factors for the patient. Prospective review of all patients admitted to the emergency room (ER) of the Teaching Hospital of Lomé (Togo) during a 2-year period. CIN was defined as an increase in serum creatinine by 0.5 mg/dL from admission after undergoing CT Scan with intravenous contrast. A total of 620 patients underwent a CT Scan in the emergency room using intravenous contrast and 672 patients took the CT Scan without intravenous contrast. Out of the patients who received intravenous contrast for CT Scan, three percent of them developed CIN during their admission. Moreover, upon discharge no patient had continued renal impairment. No patient required dialysis during their admission. The multivariate analysis of all patients who had serial creatinine levels (including those who did not receive any contrast load) shows no increased risk for acute kidney injury associated intravenous contrast (odds ratio = 0.619, p value = 0.886); only diabetes remains independent risk factor of acute kidney injury (odds ratio = 6.26, p value = 0.031).