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Background: This study aimed to describe the results of mammography done during breast cancer awareness campaigns in Lome. Methods: This was a retrospective multicenter study which focused on the analysis of mammographic examinations, with or without breast ultrasound, carried out in three (3) clinics in Lome over a period of five (5) years during the breast cancer awareness month (Pink October) campaigns. We included in our study women of all ages who underwent a mammography during the study period. Additional ultrasound was performed as needed in some women to better characterize a lesion. The parameters studied were socio-demographic data, and aspects of breast lesions. We classified the lesions in order of severity according to the BI-RADS classification. Results: During the study we counted one thousand and seventy-four (1074) women who underwent mammography examinations, corresponding to an average of 214.8 women per year. The median age of the women was 46 years. The most represented age group was 40 - 49, constituting 30% of cases. Mammography was performed on all women and ultrasound was performed on 51.3% of women. Lesions suspicious for malignancy (BI-RADS IV) and lesions highly suggestive of malignancy (BI-RADS V) represented 3.5% and 1.9% of cases respectively, amounting to a prevalence of 5.4%. They occurred more frequently from the age of 30 years with a statistically significant difference (p = 0.02). These lesions could be identified on mammograms as masses with irregular shapes and spiculated margins representing 16.1% and 9.7% of masses respectively. On ultrasound, these were solid masses with irregular and ill-defined borders, representing 25.2% and 5.2% of solid masses respectively. Lesions suspicious for malignancy were most often found in the UOQ (upper outer quadrant) in 70% of cases. Conclusion: Mammography screening for breast cancer remains a necessity in our community, even if the rate of cancer detected remains low. It allows for early diagnosis of cancers, promoting better management.

Background: This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. Materials and methods: This opinion survey was administered to radiology technicians in French-speaking West Africa from 1st June to 31st October 2020, i.e. over a period of 5 months concerning their level of CME and their need for CME. Results: Out of 100 technicians, 69% were men. The mean age was 40 years, with extremes ranging from age 23 to age 57. The majority of technicians (64%) worked in the public sector and 78% had work experience of less than 11 years. Most technicians were holders of a Bachelor’s degree (73%). The types of CMEs they knew were congresses, seminars, and modular training in 46% of the cases. The most available CMEs were seminars (63%). All technicians agreed on the need for CME and 96% said it had an impact on the delivery of radiology services. Technicians who had received CME at least once represented 61%. For 90% of technicians, the specific CME sought was management in radiology (33.33%) and radiation protection (25.81%). Conclusion: The need for CME is increasingly indisputable to radiology technicians in French-speaking West Africa; however, it remains a luxury for them, due to its scarcity and its high cost.

Background: “Gossypiboma” or “textiloma” refers to accidental retention of textile material in an operated area of the body. Abdominal surgery is most often responsible for this complication. The purpose of our study was to describe the appearance of abdominal gossypibomas on computed tomography (CT) scan images. Materials and Methods: We conducted a retrospective study over ten years (from January 1, 2009 to December 31, 2018) at the Teaching University Hospital of Lome. We collected all surgically confirmed cases of abdominal gossypibomas with abdominal CT scans. Results: Fifteen cases were compiled, with a sex-ratio of 0.36. The average age of the patients was 34 years. The initial surgery was emergent in nine of 15 cases, 11 of which consisted of gynecological interventions. The gossypiboma symptom incubation period was between 3 days and 3 years. A radiopaque marker was observed via CT scans in three of 15 cases. The gossypiboma appeared encapsulated and spongiform in six cases and cystic in seven cases. There were two cases where the gossypiboma migrated into hollow organs. Conclusion: Abdominal gossypibomas appear polymorphic on CT scans and should be considered in patients who present with an abdominal mass and a history of abdominal surgery, even for absent radiopaque markers.

Background: Ultrasound is the main method of exploring the prostate. In benign prostatic hyperplasia (BPH), it provides important morphological information and assesses its impact, helping to guide the treatment. Objective: To compare intravesical prostatic protrusion (IPP) and middle lobe volume by ultrasound in BPH. Method: This was a single center prospective, descriptive and analytical study, over a period of 6 months, including 95 patients, undergoing prostatic trans-abdominal ultrasound. Patients were selected by a single urologist for clinical suspicion of benign prostatic hypertrophy. The ultrasound examination was done by a single senior radiologist. Results: The mean age of the patients was 66.63 ± 11.55 years with ranges from 38 to 98 years. The prevalence of BPH was 76.84%. The rate of patient with middle lobe protrusion was 48.42%. The mean middle lobe volume was 11.29 ± 12.90 ml. More than half of the patients (50.91%) had an IPP stage 3 of. The mean bladder wall thickness was 6.08 ± 2.58 mm, with 50.53% being pathological. The post-voiding residue (PVR) was significant in 38.75% of patients. Renal repercussions were present in 17.89%. The correlation analysis did not note a statistical link between prostate volume and quality of life score (p > 0.05). There was a statistically significant correlation between IPP values and quality of life score (p = 00461), IPSS score (p = 0.0424) and PVR (p = 0.0395). For middle lobe volume, there was a correlation with PVR (p = 0.0018). There was no correlation with clinical impact (quality of life score and IPSS score). Conclusion: The IPP appears to be an easy element to measure and better than the volume of the prostate and the middle lobe in assessing the impact of BPH.

Internal carotid artery (ICA) dissection is a dangerous condition that results from disruption of the intimal part of the wall of the internal carotid artery. It is a rare disease that may occur spontaneously or as a result of a trauma. Spontaneous dissections of the carotid artery are rare but important causes of ischemic stroke because they usually affect young and middle-aged patients. Up to date, only a few cases were described in the literature about ICA dissection causing isolated cranial nerve palsies, with the Hypoglossal nerve being the most affected. Here, we report a case of a 56-year-old man presenting with progressive dysarthria, dysphagia to liquid diet, and difficult mastication. He was diagnosed as a case of cervical internal carotid dissection with pseudoaneurysm formation causing mass effect resulting in a compressive ipsilateral Hypoglossal nerve palsy based on magnetic resonance imaging (MRI) findings. Angiography confirmed the presence of dissecting pseudoaneurysm which was eventually managed by stenting. This case was reported to highlight and emphasize the importance of radiology, whether diagnostic or interventional, in managing rare and challenging cases such as ICA dissection.

Pleuropulmonary blastoma (PPB) is a rare malignant intrathoracic mesenchymal tumour with a variable aggressiveness. It is the most common primary malignancy in the lung during childhood. In this study, we present a case of a 3-year-old male child who complained of persistent dry cough. Radiographs suggested the diagnosis of PPB, which was been confirmed by the histo-pathological examination of a biopsy taken from the tumour under CT guidance. This case was reported to emphasise the importance of radiology, whether diagnotic or interventional, in diagnosing rare cases such as PPB.

La panniculite mesenterique est une maladie rare et benigne caracterisee par un processus inflammatoire et fibrotique chronique qui affecte le tissu adipeux mesenterique. Elle atteint souvent le sujet adulte de sexe masculin. Son etiologie reste inconnue. L´aspect tomodensitometrique de la PM varie selon l´importance de l´inflammation et de la fibrose. Nous rapportons deux cas de panniculite mesenterique reveles par une douleur abdominale. Le diagnostic a ete pose sur la base des donnees de la tomodensitometrie. Nous rappelons a travers ces cas, les aspects cliniques et tomodensitometriques de cette affection rare.

La dysplasie thanatophore est une dysplasie osseuse letale rare. Elle est causee par une mutation du gene FGFR3 (Fibroblast growth factor receptor 3), localise sur le bras court du chromosome 4. Il existe deux sous-types qui se ressemblent beaucoup dans leur caracteristiques cliniques mais ont cependant des caracteristiques radiologiques et mutations genetiques distinctes. Le diagnostic precoce est imperatif et est base sur les donnees de l´echographie antenatale. Nous rapportons un cas de dysplasie thanatophore de type I, diagnostiquee a 26 SA par une echographie antenatale de routine chez une femme âgee de 34 ans sans antecedent malformatif familial connu. Les elements echographiques qui ont oriente le diagnostic sont : une etroitesse de la cavite thoracique, un aspect raccourcit des os des membres avec un aspect incurve des femurs et un rapport BIP/LF de 3,8. Une interruption medicale de la grossesse a ete faite sur decision du couple apres information eclairee sur la pathologie fœtale. Une photo du fœtus et une radiographie corps entier post-mortem ont ete realisees et ont confirme le diagnostic de DT de type I. Vue la rarete de cette affection, nous proposons a travers ce cas rappeler les aspects diagnostiques de cette anomalie fœtale.

Intestinal duplications are rare malformations and hail sites are the most common. Today, the diagnosis is made in antenatal because of the performances of antenatal ultrasound.This was a 15-month-old male infant received for constant crying, vomiting and increased abdominal volume that had been evolving for two weeks. An abdominal ultrasound was performed and objectified an intraperitoneal cyst formation of 30 x 27 mm, surrounded by a stratified wall and contiguous to a digestive loop. Surgery was performed and confirmed the existence of non-communicating ileal duplication.Intestinal duplication is a rare malformation. Ultrasound is often sufficient for diagnosis based on the presence of a characteristic double-walled cystic mass.

Background: Radiology in elderly as pediatric radiology poses a number of problems. The normal radiological appearance of the elderly patient’s chest is very varied and the changes are ubiquitous. Purpose: To describe the computed tomography profile of the elderly subject’s chest. Materials and Methods: Descriptive prospective study from January 1st to June 30th, 2018 carried out at the University Campus Hospital of Lome. Results: We recorded 64 chest CT scans. The average age of the patients was 71.3. Internists (n = 21, 32.8%) and general practitioner (n = 16, 25%) were the major applicants for these tests. In most cases, thoracic CT examinations were requested as part of an extension assessment (n = 21, 32.8%), dyspnea and pneumonitis in 18.8% of cases each. All thoracic CT examinations were performed with contrast injection. CT with the TAP protocol was the most observed, accounted for more than half of the exams (56%). The main pathological lesions observed were diffuse parenchymal lesions (39.5%), pleurisy (11.1%) and PAH (11.1%). Conclusion: Computed tomography occupies an important place in the care of the elderly but the actors involved in their care must be trained to take optimal care.

We evaluate the level of knowledge of clinician doctors asking for echographies on the biological effects of ultrasounds and their attitudes towards ultrasounds examinations performed in Lome. Transverse study based on a survey led from August 16th till November 30th, 2013 including 105 doctors applicant of ultrasound in Lome (Togo). The middle age of the applicant doctors was of 34 years with a sex-ratio of 4/1 and more than half practiced in public facilities. Approximately ten percent applicants thought that the ultrasound is an irradiant exam and those practicing for less than 5 years were the ones who had a good level of knowledge on the not irradiant character of the ultrasounds. The existence of the thermal and mechanical effects of the ultrasounds was known only by 4.8% of the applicants and only 1.9% of the doctors had information on the thermal index (TI) and the mechanical index (MI). More than half (66.7%) analyzed the ultrasound images joined to the report but none verified the conformity with the standards of the values of the TI and at MI shown on the images. They were 43.5% to read only the conclusion. The level of knowledge of the doctors on the biological effects of the ultrasounds is unsatisfactory. The ultrasounds although not irradiant, have biological effects imposing precautionary measures which have to guide the attitude of the applicants towards the ultrasonographic explorations.

Background: Ultrasound has become the most widely practiced medical imaging examination even in developing countries because of its non-irradiating, non-invasive nature and its relatively affordable cost. Objective: The objective of this study was to review the practice of medical ultrasound in Lome city. We carried out a descriptive cross-sectional study using the pre-established fact sheets. It took place from 16 August to 30 November 2013 in the healthcare facilities of the city of Lome. Results: A total of 47 centers were surveyed, including 14 public centers and 33 private centers. The ultrasound scanners were mostly acquired in the new state (59.6%) with only 34.1% of these ultrasound scanners equipped with the Doppler mode. There were 3 ultrasound scanners (6.4%) that had a 3D probe. Radiologists were the ones who carried out most of the ultrasound examinations in public centers, while in private they accounted for half of the performers (45.5%). Physicians enrolled in a specialty in radiology played a significant role in these private structures, accounting for 24.2% of performers. Cardiac ultrasound was performed only in 2 centers (4.2%). The ultrasound report was available in all public centers using the pre-established and standardized forms. The qualification of sonographers and the status of ultrasound scanners are relatively acceptable. Conclusion: Ultrasound scanners were mostly acquired in new condition. Radiologists remained the ones who carried out the largest number of ultrasound examination in Lome.

We report the case of a 50-year-old patient, who was explored in mammography, ultrasound and CT for a large painful mass of the right breast that had been evolving for 30 years and gradually increasing in size. There was a typical “sausage slice” appearance with clear center macrocalcifications on the mammogram; an aspect of “breast in the breast” on ultrasound. The scanner had made it possible to specify the dimensions of the mass, which measured 21.4 cm in height; 18.6 cm wide and 9.5 cm thick. Histology after exeresis noted the adenolipofibromatous nature of the mass.

Background: Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions. It is safe, cost-effective and minimally invasive compared with surgical excision. Objective: The aim of this study was to evaluate the CNB’s results regarding the procedure, complications, histopathological findings and their correlation with the imaging data and surgical histopathological findings. Method: A cross-sectional prospective and descriptive study of a consecutive series of ultrasound-guided CNB of breast lesions in women conduced from January 2015 to December 2016 at the Sylvanus Olympio university hospital of Lome, in Togo. Results: There were 72 CNB performed under ultrasound guidance in women; from which 54 were retained for the study. The mean age was 44.9 years ± 9.8. 11.1% had a family history of breast cancer. Lesions were most often palpable (90.7%). They were located in the left breast in 54.7%. Lesions were categorized probably malignant or malignant (Birads 4 and 5) in 70.4% and probably benign (Birads 3) in 29.6%. Their mean size was 24.8 mm ± 7.6 at ultrasound. There were no major complications during the procedure. One CNB (1.9%) considered inconclusive was repeated. Histologically, invasive ductal carcinoma (61.1%) was the most common lesion. Fifty-three women underwent surgical procedure and histopathological confirmation. Ultrasound-guided CNB had a sensitivity of 97.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.8%, and an overall diagnostic accuracy of 98.1%. Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8%, specificity of 100%, positive predictive value of 100%, negative predictive value of 87.4%, and diagnostic accuracy of 96.2%. Conclusion: Ultrasound guided CNB represent accurate methods for the characterization of breast lesions, with high values of diagnostic accuracy, sensitivity, specificity and negative predictive value. It does not involve a major complication, even in tropical environments.

Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lome. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.

Background Gossypiboma or textiloma is an accidental retention of a textile in the operated area of the body. Abdominal surgery is the most responsible for these complication. The purpose of our study was to describe aspects observed in abdominal gossypibomas on CT-scan. Methods A retrospective study was conducted over 10 years (from January 1st, 2009 to December 31st, 2018) at the Teaching University Hospital of Lomé, including all the surgically confirmed cases of the abdominal gossypibomas who had abdominal CT-scan. Results Fifteen cases have been compiled, with a sex-ratio of 0.36. The average age of the patients was 34 years old. The initial surgery was an emergency intervention in 9/15 cases. It was a gynecological intervention in 11/15 cases. The incubation period of the symptoms related to textiloma was between 3 days and 3 years. On the CT-scan, a radiopaque marker was observed in 3/15 cases. An encapsulated and spongiform aspect in 6/15 cases. A cystic form was observed in 7/15 cases. We have noticed two cases of migration of the textiloma into a hollow organs.

Background: In French-speaking sub-Saharan Africa, thanatological imaging is not integrated into the training of radiology technicians. Thus, this raises a question about the knowledge level of radiology