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Edzie EKM, Dzefi-Tettey K, Gorleku PN, Brakohiapa EK, Appiah-Thompson P, Agyen-Mensah K, Amedi MK, Quarshie F, Boadi E, Kpobi JM, Edzie RA, Asemah AR. Computed tomography patterns of intracranial infarcts in a Ghanaian tertiary facility. Ghana Med J 2022; 56:28-37. [PMID: 35919779 PMCID: PMC9334949 DOI: 10.4314/gmj.v56i1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the Computed Tomography (CT) patterns of intracranial infarcts Design A retrospective cross-sectional study. Setting The CT scan unit of the Radiology Department, Cape Coast Teaching Hospital (CCTH), from February 2017 to February 2021 Participants One thousand, one hundred and twenty-five patients with non-contrast head CT scan diagnosis of ischaemic strokes, consecutively selected over the study period without any exclusions Main outcome measures Patterns of non-contrast head CT scan of ischaemic strokes. Results About 50.6% of the study participants were females with an average age of 62.59±13.91 years. Males were affected with ischaemic strokes earlier than females (p<0.001). The risk factors considered were, hyperlipidaemia (59.5%), hypertension (49.0%), Type 2 diabetes mellitus (DM-2) (39.6%) and smoking (3.0%). The three commonest ischaemic stroke CT scan features were wedge-shaped hypodensity extending to the edge of the brain (62.8%), sulcal flattening/effacement (57.6%) and loss of grey-white matter differentiation (51.0%), which were all significantly associated with hypertension. Small deep brain hypodensities, the rarest feature (2.2%), had no significant association with any of the risk factors considered in the study. Conclusion Apart from the loss of grey-white matter differentiation, there was no significant association between the other CT scan features and sex. Generally, most of the risk factors and the CT scan features were significantly associated with increasing age. Funding None declared.
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Affiliation(s)
- Emmanuel K M Edzie
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Radiology, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Klenam Dzefi-Tettey
- Department of Radiology, Korle Bu Teaching Hospital, 1 Guggisberg Avenue, Accra, Ghana
| | - Philip N Gorleku
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Peter Appiah-Thompson
- Department of Surgery, ENT, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kwasi Agyen-Mensah
- Department of Neurosurgery, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Neurosurgery, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Michael K Amedi
- Department of Radiology, 37 Military Hospital, Neghelli Barracks Liberation Road 37, Accra, Ghana
| | - Frank Quarshie
- African Institute for Mathematical Sciences (AIMS), Summerhill Estates, East Legon Hills, Santoe, Accra, Ghana
| | - Evans Boadi
- Department of Radiology, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Joshua M Kpobi
- Department of Radiology, Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Richard A Edzie
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Abdul R Asemah
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Dzefi-Tettey K, Saaka PS, Acquah I, Edzie EKM, Gorleku PN, Adjei P, Semetey JK, Ayem EKD, Insaidoo AJ, Samba A. Chest CT features of patients under investigation for Covid-19 pneumonia in a Ghanaian tertiary hospital: a descriptive study. Ghana Med J 2020; 54:253-263. [PMID: 33883774 PMCID: PMC8042805 DOI: 10.4314/gmj.v54i4.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has since December 2019 become a problem of global concern. Due to the virus' novelty and high infectivity, early diagnosis is key to curtailing spread. The knowledge and identification of chest Computerized Tomography (CT) features in Patients Under Investigation (PUI) for the disease would help in its management and containment. OBJECTIVES To describe the chest CT findings of PUI for COVID-19 pneumonia referred to the Department of Radiology of the Korle Bu Teaching Hospital; as well as to determine the relationship between symptom onset and severity of the chest CT findings. METHODS The study was retrospective and included 63 PUI for COVID-19 referred to the Department between 11th April, 2020 and 10th June, 2020, for non-enhanced chest CT imaging. Clinical data were obtained from patients' records and Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) results were acquired after the CT evaluation. RESULTS The mean age in years was 51.1±19.9 SD. More males (52.8%) than females (47.2%) tested positive for COVID-19 and the age range for positive cases was 7 months to 86 years, with a mean of 53.2±21 SD years. Common features of COVID-19 pneumonia were bilateral posterior basal consolidations, Ground Glass Opacities (GGO) and air bronchograms. Findings were worse in patients scanned 5-9 days after onset of symptoms. CONCLUSION Adequate knowledge of chest CT features of COVID-19 pneumonia, proves a valuable resource in triaging of symptomatic patients and consequent containment of the disease in the hospital setting. FUNDING None declared.
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Affiliation(s)
| | - Patience S Saaka
- Department of Radiology, Korle Bu Teaching Hospital, Accra. Ghana
| | - Isaac Acquah
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX 77030, USA
| | - Emmanuel K M Edzie
- Department of Medical Imaging. School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast. Ghana
| | - Philip N Gorleku
- Department of Medical Imaging. School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast. Ghana
| | - Patrick Adjei
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Edward K D Ayem
- Department of Radiology, Korle Bu Teaching Hospital, Accra. Ghana
| | - Arwen J Insaidoo
- Department of Radiology, Korle Bu Teaching Hospital, Accra. Ghana
| | - Ali Samba
- Korle Bu Teaching Hospital, Accra. Ghana
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Gorleku PN, Setorglo J, Ofori I, Edzie EKM, Dzefi-Tettey K, Piersson AD, Okara C, Ackom D, Adu-Gyamfi EA. Towards the scale and menace of unregulated sonography practice in Ghana. Journal of Global Health Reports 2020. [DOI: 10.29392/001c.17604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Philip N. Gorleku
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jacob Setorglo
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ishmael Ofori
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Emmanuel K. M. Edzie
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Albert D. Piersson
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Chinyerenwa Okara
- National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Daniel Ackom
- Department of Medical Imaging Sciences, Klintaps University College, Accra, Ghana
| | - Enoch A. Adu-Gyamfi
- Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, Peoples Republic of China
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Edzie EKM, Dzefi-Tettey K, Gorleku PN, Idun EA, Osei B, Cudjoe O, Asemah AR, Kusodzi H. Application of information and communication technology in radiological practices: a cross-sectional study among radiologists in Ghana. Journal of Global Health Reports 2020. [DOI: 10.29392/001c.13060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Emmanuel K M Edzie
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Philip N Gorleku
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ewurama A Idun
- Department of Radiology, 37 Military Hospital, Accra, Ghana
| | - Bernard Osei
- African Institute for Mathematical Science, Ghana, Accra, Ghana
| | - Obed Cudjoe
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Abdul Raman Asemah
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Henry Kusodzi
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Gorleku PN, Edzie EK, Dzefi-Tettey K, Setorglo J, Piersson AD, Ocansey S, Morny EK, Armah CD. Computed tomography estimation of the prevalence of neuro-ophthalmic injuries in head trauma patients seen in a tertiary health facility in Ghana. Heliyon 2020; 6:e04200. [PMID: 32613105 PMCID: PMC7322250 DOI: 10.1016/j.heliyon.2020.e04200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/09/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Prevalence of traumatic brain injury (TBI) is extremely high and potentially associated with severe incapacitating consequences. Literature reports that 90% of road traffic deaths and injuries including TBI occur in low and middle-income countries including Ghana. Computed Tomography (CT) scan is the imaging modality of choice for the initial assessment of the extent of head injury. Some Neuro-ophthalmic injuries (NOI) may sometimes be ambiguous and indistinct although a serious injury with potential damaging consequences. Data on the prevalence of NOI post trauma is non-existent in Ghana to inform policy. The onus therefore lies on the Radiologist who will review the head CT scan to be very meticulous not to miss any NOI if present. We therefore decided to diligently review a large cross-sectional retrospective post trauma head CT scans for occurrence of NOI. OBJECTIVE To determine the incidence of NOI secondary to head trauma and the possible loss of vision thereof in a retrospective study using patients' head CT scan data from a tertiary hospital's CT centre in Cape Coast, Ghana. METHOD All head CT scans secondary to trauma for the period January 2016 to December 2018, were retrieved and carefully analysed. A total number of 1043 of head CT scan images were analyzed by Consultant Radiologists. RESULTS Results showed out of 1043 CT scans reviewed, 742 (71,1%) were males and 301 (28.9%) were females. A total of 609 (58.4%) out of the 1043 patients sustained NOIs of various anatomical types. More Males 398 (65.4%) sustained NOI than females 211 (34.6%). The incidence of NOI was more among the youth as majority 167 (27.4%) of the patients were within the 18-29 years followed by 30-39 years bracket of 148 (24.3%). Fourteen anatomical types of NOI were elicited and further analysis revealed, intra-ocular foreign body to be the highest 107 (17.6%) cases, orbital floor fractures injury was 92 (15.1%) cases, with globe rupture injury and intraocular hemorrhage recording 79 (13.0%) cases each. Optic nerve injury was the least revealing 7 (1.1%) cases. There was a relationship between the gender of patient and the propensity to sustain NOI as males were more disposed to NOI than females. Road traffic accident (RTA) was the main pervasive cause of TBI and this accounted for 71.9% of all cases, followed by fall from height 24%, and the least cause of TBI was ascribed to gunshot injury of 0.33%. CONCLUSION Prevalence of NOI is high. Urgent measures must therefore be implemented to reduce the RTA menace in general and to mitigate the associated NOI and possible loss of vision thereof.
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Affiliation(s)
- Philip N. Gorleku
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- P.M.B University of Cape Coast, Cape Coast, Ghana
| | - Emmanuel K. Edzie
- Department of Medical Imaging, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- P.M.B University of Cape Coast, Cape Coast, Ghana
| | - Klenam Dzefi-Tettey
- Department of Radiology, Korle-Bu Teaching Hospital, Accra, Ghana
- PMB, Accra, Ghana
| | - Jacob Setorglo
- P.M.B University of Cape Coast, Cape Coast, Ghana
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Albert D. Piersson
- P.M.B University of Cape Coast, Cape Coast, Ghana
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Stephen Ocansey
- P.M.B University of Cape Coast, Cape Coast, Ghana
- Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Enyam K.A. Morny
- P.M.B University of Cape Coast, Cape Coast, Ghana
- Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Celso D.G. Armah
- P.M.B University of Cape Coast, Cape Coast, Ghana
- Department of Optometry, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Piersson AD, Nunoo G, Gorleku PN. An audit of clinical practice, referral patterns, and appropriateness of clinical indications for brain MRI examinations: A single-centre study in Ghana. Radiography (Lond) 2018; 24:e25-e30. [PMID: 29605121 DOI: 10.1016/j.radi.2017.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/13/2017] [Accepted: 10/21/2017] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of this study was to investigate current brain MRI practice, pattern of brain MRI requests, and their appropriateness using the American College of Radiology (ACR) Appropriateness Criteria. MATERIAL AND METHODS We used direct observation and questionnaires to obtain data concerning routine brain MRI practice. We then retrospectively analyzed (i) demographic characteristics, (ii) clinical history, and (iii) appropriateness of brain MRI requests against published criteria. RESULTS All patients were administered the screening questionnaire; however, no reviews were undertaken directly with patients, and no signature of the radiographer was recorded. Apart from routine brain protocol, there were dedicated protocols for epilepsy and stroke. Brain MRI images from 161 patients (85 Males; 76 Females) were analyzed. The age group with most brain MRI requests were from 26 to 45 year olds. The commonest four clinical indications for imaging were brain tumour, headache, seizure, and stroke. Using the ACR Appropriateness Criteria, almost 43% of the brain MRI scans analyzed were found to be "usually appropriate", 38% were "maybe appropriate" and 19% were categorized as "usually not appropriate". CONCLUSION There was knowledge gap with regards to MRI safety in local practice, thus there is the utmost need for MRI safety training. Data on the commonest indications for performing brain MRI in this study should be used to inform local neuroradiological practice. Dedicated stroke and epilepsy MRI protocols require additional sequences i.e. MRA and 3D T1 volume acquisition, respectively. The ACR Appropriateness Criteria is recommended for use by the referring practitioners to improve appropriateness of brain MRI requests.
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Affiliation(s)
- A D Piersson
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana; Corston Health System Ltd, P. O. Box GP 4560, Accra, Ghana.
| | - G Nunoo
- Department of Radiology, Korle-bu Teaching Hospital, Korle-bu, Accra, Ghana.
| | - P N Gorleku
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana.
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Piersson AD, Gorleku PN. Nephrogenic systemic fibrosis: A survey of the use of gadolinium-based contrast agents in Ghana. Radiography (Lond) 2017; 23:e108-e113. [PMID: 28965904 DOI: 10.1016/j.radi.2017.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of this study is to identify current practice of administration of gadolinium-based contrast agents (GBCAs) in Ghana. METHOD A total of 13 MRI (magnetic resonance imaging) facilities were sent a survey questionnaire to request information on their current practice with the use of GBCAs. RESULTS Gadodiamide, a high risk GBCA accounted for 67% of first line agents. 5 (42%) had a departmental protocol on the administration of GBCAs with regards to its association with nephrogenic systemic fibrosis (NSF). Of the 8 that use gadodiamide, 3 check kidney function in all patients, 2 check in selected patients, and 3 do not check at all. All 3 that screen all patients do not use contrast if the patient has an eGFR (estimated glomerular filtration rate) of 30-59 ml/min, 1 considers other modality; and if the patient has an eGFR of <30 ml/min, 2 do not use contrast but consider other modality, however 1 continues with the high risk agent. CONCLUSION Gadodiamide is widely used, with varied practice in screening for renal function, and risk factors associated with NSF. Current evidence shows that it is advisable to administer macrocyclic agents in patients with compromised renal function. It is also imperative to establish local guidelines in line with international guidelines in order to minimize the incidence of NSF.
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Affiliation(s)
- A D Piersson
- Department of Imaging Technology & Sonography, University of Cape Coast, Cape Coast, Central Region, Ghana; Corston Health System Ltd, P.O. Box GP 4560, Accra, Ghana.
| | - P N Gorleku
- Department of Imaging Technology & Sonography, University of Cape Coast, Cape Coast, Central Region, Ghana.
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Abstract
OBJECTIVE This study was carried out to determine the incidence of bony injuries in trauma patients who had plain radiographs done at the Central Regional Hospital in Cape Coast. DESIGN This is a retrospective study based on plain radiographs taken by trauma patients who reported to the Central Regional Hospital. METHOD The case notes of all patients with a discharge diagnosis of Road Traffic Accident or trauma of all aetiologies that presented to the hospital between January 2005 and December 2011 were retrieved, and those patients that had skeletal radiographic examinations were included in this study. RESULTS The total number of cases seen was 1,133. The ages of the patients ranged between 1 and 72 years. Sixty-nine (6.1%) of the patients were between 1 and 4 years old, with the majority between 20 and 49 years old, constituting 52.3%, with patients 60 years and above at 9.2%. There was statistically significant difference between male and female patients (p=0.001). A total of 912 (80.5%) patients had radiographic examination done out of which only 324 (35.5%) radiographs could be retrieved. There were 106 (32.7%) radiographs with various bony injuries which was statistically significant (p=0.001). Rib fractures represented 19/106 (17.9%) of which 62.5% had multiple rib fractures. Fifty-eight (54.7%) had long bone fractures. Other anatomical sites included the pelvis and the skull. CONCLUSION Trauma is a major public health problem in the country, involving mainly the productive age group. Unnecessary exposure to X-rays is common. Inadequate management of trauma patients negatively impacts on the outcome of trauma patients. Trauma prevention is the best way forward.
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Affiliation(s)
- G Amponsah
- Department of Anaesthesia & Pain Management, University of Cape Coast, School of Medical Sciences, Cape Coast, Ghana
| | - P N Gorleku
- Department of Medical Imaging, University of Cape Coast, School of Medical Sciences, Cape Coast, Ghana
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