SA Journal of Radiology

<font color="#000080">The <em>SA Journal of Radiology</em> is the official journal of the Radiological Society of South Africa and the Professional Association of Radiologists in South Africa and Namibia. The SAJR is a general diagnostic radiological journal which carries original research and review articles, pictorial essays, case reports/series, letters, editorials, radiological practice and other radiological articles.<br></font><br>

List of Papers (Total 588)

Diagnostic yield and accuracy of paediatric image-guided fine needle aspiration biopsy of deep organ tumours

BACKGROUND: Paediatric tumour cytological diagnosis by image-guided fine needle aspiration biopsy (FNAB) with rapid on-site evaluation (ROSE) has not gained wide acceptance despite increasing publications advocating the procedure. OBJECTIVE: The primary aim was an audit of the diagnostic yield and accuracy of paediatric image-guided FNAB with ROSE at a single institution...

Corrigendum: Radiology subspecialisation in Africa: A review of the current status

CORRECTION Corrigendum: Radiology subspecialisation in Africa: A review of the current status Efosa P. IyaweI; Bukunmi M. IdowuII; Olasubomi J. OmoleyeIIIICollege of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria IIDepartment of Radiology, Union Diagnostics and Clinical Services PLC, Yaba, Lagos State, Nigeria IIIDepartment of General Medicine, LouisMed Hospital and...

Revisiting the forgotten remnant: Imaging spectrum of Meckel's diverticulum

Meckel's diverticulum is a true diverticulum of the alimentary tract occurring resulting from the persistence of remnants of the vitello-intestinal duct. They are often asymptomatic and incidentally diagnosed during surgery. Complications such as intestinal obstruction, diverticulitis, intestinal haemorrhage and perforation may occur with Meckel's diverticulum, which renders them...

A lumpy bumpy stomach: The more the murkier

This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review...

A case report of multinodular hepatic steatosis mimicking pseudotumors of the liver

Fatty liver disease (FLD) is a common, benign pathology often found incidentally. We present a clinical case in which metastatic liver disease was suspected on initial imaging studies. Following further investigations, a diagnosis of 'non-alcoholic fatty liver disease (NAFLD), multinodular type' was postulated. Subsequent histology confirmed the presence of liver steatosis...

A rare case of tuberous sclerosis complex-associated renal cell carcinoma

Renal cell carcinoma is rarely described in paediatric patients with tuberous sclerosis complex. This report describes a case of an 11-year-old male with tuberous sclerosis-associated renal cell carcinoma.Keywords : tuberous sclerosis complex; renal cell carcinoma; paediatric; neuro-cutaneous; hamartomas.

Factor XIII deficiency in a neonate presenting as subpial haemorrhage

Subpial haemorrhage is a rare cause of seizures in term neonates. A 3-day-old male infant, born at term with no history of perinatal hypoxia, presented with seizures and unremarkable physical examination in the interictal state. Imaging demonstrated left temporal subpial haemorrhage with the classic 'yin-yang sign' on MRI. The patient was subsequently diagnosed with factor XIII...

Cervical extension of pancreatic pseudocyst: An unusual cause of neck stiffness and dysphagia

Pancreatic pseudocyst is a common complication that can occur following acute or chronic pancreatitis. Commonly, they are peripancreatic in location. Rarely, they can extend to the mediastinum, and further extension to the neck is even rarer. A 55-year-old man who presented with neck stiffness and dysphagia and on imaging, was found to have a cystic lesion in the neck. Aspiration...

Diagnosing rare intraductal biliary neoplasms - Intraductal papillary neoplasm of the bile duct: A case report with typical imaging findings

Intraductal papillary neoplasm of the bile duct (IPN-B) is a rare preinvasive intraductal pathology of the biliary tract. It should be differentiated from other more common benign or malignant causes of biliary obstruction and dilatation such as calculi or cholangiocarcinoma because the management and prognosis of this condition differs significantly. This case report describes a...

Sellar spine: A rare Bony variant of the Sella Turcica

A sellar spine is a rare osseous projection from the dorsum sellae, resulting in variable compression of sellar and suprasellar structures and varied clinical presentations. CT is the diagnostic modality of choice, while variable signal intensity on MRI may mimic a pituitary microadenoma. A patient presented with hypoprolactinaemia and puerperal alactogenesis due to a sellar...

Temporal trends in ultrasound utilisation in the radiology department of a tertiary hospital

BACKGROUND: Little is known about the combined impact of increasing ultrasound usage by clinical disciplines outside radiology and technical advances in other specialised radiological modalities on the role of ultrasound in tertiary-level radiology departments OBJECTIVES: The aim of this study was to evaluate temporal trends in ultrasound utilisation in a tertiary-level radiology...

Stereotactic breast biopsies: Radiological-pathological concordance in a South African referral unit

BACKGROUND: Stereotactic breast biopsies have become the gold standard for tissue diagnosis in non-palpable, sonographically occult breast abnormalities seen on mammogram. Only limited data exist in South Africa on the correlation between imaging findings and stereotactic biopsy histology OBJECTIVES: To describe the mammographic findings and histological diagnosis in patients who...

The effectiveness of the pregnancy adapted YEARS algorithm to safely identify patients for CT pulmonary angiogram in pregnant and puerperal patients suspected of having pulmonary embolism

BACKGROUND: Pulmonary thromboembolism is one of the leading causes of maternal death worldwide. Globally there has been increasing physician reliance on CT pulmonary angiogram for definitive diagnoses and exclusion of pulmonary thromboembolism. The problem, however, arises when considering the high radiation penalty from performing these investigations, highlighted by the low...

A 6-year audit of public-sector MR utilisation in the Western Cape province of South Africa

BACKGROUND: Disparities in MR access between different countries and healthcare systems are well documented. Determinants of unequal access within the same healthcare system and geographical region are poorly understood OBJECTIVE: An analysis of public sector MR utilisation in South Africa's Western Cape province (WCP METHODS: A retrospective study of WCP MR and population data...

Appropriateness of imaging modality choice by doctors at the Kenyatta National Hospital's Accident and Emergency Department

BACKGROUND: Clinical imaging guidelines assist doctors in selecting the most appropriate radiological investigation(s) according to the patient's clinical presentation and also help to avoid unnecessary radiation exposure OBJECTIVES: This study aimed to determine the appropriateness of choice of imaging procedures requested by the doctors in the Accident and Emergency Department...

Diagnostic accuracy and inter-reader reliability of the MRI Liver Imaging Reporting and Data System (version 2018) risk stratification and management system

BACKGROUND: Hepatocellular carcinoma (HCC) can be diagnosed non-invasively, provided certain imaging criteria are met. However, the recent Liver Imaging Reporting and Data System (LI-RADS) version 2018 has not been widely validated OBJECTIVES: This study aimed to evaluate the diagnostic accuracy and reader reliability of the LI-RADS version 2018 lexicon amongst fellowship trained...

Paediatric minor head injury applied to Paediatric Emergency Care Applied Research Network CT recommendations: An audit

BACKGROUND: Traumatic brain injury (TBI) is a common cause of paediatric morbidity and mortality, with higher TBI rates in low- and middle-income countries. Non-contrast brain CT is the gold standard for diagnosing intracranial injuries; however, it exposes patients to ionising radiation. The Paediatric Emergency Care Applied Research Network (PECARN) clinical decision rule (CDR...

A digital audit of emergency upper gastrointestinal fluoroscopy workflow in children with bilious vomiting

BACKGROUND: Bilious vomiting in children requires an urgent evaluation with upper gastrointestinal (UGI) fluoroscopy as it may herald life-threatening midgut malrotation with volvulus (MMWV). There are no published data available on the duration of time-critical UGI workflow steps. OBJECTIVES: A digital audit of workflow in emergency UGI contrast studies performed on children...

Primary giant cell tumour of the breast with recurrence: A rare case report

Giant cell tumour (GCT) arising from the soft tissues of the breast is a rare disease with only eight cases previously reported in the literature. We present a case of histologically proven GCT of the breast, which demonstrated recurrence a few months after resection.Keywords : giant cell tumour; breast tumour; GCT-ST; breast imaging.

An audit of the adequacy of contrast enhancement in CT pulmonary angiograms in a South African tertiary academic hospital setting

BACKGROUND: Undiagnosed pulmonary embolism carries high mortality and morbidity. Computed tomography pulmonary angiogram (CTPA) is the diagnostic method of choice for accurate diagnosis. Inadequate contrast opacification is the second most common cause of indeterminate CTPAs. OBJECTIVES: Audit the adequacy of CTPA contrast enhancement and determine whether inadequate enhancement...

Concurrent cranial and cervical spine injuries by associated injury mechanisms in traumatic brain injury patients

BACKGROUND: The incidence of concurrent traumatic brain injury (TBI) and cervical spine injury (c-spine) is relatively high, with a variety of risk factors. OBJECTIVES: The purpose of this study was to determine the incidence and related factors associated with combined cranial and c-spine injury in TBI patients by assessing their demographics and clinical profiles. METHOD: A...

Otosyphilis: A rare cause of acute bilateral sensorineural hearing loss in a HIV-negative patient

Bilateral acute hearing loss is rare, and the aetiology is poorly defined. Less common treatable pathologies such as otosyphilis must be part of the differential diagnosis and should be actively excluded. We present a case of a 23-year-old woman who developed acute bilateral hearing loss due to otosyphilis, confirmed on audiometry and laboratory tests. In this article, the CT...

A retrospective review of CT pulmonary angiogram confirmed pulmonary emboli in COVID-19 patients admitted to Groote Schuur Hospital, Cape Town

BACKGROUND: A high incidence of thromboembolic phenomena has been widely reported in patients with coronavirus disease 2019 (COVID-19) pneumonia. There is, however, a paucity of data detailing the incidence and characteristics of pulmonary emboli (PE) in COVID-19 patients in the South African setting OBJECTIVES: To describe the incidence and characteristics of PE confirmed by CT...

Fatal non-accidental injury in South Africa: A Gauteng hospital's perspective on the incidence and fracture types in post-mortem skeletal surveys

BACKGROUND: In its severest form, non-accidental injury (NAI) in children is fatal. South Africa has been reported to have double the global average of child homicides. Autopsy is the main investigation in fatal NAI with post-mortem skeletal surveys (PMSS) playing an adjunctive role. Whilst fracture patterns associated with NAI in living patients have been established, this has...

A review of teleradiology in Africa - Towards mobile teleradiology in Nigeria

eHealth is promoted as a means to strengthen health systems and facilitate universal health coverage. Sub-components (e.g. telehealth, telemedicine, mhealth) are seen as mitigators of healthcare provider shortages and poor rural and remote access. Teleradiology (including mobile teleradiology), widespread in developed nations, is uncommon in developing nations. Decision- and...