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   Table of Contents - Current issue
Coverpage
January-June 2021
Volume 2 | Issue 1
Page Nos. 1-42

Online since Tuesday, June 22, 2021

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REVIEW ARTICLE  

Role of magnetic resonance imaging in defining rectal anatomical landmarks and primary rectal cancer evaluation Highly accessed article p. 1
Kenis Shedrack Felangu, Akims Shattah, Ubaka Edwin Akanegbu, Omofuma Ighodalo Oisenele, Ibinaiye Philip Oluleke
DOI:10.4103/jrmt.jrmt_1_21  
In contemporary practice, magnetic resonance imaging (MRI) has become a useful tool in evaluating rectal and perirectal anatomy. It encourages accurate local staging of rectal cancer and has overall improved presurgical evaluation and planning, leading to reduce local recurrence and more sphincter conserving procedures. This article aims at providing a concise review of rectal MRI technique and anatomy and to relate this to local staging and surgical management. Locally generated images in our practice were reviewed and images that best depict different anatomical landmarks and pathologies were selected and presented. Also, PubMed database was searched for relevant and contemporary existing literature on the subject.
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ORIGINAL ARTICLES Top

Computerized tomographic patterns of intracranial tumors in Northwest Nigeria p. 6
Suleiman Aliyu, Phillip Oluleke Ibinaiye, Nuhu Dung Chom, Abdullahi Jimoh, Muhammed Zaria Ibrahim, Okafor Emeka Kingsley
DOI:10.4103/JRMT.JRMT_34_20  
Background: Brain tumors are among the most challenging disorders encountered worldwide. Early and accurate diagnosis is essential for the management of these tumors. Different patterns of distribution of intracranial tumors have been described in various regions of the world, with previous reports in Africa suggesting that brain tumors were uncommon. This relative rarity has been attributed to low detection due to lack of neurosurgical and advanced neuroimaging facilities previously, a limitation that has now been gradually surmounted with the establishment of neurosurgical and more advanced radiological facilities on the continent. Objectives: The objective of this study is to describe the current pattern of intracranial tumors on computed tomography (CT) scan seen in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northwest Nigeria. Methods: This is a retrospective study of CT images of 60 patients of all age groups diagnosed with brain tumors between January 2015 and December 2019. The CT scans of the brain were performed using General Electric Hi-Speed NX/i dual-slice CT scanner (Germany). The age, sex, diagnosis using the WHO histological, and the pattern on CT were recorded, and data were analyzed using Statistical Package for the Social Sciences version 22.0, ARMONK, NY, USA 2013. Only cases with conclusive histology diagnosis were analyzed. This study was approved by the Health Research Ethics Committee of the ABUTH, Zaria (approval Number ABUTH/HREC/M36/2015), on January 23, 2015, before commencement. Results: In the 60 cases of brain tumors studied, patients' age range was 6 months–65 years, with a peak in the fourth and fifth decades of life (accounting for 38.3%). The mean age was 33.04 years ± 17.73 standard deviation. There was equal occurrence among males and females. About 96.7% of the tumors were primary and 3.7% secondary tumors; meningioma (MEN) (45%) was the most common tumor seen. About 45% of the cases were extra-axial, while 55% were intra-axial. Most (81.67%) of the tumors were located in the supratentorial region, while 18.33% were infratentorial. Headache (75%) and visual impairment (53.3%) were the most frequent clinical presentations. Conclusion: MEN was the most common tumor type seen in this study. This corroborates most studies in Nigeria and other African countries but contradicts some studies among Caucasians that showed glioma to be more common. This affirms that racial factors and environmental influence could have significant effects on the pattern of diseases. The results of this study will provide useful data on the pattern of brain tumors in this environment.
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Brain computed tomographic pattern and clinical presentation of patients with hypertensive haemorrhagic stroke at aminu Kano teaching hospital, Kano, Nigeria p. 12
Umar Jibo, Mohammed Kabir Saleh, Abdulkadir Musa Tabari, Anas Ismail, Mansur Adamu Yahuza, Abubakar Mohammed Jibo, Usman Muhammad Ibrahim, Mohammed Sidi, Idris Sule Kazaure
DOI:10.4103/JRMT.JRMT_35_20  
Background: Stroke or cerebrovascular disease is a clinical syndrome consisting of rapidly developing clinical signs of focal or global neurological deficits lasting more than 24 h or leading to death with no apparent cause other than a vascular origin. Study Aims: This study was aimed at evaluating pattern and clinical presentation of hemorrhagic stroke on brain Computed Tomography (CT) scan in Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: This was a prospective study carried out between March 2018 and August 2018 on brain computed tomographic findings of 100 patients diagnosed with hemorrhagic stroke. Ethical approval to conduct the study was obtained from the Human Research and Ethics Committee of the Aminu Kano Teaching Hospital. Images were acquired using Prime Aquilion Toshiba Japan 2012 160 slice CT machine in the Department of Radiology. The patients' information and CT findings were recorded on the data capture sheet. Results: Headache was the most common clinical presentation seen in 72% of the patients, followed by dysphasia seen in 58%, followed by vomiting seen in 42%, and the least was convulsion seen in 28% of the patients. The most common site of hematoma was putamen with 54%, followed by thalamus 14%, and the least regions affected were parietal lobe, pons, and frontal lobes with 4% each. Conclusion: Headache was the most common clinical presentation of the patients with hemorrhagic stroke and the most common site of the hematoma was putamen.
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Radiology request form: Evaluating its complete filling in South-South, Nigeria p. 18
Ebbi Donald Robinson, Olukumni Yetunde Ijeruh, Woroma Wonodi, Rufus Abam, Chidinma Wekhe
DOI:10.4103/JRMT.JRMT_36_20  
Introduction: Radiology request form (RRF) is a medical referral to a radiologist requesting input concerning the diagnosis, treatment, follow-up of patients, and intervention where necessary. The RRF usually provides information on the patient(s) and the investigation(s) being requested. Methodology: This was a cross-sectional descriptive study, in which request forms were retrospectively reviewed over a period of 6 months in the Radiology Department of the Rivers State University Teaching Hospital. A total of 1131 request forms filled by medical doctors were analyzed to ascertain the degree of completeness of filling the forms. The data were collated and analyzed using the IBM Statistical Package for the Social Sciences version 23. The results were expressed in simple percentages, frequencies, and presented in tables, charts, and graphs. Results: Ultrasonography was the most requested radiologic investigation (55.4%), while X-ray and computed tomography scan account for 41.4% and 1.1%, respectively. Majority of the forms had adequately entered date of request (97.7%) and required investigation and patient's names (99.6%). Patient's age was appropriately entered in 51.9% of cases, while 34.1% kept the space blank. Clinical information was indicated in 50.8% of the forms, while 97.2% did not include history of patient's allergy as regards the use of radiopharmaceutical agents. The patient's consultant and resident's doctor names were appropriately entered in 72.1% and 81.7% of the request forms, respectively. Signature authentication by the resident doctor is available in 13.2% of the request forms. Conclusion: It was observed that majority of the RRFs were not completely and appropriately filled; thus, complete information regarding the patient is not provided to the radiologist to enhance report accuracy. Clinical information if adequately provided can improve the quality of patient management, follow-up, training, and research.
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Computed tomographic pattern of stroke among hypertensive and diabetic patients in Kano, Nigeria p. 24
Mansur Yahuza Adamu, Naimatu A T Abdullahi, Kabiru Isyaku, SK Idris, Yusuf Lawal
DOI:10.4103/jrmt.jrmt_2_21  
Background: Stroke accounts for a significant proportion of neurological disorders and carries a high morbidity and mortality. Hypertension and diabetes mellitus are the major risk factors for stroke in Nigeria. Aims and Objectives: The need to determine the pattern of radiologic changes of stroke in patients with hypertension or diabetes mellitus on computed tomography scan (CT) of the brain. Materials and Methods: A prospective study using CT of the brain of 104 adult patients with stoke per group was carried out. Results were analyzed using (SPSS) version 16.0 software. Proportion of pattern of stroke in each group was analyzed and possible association between the socio-demographic factors was determined. Results: 104 diabetic patients (67 males and 37 females) and 104 hypertensive patients (68 males and 36 females) were studied. Their ages ranged from 30-90 years. Most of the patients had thrombotic stroke with the diabetic having a higher proportion (92.3%) than their hypertensive counterparts (66.3%). The parietal lobe is most affected part with (58.7%) in hypertensive's and 44.2% of the diabetics. The left side of the brain was most affected in more than 50% of both the hypertensive and diabetic stroke patients. Conclusion: Ischaemic stroke was equally prevalent in both diabetic and hypertensive patients while haemorrhagic stroke was more common among hypertensive patients. The parietal lobe and the left side of the brain were the more frequent area of predilection in both groups.
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Evaluation of knowledge, effectiveness, and challenges of picture archiving and communications system in national orthopaedic hospital Dala-Kano, Nigeria p. 31
Adamu Muhammad Saidu, Nasiru Musa Tahir, Nuhu Muhammad Salihu, Mohammed Sidi, Dahiru Mohammed Yunusa
DOI:10.4103/jrmt.jrmt_3_21  
Background: Picture Archiving and Communications System (PACS) is a networked group of computers, servers, and archives that can be used to manage digital images, specifically designed for the radiology department. Aims: The study aims at evaluating the knowledge, effectiveness, and challenges of picture archiving and communications system (PACS) in National Orthopaedic Hospital Dala-Kano, Nigeria. Materials and Methods: The study design was cross-sectional, and it was prospectively carried out from July 2020 to December 2020. A total number of 120 semi-structured questionnaires were distributed to consented respondents for the purpose of data collection. The validity and reliability of the questionnaire were tested. The collected data were analyzed using SPSS version 21.0. Results: The results showed that 78 (85%) of the respondents had a better knowledge on how to use PACS, 80 (87%) admitted that PACS saves a lot of their time, and 91 (99%) admitted that PACS improves the quality of their work in providing better patient care. Eighty-five (92%) admitted that images on PACS have diagnostic information and 73 (79%) were satisfied with the quality of images on PACS. Challenges faced by the PACS user include epileptic power supply, unavailability of PACS computers at all service points, slow network, improper patient identification, and sometime poor image quality. Conclusion: This study shows that majority of the respondents had good knowledge of PACS and it was highly effective.
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The value of cross-sectional imaging in evaluation of stroke patients p. 36
Yunusa Dahiru, H Umar Umar, U Usman Aminu, T Sa'ad Suleiman, Philip Oluleke Ibinaiye, MC Dahiru Aminu, Yusuf Hadiza
DOI:10.4103/JRMT.JRMT_31_20  
Background: Due to poor availability of functional cross-sectional imaging in the developing countries, cerebrovascular accident (CVA) and its management has continued to be a major health problem. The need for cross-sectional imaging such as computed tomography (CT) of the brain for the exclusion of stroke mimics and for therapeutic decision cannot be overemphasized. Materials and Methods: This was a prospective case study conducted at the Federal Teaching Hospital, Gombe, from June 2016 to December 2016. One hundred and thirty patients who presented with clinical features and provisional diagnosis of CVA (also known as stroke) and were referred to the radiology department for brain CT were consecutively selected. A total of 111 had CT scan features of acute stroke, 6 had brain atrophy, 8 had intracranial space-occupying lesions, and 5 were normal brain scan. Data were analyzed using SPSS version 16.0 package. P ≤ 0.05 and a confidence interval of 95% were adapted for the statistical analysis. All comparisons of variables were done applying kappa statistical analysis. Results: There were 81 (62%) males and 49 (38%) females aged 18–80 years (mean ± standard deviation of 57.49 ± 13.47 years). About 15% (19) of the patients had a diagnosis other than stroke (stroke mimics). One hundred and eleven (85%) had a stroke, of which 94 (84.7%) were ischemic stroke, while the remaining 17 (15.3%) were hemorrhagic stroke. This study also found a discordance between clinical and CT diagnosis of stroke and stroke subtypes; κ = 0.289. Conclusion: The clinical diagnosis of stroke and stroke subtypes may not be reliable without neuroimaging, and the need for CT scan for proper evaluation of stroke patients is well justified.
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CASE REPORT Top

Plain radiographic diagnosis of “osteogenesis imperfecta congenita” (Type III) in a 2-year-old boy p. 40
Bello O Usman, Fatai A Oyewole, Lawal Suleiman
DOI:10.4103/JRMT.JRMT_28_20  
Osteogenesis imperfecta (OI), or brittle bone disease, is a rare disorder with congenital bone fragility caused by mutations in the genes. This case is reported because of its rarity and paucity in the literature in Nigeria. Available data on OI in Black African children are limited.
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