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Referring Physicians’ Knowledge on Justification of Medical Exposure in Diagnostic Imaging in a Sub-Saharan African Country, Cameroon

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Open Journal of Radiology 2014年第1期4卷 60-68页

作者： Boniface Moifo annick laure edzimbi Haoua Tebere Joshua Tambe Richard Ndi Samba Joseph Gonsu Fotsin Department of Radiology and Radiation Oncology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Department of Radiology and Radiation Oncology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Radiology Department Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaounde Cameroon National Radiation Protection Agency Yaounde Cameroon

Background: Justification is the process of weighing the potential benefit of the exposure against potential detriment for that individual. Its role has been largely delegated to imaging professionals. Nevertheless, justification process involves referring physicians, radiographers and radiologists. Objective: To assess the knowledge of referring physicians regarding justification of irradiating examinations in medical imaging at the university-affiliated hospitals in Yaoundé Cameroon. Materials and Methods: A questionnaire (18 questions) based on the French guide for the proper use of medical imaging tests in relation to the justification of irradiating examinations, was self-administered to 151 referring physicians in Yaounde (Cameroon) between October 2012 and January 2013. The pre-tested questionnaire was completed in the presence of the investigator. A scoring system was then adopted with a total of 15 points from the level of knowledge on justification which could be classified as satisfactory or not. Results: Referring physicians were 75 (49.7%) GPs, 53 (35.1%) residents and 23 (15.2%) specialists. Knowledge on justification was unsatisfactory for 79.5% of referring physicians with no significant difference in terms of professional experience (p = 0.95) or specialty (p = 0.119). The concepts of “useful exam” and “justified exam” were not known by 113 (74.8%) and 95 (62.9%) practitioners. MRI was selected as irradiating by 62 (41.1%), SPECT and PET-scan as non-radiating examinations by 98 (64.9%) and 115 (76.1%) participants. The main reasons for repeating a giving radiology exam were: unsatisfactory interpretation, unknown of where it was performing and poor quality exam respectively for 23 (15.2%), 37 (24.5%) and 43 (28.5%) referring physicians. Justification was the responsibility of the referring physician alone for 57% of respondent. Only 11 clinicians knew the reference of “Justification-Optimization-Limitation” to radiation protection. Conclusion: The k

关键词： Assessment Justification Referring Physician Radiation Protection Best Practices Cameroon

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Impact of Standardized Scheme on the Detection of Chest X-Ray Abnormalities and Radiographic Diagnosis of Pulmonary Tuberculosis in Adult

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Open Journal of Medical Imaging 2014年第1期4卷 23-30页

作者： Marie laure Gharingam Boniface Moifo Eric Walter Pefura Yone André Pascal Kengne Jean Roger Moulion Tapouh annick laure edzimbi Georges Nguefack-Tsague Samuel Nko’o Amvene Department of Medical Imaging and Radiation Therapy The University of Yaoundé I Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Internal Medicine and Specialties The University of Yaoundé I Yaoundé Cameroon Service of Pulmonology Yaounde Jamot Hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Medical Imaging and Radiation Therapy The University of Yaoundé I Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Public Health The University of Yaoundé I Yaoundé Cameroon South African Medical Research Council & University of Cape Town Cape Town South Africa

Purpose: The complexity of chest radiography (CXR) is a source of variability in its interpretation. We assessed the effect of an interpretation grid on the detection of CXR anomalies and radio- graphic diagnosis of tuberculosis in an endemic area for tuberculosis. Methods: The study was conducted in Yaounde (Cameroon). Six observers (2 pulmonologists, 2 radiologists and 2 senior residents in medical imaging) interpreted 47 frontal CXR twice two months apart without (R1) and with (R2) the aid of an interpretation grid. We focused on the detection of micro nodules (n = 16), cavitations (n = 12), pleural effusion (n = 6), adenomegaly (n = 6), and diagnosis of tuberculosis (n = 23) and cancer (n = 7). Results: The average score for accurate detection of elementary lesions was 40.4% [95%CI: 25% - 58.3%] in R1 and 52.1% [36.9% - 65.3%] in R2. The highest im- provement was observed for micro nodules (19.8%). Cavitations had the highest proportions of accurate detections (58.3% in R1 and 65.3% in R2). The average score of accurate diagnosis was 46.1% in R1 and 57.4% in R2. Accurate diagnosis improved by 3.6% for tuberculosis and 19% for cancer between R1 and R2. Intra-observer agreement was higher for the diagnosis of cancers (0.22 ≤ k ≤ 1) than for diagnosing tuberculosis (0.21 ≤ k ≤ 0.68). Inter-observer agreement was highly variable with a modest improvement for the diagnosis of tuberculosis in R2. Conclusion: Standardized interpretation scheme improved the detection of CXR anomalies and diagnosis of tuberculosis. It significantly improved inter-observer’s agreement in diagnosing tuberculosis but not in detecting most lesions.

关键词： Chest Radiography Interpretation Scheme Tuberculosis Micro Nodules Cavitations Agreement

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Potential Association between Anterior Cruciate Ligament Tear and “Bi-Collateral” Ligamentous Rupture: A Retrospective Study

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Open Journal of Radiology 2015年第4期5卷 217-223页

作者： Jean Roger Moulion Tapouh Boniface Moifo Cathy Monabang Zoé Marc Leroy Guifo Haoua Tebere annick laure edzimbi Samuel Nko’o Amvene Department of Radiology and Radiation Oncology Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaounde Cameroon Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH) Yaounde Cameroon Yaounde University Teaching Hospital Yaounde Cameroon Department of Surgery and Sub-Specialties (FMBS) Yaounde Cameroon

Background: Anterior cruciate ligament (ACL) tears are common complications of knee trauma. This entity can be reliably diagnosed by Magnetic Resonance Imaging. There is a lack of data on the epidemiology of ACL tears in Sub-Saharan Africa. The aim of this study is to describe the radiological aspects of post traumatic ACL tears in a black African setting (Yaounde Teaching Hospital). Methods: ninety six (96) MR studies of the knee were retrospectively reviewed. They were realized on a low field device (0.2T) from July 2012 to December 2013. All the examinations were indicated for knee trauma. Ligamentous, meniscal, bony and joint lesions were sought on coronal and sagittal sections. Results: the sample consists of 70% (68/96) of men. The mean age is 35.36 ± 11.86 years. The prevalence of ACL tears is 45.8% (44/96) of which 36 (81.81%, 36/44) are total tears. 23 (24%) have associated meniscal lesion and 8 (8.3%) have a simultaneous damage of the collateral ligaments. The most frequently injured part of the meniscus is its posterior horn (12/23 cases). Meniscal and “bi-collateral” ligament injuries are independently associated to ACL tears. Conclusion: The prevalence of ACL tears at the Yaounde Teaching Hospital is 45.8%. It is independently associated to meniscal tears and concomitant injury of the tibial and fibular collateral ligaments.

关键词： Anterior Cruciate Ligament Magnetic Resonance Imaging Meniscal Tears Knee Trauma

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