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Epidemiological, Diagnostic and Therapeutic Aspects of Breast Cancer in the Gynecology and Obstetrics department of the CHU Gabriel Touré from 2020 to 2022

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Advances in Breast Cancer Research 2023年第3期12卷 97-113页

作者： Sirama Diarra Moussa Samake Amaguiré Saye Brehima Dembélé Birama Traoré Souleymane B. Dembélé Déssé Diarra Yely Dianéssy Abdou Guiré Bakarou Kamate Gynecology and Obstetrics department of the District Hospital of commune IV Bamako Mali General Surgery department of the commune IV District Hospital Bamako Mali Obstetrics Gynecology Service of the csref of San Bamako Mali Anatomo-Pathology and Cytology department of the Point G University Hospital Bamako Mali

In Mali, breast cancer remains a real health problem in the absence of an adequate and adapted health policy for their early diagnosis and their often late or even non-existent treatment. Objectives: This study aimed to study the epidemiological, diagnostic, and therapeutic aspects of breast cancer to write the clinical aspects of breast cancer in the gynecology-obstetrics department of the CHU Gabriel Touré from 2020 to 2022. Methodology: This was a retrospective and descriptive study of 219 cases of breast cancer that were diagnosed in the gynecology and obstetrics department of the CHU Gabriel Touré in Bamako, from 2020 to 2022. Results: The annual frequency was 77.2 cases per year, the average age 45.55 years with extremes of 16 to 85 years;housewives represented 92.7%;multiparas were reported at 57%. Considering the history, the personal history of benign breast pathology was 55.6%. Regarding the localization, the left breast was the most affected with 53.9%, and the tumor was found in the supero-external quadrant in 53.9%. The cancer was metastatic in 81.28%. The diagnosis biopsy + histology contributed to 98.6%. The histological type was invasive carcinoma of non-specific type in 95%. As for the histoprognostic grade of SBR studied, grade II was predominant at 46%, grade iii at 34.95%. The therapeutic strategy was chemotherapy in 83.1%. Neoadjuvant chemotherapy followed by surgery in 10%, primary surgery in 6.4%, radiotherapy in 0.5%. Conclusion: The major challenges in the fight against breast cancer in Mali remain a better organization of the system for early diagnosis, the establishment of a screening program, early diagnosis in women from the age of 40 and also adequate care.

关键词： Epidemiology Diagnosis Therapeutics Breast Cancer Bamako (Mali)

Reliability of Medical Imaging in the Pre-Therapeutic Assessment of Acute Intestinal Obstruction at the Centre Hospitalier Universitaire Du Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 147-156页

作者： Abdoulaye Koné Mahamadou Daou Youssouf Koné Moussa Traoré Moussa Konaté Ouncoumba Diarra Ibrahima Coulibaly Youssouf Diawara Amadou Doumbia Cheick Oumar Touré Kassim Sidibé Mody A. Camara Oumar Aba Ata Mahamadou Diallo Adama Diaman Keita Salia Coulibaly Zimogo Zié Sanogo Siaka Sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging department of the University Hospital of Point G Bamako Mali radiology department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging department of GABRIEL TOURE Hospital Bamako Mali radiology department of csref commune iii Bamako Mali Medical Imaging Service Health Center of Ref commune VI Bamako Mali Medical Imaging Service Health Center of Ref commune IV Bamako Mali DCSSA Kati Mali Medical Imaging department of Mali Hospital Bamako Mali Medical Imaging department of Kati Hospital Bamako Mali department of General Surgery of Point G University Hospital Bamako Mali

Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.

关键词： Medical Imaging Acute Intestinal Obstruction Abdominal CT Reliability

Macro-and microcirculation patterns of intrahepatic blood flow changes in patients with hereditary hemorrhagic telangiectasia

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World Journal of Gastroenterology 2017年第3期23卷 486-495页

作者： Roland C Schelker Ana P Barreiros Christina Hart Wolfgang Herr Ernst-Michael Jung department of Internal Medicine iii Hematology and OncologyUniversity Hospital of Regensburg93051 RegensburgGermany Ernst-Michael Jung Department of RadiologyUniversity Hospital of Regensburg93051 RegensburgGermany

AIM To evaluated vascular dynamic processes in the liver of hereditary hemorrhagic telangiectasia(HHT) patients by ultrasound(US) considering quantitative analytic methods. METHODS The imaging features on US and contrast-enhanced ultrasound(CEUS) in 18 patients diagnosed with HHT were retrospectively analyzed. Regarding CEUS, realtime contrast harmonic imaging and sulfur hexafluoridefilled microbubbles were used. RESULTS HVa Ms were identified in all 18 patients. By US, the two major Caselitz criteria could be detected in 55.6% patients. "Color spots" were detected in 72.2% of the cases. Respecting sonographic grading criteria by Buscarini, grade 3 could be demonstrated most frequent(40%). By CEUS, all the patients showed quick and early hyperenhancement during the arterial phase. Significant lowest time to peak(TTP) and highest area under the curve(AUC) values were identified in the hepatic artery(TTP: 69.8%; AUC: 100%) and highest TTP and lowest AUC in the hepatic parenchyma and the portal vein. CONCLUSION For the first time we analyzed CEUS findings of a group of HHT patients regarding macro- and microcirculation. Our data demonstrate significant differences in TTP and AUC values in the four selected regions: hepatic artery, shunt region, portal vein and hepatic parenchyma.

关键词： Hereditary hemorrhagic telangiectasia Intrahepatic shunts Contrast-enhanced ultrasound Time-intensity-curve

Feasibility of Scanopelvimetry in the Medical Imaging department of the University Hospital of Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 157-164页

作者： Abdoulaye Koné Moussa Konaté Youssouf Koné Moussa Traore Youssouf Diawara Ibrahima Coulibaly Ouncoumba Diarra Fatoumata Kalapo Amadou Doumbia Kassim Sidibe Cheick Oumar Touré Oumar Aba Ata Mody A. Camara Mamadou Sima Coulibaly Salia Mahamadou Diallo Adama Diaman Keita Siaka Sidibé Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging department of the University Hospital of Point G Bamako Mali radiology department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging department of GABRIEL TOURE Hospital Bamako Mali radiology department of csref commune iii Bamako Mali Medical Imaging Service Health Center of Ref commune VI Bamako Mali DCSSA Kati Mali Medical Imaging Service Health Center of Ref commune IV Bamako Mali Medical Imaging Service of the Mali Hospital Bamako Mali. Surgery of Gynecology-Obstetrics CHU Point G Bamako Mali Medical Imaging department CHU BSS Kati Mali

Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department and to evaluate the cost of radiopelvimetry. Patients and Method: This was a prospective, cross-sectional study that took place over a 12-month period from January 1 to December 31, 2018. It focused on pregnant women in whom scanopelvimetry was performed in the medical imaging department of Point G University Hospital during the study period. Results: Out of 8615 CT examinations performed in the radiology department, we collected 65 cases of scanopelvimetry, i.e., 0.7% of the CT examinations. Primigravida and paucigravida dominated the study (40% each). In 60% of the pregnant women the height was less than 150 cm. The most frequent indication for CT scanning was clinical pelvic narrowing (50%). In 80% of the cases, the scanopelvimetry was performed after 37 weeks of amenorrhea. A predominance of narrowing of the superior strait was noted (40%). 4.6% of the pregnant women had a Magnin index of less than 20. CT scanopelvimetry is a feasible examination in our context but the level of demand is low because of the high cost of the examination (49500 fca). Conclusion: In light of the results obtained, we can say that CT pelvimetry allows us to predict the probable route of delivery and thus we can reduce the risk of fetomaternal morbidity and mortality to improve maternal and child health.

关键词： Scanopelvimetry Prognosis Magnin Index Delivery

Gd-EOB-DTPA-enhanced magnetic resonance imaging for focal liver lesions in Chinese patients:a multicenter,open-label,phase Ⅲ study

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Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 607-616页

作者： Meng-Su Zeng Hui-Yi Ye Liang Guo Wei-Jun Peng Jian-Ping Lu Gao-Jun Teng Josy Breuer Yi Huan Ping Li Jian-Rong Xu Chang-Hong Liang department of radiology Zhongshan HospitalFudan UniversityNo.180 Fenglin Road departmentof radiology General Hospital of PLA department of radiology First Affiliated HospitalSoochowUniversity department of radiology Cancer HospitalFudan University department of radiology Changhai HospitalSecond Military MedicalUniversity department of radiology Zhongda HospitalSoutheast University Bayer HealthCare Bayer Schering Pharma AG department of radiology Xijing HospitalFourth Military MedicalUniversity Bayer HealthCare CompanyLtd department of radiology RenjiHospitalShanghai Jiaotong University department of radiology Guangdong General Hospital

BACKGROUND:Contrast agents help to improve visibility in magnetic resonance(MR)***,owing to the large interstitial spaces of the liver,there is a reduction in the natural contrast gradient between lesions and healthy *** study was undertaken to evaluate the efficacy and safety of the liverspecific MR imaging contrast agent gadoxetate disodium(GdEOB-DTPA)in Chinese ***:This was a single-arm,open-label,multicenter study in patients with known or suspected focal liver lesions referred for contrast-enhanced MR *** imaging was performed in 234 patients before and after a single intravenous bolus of Gd-EOB-DTPA(0.025 mmol/kg body weight).Images were evaluated by clinical study investigators and three independent,blinded *** primary efficacy endpoint was sensitivity in lesion ***:Gd-EOB-DTPA improved sensitivity in lesion detection by 9.46%compared with pre-contrast imaging for the average of the three blinded readers(94.78%vs 85.32%for Gd-EOB-DTPA vs pre-contrast,respectively).Improvements in detection were more pronounced in lesions less than ***-EOB-DTPA improved diagnostic accuracy in lesion ***:This open-label study demonstrated that Gd-EOB-DTPA improves diagnostic sensitivity in liver lesions,particularly in those smaller than 1 ***-EOB-DTPA also significantly improves the diagnostic accuracy in lesion classification,and furthermore,Gd-EOB-DTPA is safe in Chinese patients with liver lesions.

关键词： gadoxetate disodium magnetic resonance imaging liver focal liver lesions

Management and outcome of hepatocellular adenoma with massive bleeding at presentation

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World Journal of Gastroenterology 2017年第25期23卷 4579-4586页

作者： Anne J Klompenhouwer Robert A de Man Maarten GJ Thomeer Jan NM Ijzermans department of Surgery department of Gastroenterology and Hepatology department of radiology

To evaluate outcome of acute management and risk of rebleeding in patients with massive hemorrhage due to hepatocellular adenoma (HCA). METHODSThis retrospective cohort study included all consecutive patients who presented to our hospital with massive hemorrhage (grade II or iii) due to ruptured HCA and were admitted for observation and/or intervention between 1999-2016. The diagnosis of HCA was based on radiological findings from contrast-enhanced magnetic resonance imaging (MRI) or pathological findings from biopsy or resection of the HCA. Hemorrhage was diagnosed based on findings from computed tomography or MRI. Medical records were reviewed for demographic features, clinical presentation, tumor features, initial and subsequent management, short- and long-term complications and patient and lesion follow-up. RESULTSAll patients were female (n = 23). Treatment in the acute phase consisted of embolization (n = 9, 39.1%), conservative therapy (n = 13, 56.5%), and other intervention (n = 1, 4.3%). Median hemoglobin level decreased significantly more on days 0-3 in the intervention group than in the patients initially treated conservatively (0.9 mmol/L vs 2.4 mmol/L respectively, P = 0.006). In total, 4 patients suffered severe short-term complications, which included hypovolemic shock, acute liver failure and abscess formation. After a median follow-up of 36 mo, tumor regression in non-surgically treated patients occurred with a median reduction of 76 mm down to 25 mm. Four patients underwent secondary (elective) treatment (i.e., tumor resection) to address HCA size of > 5 cm and/or desire for future pregnancy. One case of rebleeding was documented (4.3%). None of the patients experienced long-term complication (mean follow-up time: 36 mo). CONCLUSIONWith a 4.3% risk of rebleeding, secondary (elective) treatment of HCA after massive hemorrhage may only be considered in patients with persistent HCA > 5 cm.

关键词： Hepatocellular adenoma Management Bleeding Outcome Hemorrhage

The Factors of the Failure in the Treatment of Congenital Equinus Clubfoot Varus by the Ponseti Method at the Reference Health Care Center (csref) of commune iii of Bamako

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Surgical Science 2023年第5期14卷 398-404页

作者： Seydou Sanogo Soumaila Diallo Boubacar Karembé Lassine Cissé Almami Kire Moussa Cissé Abdoulaye Coulibaly Aboubacar Touré Boureima Traoré Moustapha Yossi Moussa Samaké Drissa Diarra Mohamed Traore Seydou Mariko Mariko Issa Fomba Layes Touré Adégné Togo department of Orthopedic-Traumatology CSREF CIII Bamako Mali

Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of commune iii of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.

关键词： Chess’ Factors Club Foot Ponseti Method Pirani Score

Rare Antenatal Fetal Malformations of the Anterior Abdominal Wall in Mali: About a Case

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Open Journal of Medical Imaging 2022年第4期12卷 208-214页

作者： Ousmane Traore Ouncoumba Diarra Mamadou N’Diaye Souleymane Sanogo Ilias Guindo Abdoulaye Kone Hamady Sissoko Mahamadou Diallo Siaka Sidibe Adama Diaman Keita radiology department of the Medical Clinic “Marie Curie” Bamako Mali department of radiology Center Hospital-University “Le Point G” Bamako Mali radiology department Commune III Reference Health Center of Bamako Bamako Mali radiology department of the Military Camp of Bamako Bamako Mali department of radiology Center Hospital-University “Le Luxembourg” Bamako Mali radiology department Center Hospital-University de Kati Bamako Mali radiology department of the Medical Clinic “Pasteur” Bamako Mali department of radiology Center Hospital-University “Gabriel Toure” Bamako Mali

Abdominal wall malformations correspond to a wide spectrum of congenital anomalies that are due to a defect in the closure of the anterior abdominal wall and can be fatal. We report the case of laparoschisis associated with a poly malformation syndrome in the same fetus at the reference health center of commune iii of the district of Bamako. The objective is to clarify the interest of antenatal ultrasound in the diagnosis and prognosis of these malformations. It was a 19-year-old prim gravid woman received as part of the prenatal check-up. Antenatal ultrasound had allowed the diagnosis of malformation of the anterior abdominal wall of the gastroschisis type associated with abnormalities of the neural tube, the urogenital system and the bone skeleton. The antenatal diagnosis of the malformations had motivated the realization of a therapeutic termination of pregnancy at 19 weeks of amenorrhea and 3 days by triggering and vaginal delivery, allowing the confirmation of the diagnosis of gastroschisis and the poly malformation syndrome which is extremely rare. Antenatal ultrasound remains an ideal means of imaging for monitoring pregnancy and had made it possible to make the prognosis and antenatal diagnosis of multiple malformations in association, and to indicate better therapeutic decision-making.

关键词： Malformation Fetus Antenatal Ultrasound Laparoschisis

Epidemio-Clinical and Uretrocystographic Profile of Pathologies of the Lower Urinary Tract at the Chu Pr Bss of Kati

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Open Journal of Medical Imaging 2023年第1期13卷 40-48页

作者： Ilias Guindo Souleymane Sanogo Alassane Kouma Dramane Bagayoko Issa Diarra Mamadou N’diaye Ouncoumba Diarra Amadou Kassogue Salia Coulibaly Adama Diaman Keita Medical Imaging department Kati University Hospital Kati Mali department of radiology Luxembourg Mother-Child Hospital Bamako Mali radiology department Bamako Infirmary Bamako Mali Medical Imaging Service CS Ref of Commune III Bamako Mali department of Urology University Hospital of Kati Kati Mali department of radiology and Nuclear Medicine Point “G” University Hospital Bamako Mali

Introduction: Pathologies of the lower urinary tract are common in urology composed of various conditions, responsible for urinary disorders. Despite the new methods, exploration in Africa is mainly based on retrograde urethrocystography (UCR). The main objective was to determine the importance of UCR in the diagnosis of pathologies of the lower urinary tract. Materials and Methods: This was a retrospective and descriptive study covering a period of 5 years (July 2016-June 2021). It involved all patients admitted to the ward for retrograde urethrocystography during the period. A remote-controlled table of the GE PRESTILIX 1600× type was used for the examinations. Results: At the end of our study we collected 100 cases of pathologies of the lower urinary tract out of a total of 112 RCUs performed or 89.28%. Pathologies of the lower urinary tract accounted for 78% of the UCRs in the department. The age group of (61 - 70) was the most affected with extremes from 1 year to 101 years. Non-specific urination disorders were the most common indications (43%), followed by acute urine retention (18%). Acquired urethral pathology was the most common (89%), followed by bladder neck disease 5% and posterior urethral valve with 4%, Bladder struggle was the most common associated sign (54%) with post-urination residue in 97% of patients. Conclusion: Pathologies of the lower urinary tract are relatively common in our region, dominated by urethral narrowings. Retrograde urethrocystography remains the reference examination in our control for the diagnosis of obstructive pathologies of the lower urinary tract while specifying the seat of the obstacle.

关键词： Pathologies of the Lower Urinary Tract UCR CHU Kati