Utility, Appropriateness of Request and Report of Computed Tomography Scan for the Diagnosis of Paranasal Sinuses Pathologies in a Sub-Saharan Africa Urban Setting
Background: Computed tomography (CT) Scan is the imaging of choice for the diagnosis of sino nasal (SN) pathologies in sub-Saharan African setting. However, it is often requested by non experienced practitioners. We aimed to describe the utility and the appropriateness of CT Scan request forms and results in the diagnosis of SN pathologies. Method: We conducted a retrospective cross-sectional study in four health facilities in Yaoundé, Cameroun, from October 2018 to September 2019. All patients to whom SN CT Scan was performed were called for an appointment. After informed consent, data on the appropriateness and conformity of the request form were collected and compared to the guidelines of the French society of radiology. CT Scan results were also collected and the quality of the report was evaluated. Results: A total of 206 SN CT Scan request forms and reports were included, with a mean patient age of 37.7 ± 16.1 years. The request form was conformed to guidelines in 8.3% of cases and was found appropriate in 62.6% of cases. No CT Scan report had all the items required, and 159 (77.2%) reports were useful. The most common diagnosis in patients with abnormal results was chronic sinusitis (49.5%) and SN polyp or polyposis (19.4%). Conclusion: Most of SN CT Scan requested were appropriate and useful. However, the conformity of request forms and reports to the guidelines is low. Suggesting the need for capacity building for the diagnosis of SN pathologies especially for non specialists like general practitioners and nurses.
References
[1]
Stelow, E.B. (2015) Sinonasal and Nasopharyngeal Pathology. In: Wick, M.R., LiVolsi, V.A., Pfeifer, J.D., Stelow, E.B. and Wakely, P.E.J., Eds., Silverberg’s Principles and Practice of Surgical Pathology and Cytopathology. 5e éd. Cambridge University Press, Cambridge, 1125-1177. https://doi.org/10.1017/9781139137201.016
[2]
Wahid, N.W., Smith, R., Clark, A., Salam, M. and Philpott, C.M. (2020) The Socioeconomic Cost of Chronic Rhinosinusitis Study. Rhinology, 58, 112-125.
https://doi.org/10.4193/Rhin19.424
[3]
Yip, J., Vescan, A.D., Witterick, I.J. and Monteiro, E. (2017) The Personal Financial Burden of Chronic Rhinosinusitis: A Canadian Perspective. American Journal of Rhinology & Allergy, 31, 216-221. https://doi.org/10.2500/ajra.2017.31.4452
[4]
Shashy, R.G., Moore, E.J. and Weaver, A. (2004) Prevalence of the Chronic Sinusitis Diagnosis in Olmsted County, Minnesota. Archives of Otorhinolaryngology-Head & Neck Surgery, 130, 320-323. https://doi.org/10.1001/archotol.130.3.320
[5]
Liale Honore, T. (2016) Prevalence and Management of Rhinosinusitis in Developing Countries: The Case of Mbingo Baptist Hospital, North West Region, Cameroon. Texila International Journal of Clinical Research, 3, 47-66.
https://doi.org/10.21522/TIJCR.2014.03.02.Art004
[6]
Ferrie, J.-C., Fontanel, J.-P., Delagranda, A., Dufour, X. and Klossek, J.-M. (2008) Imagerie radiologique des cavités sinusiennes et nasales. Radiologie et imagerie médicale, 3, 1-19. https://doi.org/10.1016/S1879-8535(08)72770-3
[7]
Indicateur Conformité des demandes d’examens d’imagerie [Internet]. France: Haute Autorité de Santé; 2011 juill [cité 3 mars 2021]p.28.
https://www.has-sante.fr/plugins/ModuleXitiKLEE/types/FileDocument/doXiti.jsp?id=c_1098040
[8]
(2013) Société Française de Radiologie, Société Française de Médecine Nucléaire. Guide du Bon Usage des examens d’imagerie médicale [Internet].
http://gbu.radiologie.fr/
[9]
Groupe de travail SFR—CRR. (2007) Recommandations générales pour l’élaboration d’un compte-rendu radiologique (CRR). Journal de Radiologie, 88, 304-306.
https://doi.org/10.1016/S0221-0363(07)89822-2
[10]
Moifo, B., Ndeh Kamgnie, M., Ninying Fuh, F., Zeh, O., Tebere, H., Moulion Tapouh, J., et al. (2013) Pertinence of Indications of Medical Imaging Examinations at Yaounde—Cameroon. Health Sciences and Disease, 14, 1-8.
[11]
(2013) World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310, 2191-2194.
https://doi.org/10.1001/jama.2013.281053
[12]
Roussel, N. and Lelièvre, P. (2002) Améliorer la qualité des prescriptions d’examens d’imagerie médicale. European Journal of Radiology, 83, 621-625.
[13]
Stanescu, G., Rosca-Fartat, G. and Stanescu, D. (2015) Justification of CT Scans Using Referral Guidelines for Imaging. Radiation Protection Dosimetry, 165, 43-46.
https://doi.org/10.1093/rpd/ncv060
[14]
Lehnert, B.E. and Bree, R.L. (2010) Analysis of Appropriateness of Outpatient CT and MRI Referred from Primary Care Clinics at an Academic Medical Center: How Critical Is the Need for Improved Decision Support? Journal of the American College of Radiology, 7, 192-197. https://doi.org/10.1016/j.jacr.2009.11.010
Bellin, M.-F., Stacul, F., Webb, J.A.W., Thomsen, H.S., Morcos, S.K., Almén, T., et al. (2011) Late Adverse Reactions to Intravascular Iodine Based Contrast Media: An Update. European Radiology, 21, 2305-2310.
https://doi.org/10.1007/s00330-011-2200-9
[17]
Chin, J.Y., Goldstraw, E., Lunniss, P. and Patel, K. (2012) Evaluation of the Utility of Abdominal CT Scans in the Diagnosis, Management, Outcome and Information Given at Discharge of Patients with Non-Traumatic Acute Abdominal Pain. The British Journal of Radiology, 85, e596-e602. https://doi.org/10.1259/bjr/95400367