ABSTRACT
The Prostate Imaging Reporting and Data System (PIRADS) is a cornerstone of modern prostate cancer diagnostics, standardizing the acquisition, interpretation, and reporting of multiparametric Magnetic Resonance Imaging (mpMRI). This article provides a comprehensive guide to PIRADS version 2.1, detailing its structured algorithm for assigning a risk score from 1 to 5 that correlates with the likelihood of clinically significant prostate cancer (csPCa). We explain the zone-dependent rules, sequence-specific criteria, and key improvements of v2.1, including its refined transition zone assessment. Furthermore, we contextualize its clinical impact with current evidence and discuss emerging trends, such as biparametric MRI and artificial intelligence, that are shaping the future of prostate imaging.

ABSTRACT
Stillbirth is more common in low and middle-income countries like Tanzania. The risk of stillbirth is high in intrauterine growth-restricted fetuses. Placental insufficiency is associated with intrauterine growth restriction as well as the risk of both preeclampsia and stillbirth. We present a 36-year-old preeclamptic woman with sonographic features of placental insufficiency, intrauterine growth restriction, whose obstetric outcome was a stillbirth. The obstetric Doppler findings indicated severe placental insufficiency and absent end-diastolic flow in the middle cerebral artery, which we consider a sign of impending fetal death/stillbirth.

ABSTRACT
Lissencephaly is a rare and severe neurodevelopmental disorder caused by defective neuronal migration during the first trimester of embryogenesis, resulting in a smooth cerebral cortex lacking normal gyri and sulci. We present case report of a female neonate, less than one month old who was admitted to NICU at the Komfo Anokye Teaching Hospital in Kumasi, Ghana, presenting with neonatal jaundice and an elongated cranial shape. Further investigations, with a Magnetic Resonance Imaging (MRI) on a Toshiba Achieva 1.5 Tesla scanner, revealed bilateral frontoparietal and temporal lissencephaly, absence of the septum pellucidum, basal ganglia fusion with poor internal capsule definition, and ventricular dilation. These findings were consistent with lissencephaly, likely resulting from tubulinopathy, coexisting with lobar holoprosencephaly. A multidisciplinary approach was employed in the management of this neonate. This case highlights the importance of MRI in diagnosing and understanding complex congenital brain anomalies, particularly in resource-limited settings like Ghana.

ABSTRACT
Background: Sacrococcygeal teratoma (SCT) is the most common congenital tumor in infants, with early diagnosis and accurate preoperative characterization being crucial for optimal management. Imaging modalities, particularly X-ray and ultrasonography (USG), play a key role in identifying tumor features and guiding surgical planning. This study aimed to correlate imaging findings with histopathological outcomes in infants and toddlers with SCT. Methods: This cross-sectional observational study was conducted at the Department of Radiology and Imaging, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh, from December 2020 to March 2025. A total of 40 infants and toddlers with SCT who underwent surgical excision were included consecutively. X-ray and USG evaluations were performed preoperatively, assessing features such as soft tissue mass, calcifications, cystic and solid components, mixed echogenicity and vascularity. Histopathology was considered the gold standard, classifying tumors as mature or immature. Imaging findings were correlated with histopathological diagnosis. Results: Among the 40 patients, 55% were aged 6–12 months and 65% were female. Histopathology revealed 38 (95%) mature and 2 (5%) immature teratomas. X-ray showed a soft tissue mass in 75% of cases, calcifications in 30% and bony involvement in 10%. USG demonstrated cystic components in 70%, solid components in 40%, mixed echogenicity in 35%, calcifications in 25% and vascularity in 15%. Imaging correctly identified 38 mature tumors as benign, while 2 were immature tumors. Conclusion: Conventional X-ray and USG demonstrate high concordance with histopathology and effectively identify mature SCTs, while highlighting features suggestive of immaturity. These modalities remain valuable tools for preoperative assessment, especially in resource-limited settings.

ABSTRACT
Abstract: Neuronal migration disorders (NMDs) are congenital brain malformations caused by disrupted neuronal development and often lead to epilepsy and other neurological deficits. These conditions are rare, occurring in approximately one in every 2,500 live births. Early detection through prenatal and neonatal imaging is crucial for prompt genetic counselling, testing, and neurosurgical intervention. In Ghana, limited access to advanced medical imaging services such as magnetic resonance imaging (MRI) and computed tomography complicates the diagnosis of NMD. This medical imaging case report describes a 39-year-old Ghanaian woman with a 24-year history of epilepsy. Although the patient had a CT scan 15 years before the current hospital visit, a definitive diagnosis was not achieved until now through MRI. The MRI findings revealed a hypoplastic cerebellum, heterotopia, lissencephaly, expansion of the fourth ventricle, and a dilated cisterna magna, in keeping with NMD. The discussion focuses on the diagnostic capabilities of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) in identifying congenital brain malformations. It emphasises their respective advantages and limitations, while also highlighting the urgent need to enhance neuroimaging accessibility and to develop specialised radiological training programs in Ghana. The case underscores the paramount importance of MRI in accurately delineating cerebral anatomy and offers valuable insights into the detection and management of neuronal migration disorders.

ABSTRACT
This observational study evaluates the diagnostic accuracy of Magnetic Resonance Imaging (MRI) in detecting meniscal injuries of the knee joint. A total of 40 patients presenting with knee-related symptoms—such as pain, swelling, stiffness, or mechanical locking—were included. Both inpatients (IPD) and outpatients (OPD) were examined between March and June 2025 at a tertiary care radiology center. MRI scans were performed using a dedicated knee coil, incorporating standard sequences such as T1-weighted, T2-weighted, Proton Density (PD) with fat saturation, STIR (Short Tau Inversion Recovery), and Gradient Echo (GRE). These imaging protocols enabled detailed evaluation of meniscal morphology, detection of degenerative signal changes, and precise localization of anterior and posterior horn tears in both the medial and lateral menisci. Findings confirm that MRI offers superior soft tissue contrast, enabling the early and accurate diagnosis of meniscal tears. Its non-invasive nature and diagnostic precision make MRI a crucial tool in clinical decision-making and treatment planning, particularly in cases of sports injuries or trauma.

ABSTRACT
The VACTERL association refers to a collection of congenital anomalies that typically affect the vertebral column (V), anus (A), cardiovascular system (C), tracheoesophageal structures (TE), renal and urinary tract (R), and limbs (L). The diagnosis is considered when a patient has defects in at least three of these systems. This multisystem disorder can be life-threatening if not identified and managed early. Prompt and thorough evaluation is crucial to reduce long-term complications and morbidity. Here, we describe the case of a neonate born from a twin pregnancy at 38 weeks’ gestation, with antenatal findings of severe polyhydramnios and a single umbilical artery and vein. This report focuses on the imaging characteristics of congenital cardiac, skeletal, and tracheoesophageal abnormalities in this infant.