SUMMARYBackground: Cardiothoracic ratio is a simple and cheap tool in the estimation of heart size. It is a useful index of cardiac size evaluation, and a value of 50% is generally considered to indicate the upper limit of normal. Study Objective: This study is to ascertain the normal mean value in cardiothoracic ratio of Ghanaians using chest radiography to serve as baseline for screening for cardiomegaly. Methodology: Standard postero-anterior radiographs of the -clients/patients were used in the study. The cardiothoracic ratio (CTR) was obtained by dividing the transverse cardiac diameter [sum of the horizontal distances from the right and left lateral-most margins of the heart to the midline (spinous processes of the vertebral bodies)] by the maximum internal thoracic diameter. Systematic sampling with appropriate inclusion and exclusion criteria were used to obtain a sample size of 1989. Results: The mean transverse cardiac diameter and cardiothoracic ratio increased with age. The transverse thoracic diameter increased with age until the sixth decade when it reduced with age. The mean CTR increased gradually with age with females having greater values than males. The mean CTR of the study population were 0.459, 0.467 and 0.452 for the general population, females and males respectively. Conclusion: This study has been able to establish 0.459 as the mean CTR values for Ghanaians. It has also shown the relationship between age and clients /patient's cardiothoracic ratio which compares favourably with findings of a similar study in Nigeria, a neighbouring country in the West African sub region with similar ethnic and social structure.

The history of Radiology in Ghana which began in 1951 has not been fully documented. The establishment of the Ghana College of Physicians and Surgeons, of which the Faculty of Radiology is a part, the West African College of Surgeons, as well as other institutions for radiography training, have played a major role in improving the Radiologist/Population-, Radiologist/Radiographer- and Radiographer/Population ratios in the country. Credence has also been given to a number of aims and objectives of the Faculty of Radiology of the Ghana College of Physicians and Surgeons such as a) The turning out of Radiologists for 9 out of the 16 regions of the country. b) A vast improvement in the quality and quantity of radiological services to the citizenry by the provision of modern radiological equipment, as well as increased manpower for the various diagnostic procedures. c) The establishment of subspecialties such as Interventional radiology, Neuroradiology and Paediatric radiology. The article seeks to highlight some of the major achievements and challenges in the delivery of radiological services to the citizenry of Ghana. Some of the challenges facing the specialty such as inadequate equipment in some public hospitals and the lack of maintenance of same are discussed. There is also inequitable distribution of radiologists across the country. Recommendations in the area of increased number of resident’s slots for postgraduate training by the Ministry of Health, as well as the reestablishment of external exposure for trainers to deepen their knowledge for the training of residents have been mentioned.