Внебольничная пневмония. Дифференциальная диагностика. COVID-19

Abstract

Introduction. The paper presents the results of X-ray examination of patients with lung lesions caused by diseases and computed tomography (CT) of patients with COVID-19 of varying degrees of infiltration according to the categorical CT scheme from CO-RADS 1 to CO-RADS 6, developed by the Dutch Radiological Society (NVvR). Good results can be achieved by detecting the early stage of the disease in COVID-19. The work considers indications, contraindications, methodology and interpretation, at different phases of infil-tration in COVID-19. Objective. To review the dynamic models of CT imaging of lungs affected by COVID-19, to define CT character of primary and post-primary infection and discuss the role of imaging in differential diagnostics and monitoring of the pathology. Materials and research methods. 85 patients (the median of 48 y.o. to the 17 to 84 y.o. range) were examined. All patients un-derwent CT procedure («Toshiba Corp.» 64-sl. CT). Results. At an early stage bilateral basal peripheral changes of the «ground glass» type opacity, generally of minuscule area, pre-dominate which precurse development of viral pneumonia in COVID-19. As the disease progresses areas of change in the tissue appear patterned according to the type of «patchwork», consolidation areas form resembling OP «reverse halo». Complete resorption of changes in lungs is likely. Resolution of pathological changes could be observed after a month and longer with a successful outcome. Conclusion. At the stage of the outbreak progression the role of CT imaging methods in assessing the condition of lungs could not be overestimated. They provide means to identify changes at the subclinical stage, to assess the severity of the course and conduct differential diagnostics, but also to inform about the likelihood of COVID-19 when PCR testing results are lacking. The role of CT is in-deed prevailing in clinical conditions of limited resources and while coping with a large patient cohort with acute respiratory diseases of undefined aetiology. Key words: Differential diagnosis; CT examination; COVID-19; CO-RADS scheme.