Abstract
PurposeThe aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019.Materials and methodsFifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated.ResultsThe agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases.ConclusionsThe agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.
Highlights
To date, no proper and standardized pathway has been established to conduct follow-up after the resolution of patients’ clinical symptoms of coronavirus disease 2019 (COVID-19) and after the real-time polymerase chain reaction (RT-PCR) sampling has turned negative.To cope with the COVID-19 emergency, it is essential to ensure the prompt discharge of healed patients while at the same time confirming their non-infectivity
The present study revealed the promising results regarding magnetic resonance imaging (MRI)’s reliability and appropriateness in the evaluation of COVID-19 patients’ follow-up as compared with computed tomography (CT) as the standard imaging modality
MRI proved to be very reliable in assessing the resolution or progression of radiological signs relative to the previous CT scan, showing almost perfect agreement (k = 0.857) with CT
Summary
No proper and standardized pathway has been established to conduct follow-up after the resolution of patients’ clinical symptoms of coronavirus disease 2019 (COVID-19) and after the real-time polymerase chain reaction (RT-PCR) sampling has turned negative. To cope with the COVID-19 emergency, it is essential to ensure the prompt discharge of healed patients while at the same time confirming their non-infectivity. In Italy, the Superior Health Council of the Ministry of Health stated that a patient hospitalized for COVID-19 can be considered healed after the resolution of symptoms and after two RT-PCR tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, performed at least 24 h apart are negative. Despite the variability in the abovementioned adopted criteria, a chest imaging examination is commonly performed in all COVID-19 patients prior to discharge
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