Dual-Energy Computed Tomography of the Lung in COVID-19 Patients: Mismatch of Perfusion Defects and Pulmonary Opacities.

Saif Afat,Ahmed E Othman,Konstantin Nikolaou,Sebastian Gassenmaier

doi:10.3390/diagnostics10110870

Abstract

To evaluate contrast-enhanced dual-energy computed tomography (DECT) chest examinations regarding pulmonary perfusion patterns and pulmonary opacities in patients with confirmed COVID-19 disease. Fourteen patients with 24 DECT examinations performed between April and May 2020 were included in this retrospective study. DECT studies were assessed independently by two radiologists regarding pulmonary perfusion defects, using a Likert scale ranging from 1 to 4. Furthermore, in all imaging studies the extent of pulmonary opacities was quantified using the same rating system as for perfusion defects. The main pulmonary findings were ground glass opacities (GGO) in all 24 examinations and pulmonary consolidations in 22 examinations. The total lung scores after the addition of the scores of the single lobes showed significantly higher values of opacities compared to perfusion defects, with a median of 12 (9–18) for perfusion defects and a median of 17 (15–19) for pulmonary opacities (p = 0.002). Furthermore, mosaic perfusion patterns were found in 19 examinations in areas with and without GGO. Further studies will be necessary to investigate the pathophysiological background of GGO with maintained perfusion compared to GGO with reduced perfusion, especially regarding long-term lung damage and prognosis.

Highlights

In December 2019, a novel coronavirus called severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) emerged in mainland China, leading to pneumonia of different severity [1,2]
Fourteen confirmed COVID-19 patients with 24 dual-energy computed tomography (DECT) examinations performed between April and May 2020 were found and displayed the final study group
This study study investigated investigated the the relationship relationship between between pulmonary pulmonary perfusion perfusion defects defects and and pulmonary pulmonary opacities in patients with confirmed

Summary

Introduction

2 (SARS-CoV-2) emerged in mainland China, leading to pneumonia of different severity [1,2]. This kind of pneumonia was later named “Coronavirus Disease 2019” (COVID-19) by the World Health. The outbreak of COVID-19 has developed into a pandemic, affecting almost every country worldwide and leading to millions of infections and hundreds of thousands of deaths. To confine the further spread of this disease, an early diagnosis of COVID-19 is vital. During the course of the pandemic, computed tomography (CT) imaging of the chest has gained increasing importance for diagnosis, the assessment of the extent of pulmonary involvement, the prediction and confirmation of possible complications, and for follow-up [5,6]. Typical CT imaging patterns have been described previously, mainly bilateral ground glass opacities (GGO), interlobular septal thickening, crazy paving, and consolidation [1,6,7,8,9,10,11,12,13,14,15]

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