Chest Computed Tomography Findings Research Articles

Comparison of Chest Computed Tomography Findings in Patients with H1N1 and Coronavirus Disease-2019 Pneumonia

Comparison of Chest Computed Tomography Findings in Patients with H1N1 and Coronavirus Disease-2019 Pneumonia

Clinical features and risk factors for outcome in hemodialysis patients with COVID-19 after complete liberalization of epidemic control in China.

Patients undergoing hemodialysis (HD) are highly vulnerable during the COVID-19 pandemic. We aimed to investigate the risk factors associated with the severity of COVID-19 and death after the complete liberalization of epidemic control in China. We followed the outcomes of the HD patients of Central Hospital of Dalian University of Technology, from December 6, 2022 to January 8, 2023. The non-contrast enhanced chest computed tomography (CT) was performed on all COVID-19-infected hospitalized patients. We recorded the patient's clinical characteristics, demographic features, vaccination history, treatments, and lung lesions. Odds ratios and 95% confidence intervals were calculated using logistic regression models to identify independent risk factors for COVID-19-related severity and mortality. This study included a total of 858 hemodialysis patients, of which 660 were infected with COVID-19. The mean age was (55.61±14.61) years, with a median (interquartile range) dialysis duration of 44.5 (69.5) months. Over half (60%) of the study participants were male, and the majority had hypertension as a comorbidity. Multivariable analysis revealed that age, pre-dialysis diastolic pressure, fever, white blood cell (WBC) count, potassium, β2-microglobulin level and calcium were independent risk factors for disease severity, while platelets, urea nitrogen and creatinine were identified as independent protective factors. Furthermore, total iron- binding capacity and vaccination were found to be independent protective factors against mortality, and WBC count was an independent risk factor for in-hospital mortality (p < 0.05). The most frequent CT finding among hospitalized patients with chest symptoms was patchy shadow or pleural effusion, observed in 64.8% of cases. More than half of the patients exhibited bilateral lung lesions, and over 60% involved two or more lobes. The majority of HD patients are susceptible to COVID-19. Demographic, clinical features and laboratory indicators can be used to predict the severity and mortality associated with COVID-19. Our findings will assist clinicians in identifying markers for the early detection of high mortality risk in HD patients with COVID-19.

Concordance of Chest Radiography and Chest Computed Tomography Findings in Patients with Hematologic Malignancy and Invasive Mucormycosis: What Are the Prognostic Implications?

Invasive pulmonary mucormycosis (IPM) is a deadly opportunistic mold infection in patients with hematological malignancies (HM). Radiologic imaging is essential for its timely diagnosis. Here, we compared IPM lesions visualized by chest computed tomography (CCT) and chest X-ray (CXR) and determined the prognostic significance of discordant imaging. Therefore, we reviewed 44 consecutive HM patients with probable/proven IPM at MD Anderson Cancer Center in 2000-2020 who had concurrent CCT and CXR studies performed. All 44 patients had abnormal CCTs and 39 (89%) had anormal CXR findings at IPM diagnosis. However, only 26 patients (59%) showed CCT-matching IPM-suspicious lesions on CXR. Acute Physiology and Chronic Health Evaluation II score > 18 at IPM diagnosis and breakthrough infection to Mucorales-active antifungals were the only independent risk factors for 42-day and/or 84-day mortality. Absence of neutropenia at IPM diagnosis, neutrophil recovery in neutropenic patients, and surgical revision of mucormycosis lesions were protective factors. Although not reaching significance on multivariable analysis, visualization of CCT-matching lesions on CXR was associated with significantly increased 84-day mortality (log-rank test, p = 0.033), possibly as a surrogate of extensive lesions and tissue necrosis. This observation supports the exploration of radiologic lesion kinetics as a prognostic staging tool in IPM patients.

The Differential Diagnostic Value of Chest Computed Tomography for the Identification of Pathogens Causing Pulmonary Infections in Patients with Hematological Malignancies.

The role of chest computed tomography (CT) in distinguishing the causative pathogens of pulmonary infections in patients with hematological malignancies (HM) is unclear. The aim of our study was to compare and assess the clinical characteristics, radiologic features and potential differential diagnostic value of CT in HM patients and other different immune statuses patients with pulmonary infections. Patients were divided into immunocompetent (105 cases) and immunocompromised groups (99 cases) according to immune status. Immunocompromised patients included the HM group (63 cases) and the non-HM group (42 cases). The basic clinical data and CT findings were collected and statistically analyzed. Regarding the pathogen distribution, viral, Pneumocystis jirovecii and mixed infections were more common in the immunocompromised group than the immunocompetent (p < 0.01), but viral infections were more common in the HM group than in the non-HM group (p=0.013). Immunocompromised patients had more diverse CT findings and more serious lesions (mostly graded 2-4) than immunocompetent patients. The most common CT findings in HM patients were consolidation and ground-glass opacities (GGO), which were also found in the non-HM group. The overall diagnostic accuracy of CT was lower in immunocompromised patients than in immunocompetent patients (25.7% vs 50.5%, p< 0.01). CT had better diagnostic efficacy for fungi and Pneumocystis jirovecii in HM patients. CT diagnosis is less efficient in distinguishing the causative pathogens of HM patients. However, CT can help distinguish fungal pneumonia and Pneumocystis jirovecii pneumonia in HM patients. Our study might facilitate clinical decision-making in fungal pneumonia and Pneumocystis jirovecii pneumonia in HM patients.

Artificial intelligence-powered chest computed tomography analysis unveils prognostic insights for COVID-19 mortality among prevalent hemodialysis patients.

Coronavirus disease 2019 (COVID-19) has led to severe pneumonia and mortality worldwide, however, clinical outcomes in end-stage renal disease patients remain unclear. This study evaluates the prognostic value of chest computed tomography (CT) findings in predicting COVID-19-related outcomes in prevalent hemodialysis patients. We retrospectively analyzed 326 prevalent hemodialysis patients diagnosed with COVID-19 who underwent chest CT scans. Characteristics assessed included pleural effusion, lung involvement volume, nodular consolidation, patchy infiltration, and ground-glass opacity. Artificial intelligence (AI)-assisted CT analysis quantified lung involvement. The primary endpoint was in-hospital mortality. Clinical data were collected, and logistic regression analysis assessed the association between CT findings and mortality. The mean age of the patients was 66.7 ± 12.6 years, 61.0% were male, and 58.6% were diabetic. Chest CT showed that 18.1% had lung involvement >10%, 32.5% had pleural effusion, 68.7% had nodular consolidation, 57.1% had patchy infiltration, and 58.0% had ground-glass opacity. Seventy patients (21.5%) died. Multivariate logistic regression analysis identified lung involvement >2.7% (odds ratio [OR], 16.70; 95% confidence interval [CI], 4.35-65.63), pleural effusion (OR, 3.28; 95% CI, 1.15-9.35), nodular consolidation (OR, 4.08; 95% CI, 1.12-14.82), and patchy infiltration (OR, 3.75; 95% CI, 1.17-12.03) as significant mortality risk factors. Chest CT findings, including lung involvement >2.7% and the presence of pleural effusion, nodular consolidation, and patchy infiltrates, significantly indicated mortality in COVID-19 pneumonia among prevalent hemodialysis patients. AI-assisted CT analysis proved useful in assessing lung involvement extent, showing that even minimal lung involvement can be associated with increased mortality.

Osteosarcoma Metastasis to the Thorax: A Pictorial Review of Chest Computed Tomography Findings.

Background: Osteosarcoma, a primary bone malignancy in children and adolescents, frequently metastasizes to the lungs, contributing significantly to morbidity and mortality. Lung Metastases: At diagnosis, 15-20% of patients present with detectable lung metastases. Chest computed tomography (CT) is vital for the early detection and monitoring of these metastases. Lung involvement typically presents as multiple nodules of varying sizes and can include atypical features such as cavitation, cystic lesions, ground-glass halos, intravascular tumor thrombi, and endobronchial disease. Additional Findings: Pleural metastasis often occurs alongside pulmonary disease, and complications like spontaneous pneumothorax may arise. Additional findings may include thoracic lymphadenopathy, cardiac tumor thrombus, and chest wall deposits. Conclusion: Familiarity with these imaging patterns is essential for radiologists to ensure timely diagnosis and effective management. This review highlights the critical role of chest CT in detecting and characterizing osteosarcoma metastasis.

Evaluating the Accuracy of Chest CT in Detecting COVID-19 Through Tracheobronchial Wall Thickness: Insights From Emergency Department Patients in Mid-2023.

Background The post-pandemic phase of the coronavirus infectious diseasethat emerged in 2019 (COVID-19) has necessitated updates in radiology, with emerging evidence suggesting tracheobronchial wall thickness as a potential new diagnostic marker. Purpose To evaluate the accuracy of chest computed tomography (CT) scans in identifying COVID-19 by assessing tracheobronchial wall thickness in mid-2023. Material and methods A retrospective review was conducted on 60 patients who underwent thoracoabdominal CT and the severe acute respiratory syndrome coronavirus (SARS-CoV-2) antigen tests during emergency visits between June and August 2023. Tracheobronchial wall thickness was measured using a 4-point scale (1=no thickening, 2=mild, 3=moderate, 4=significant). Lung assessment employed the COVID-19 Reporting and Data System (CO-RADS). Patients were classified based on antigen test results. The Mann-Whitney U test and Fisher's exact test compared characteristics and CT findings. Diagnostic performance was evaluated using the area under the receiver operating characteristic curves (AUC). Results The SARS-CoV-2-positive group showed significantly thicker tracheobronchial walls (median 1.5 mm vs. 1.2 mm, P < 0.001), especially in the trachea's membranous wall (median 1.2 mm vs. 0.9 mm, P < 0.001) and higher scores (median 3 vs. 2, P < 0.001). CO-RADS scores showed no significant difference. Quantitative and qualitative wall thickness assessments demonstrated high diagnostic value, with AUCs of 0.90 and 0.94, and accuracies of 85% and 87%, respectively. Conclusion Tracheobronchial wall thickness on chest CT exhibited high diagnostic accuracy, establishing it as a reliable marker for COVID-19 detection in mid-2023.

A Cross-Sectional Study Conducted in Tehran, Iran, Analyzed the Typical Patterns of Primary Lung CT Scans in Critically Ill COVID-19 Patients Using a Semi-Quantitative Scoring System

Background: Given the ongoing COVID-19 global pandemic and the potential for respiratory failure in several COVID-19 patients, early diagnosis and timely treatment are of paramount importance. Objectives: In this context, we aimed to investigate the role of initial chest computed tomography (CT) in predicting the severity of COVID-19. Methods: The study, conducted at Imam Hossein Hospital between March 6, 2020, and May 6, 2020, was cross-sectional in nature. All patients diagnosed with severe to critical COVID-19 underwent high-resolution chest CT (HRCT), and the findings of the chest CT were meticulously analyzed using a semi-quantitative scoring system. Results: Out of 47 patients with severe to critical COVID-19, 72.4% were male, with a mean age of 62 ± 14 years. The most common chest CT findings were ground-glass opacity (55%) and consolidation (30%). Bilateral involvement was observed in all patients, with the most frequently affected areas being the peribronchovascular distribution (76%) and peripheral distribution (74%). Most patients had pulmonary involvement across all five lobes, with scores ranging from a minimum of 3.25 to a maximum of 21.25 (CI: 12 - 15; mean: 13.25). Conclusions: This study suggests a relationship between the initial chest CT scan findings and the severity of respiratory disease in COVID-19 patients. However, further studies are needed to confirm these findings.

Direct visualization of postoperative aortobronchial fistula on computed tomography.

Postoperative aortobronchial fistula (ABF) is a rare complication that can occur in 0.3%-5.0% of patients over an extended period of time after thoracic aortic surgery. Direct visualization of the fistula via imaging is rare. To investigate the relationship between computed tomography (CT) findings and the clinical signs/symptoms of ABF after thoracic aortic surgery. Six patients (mean age 71 years, including 4 men and 2 women) with suspected ABF on CT (air around the graft) at our hospital were included in this retrospective study between January 2004 and September 2022. Chest CT findings included direct confirmation of ABF, peri-graft fluid, ring enhancement, dirty fat sign, atelectasis, pulmonary hemorrhage, and bronchodilation, and the clinical course were retrospectively reviewed. The proportion of each type of CT finding was calculated. ABF detection after surgery was found to have a mean and median of 14 and 13 years, respectively. Initial signs and symptoms were asymptomatic in 4 patients, bloody sputum was found in 1 patient, and fever was present in 1 patient. The complications of ABF included graft infection in 2 patients and graft infection with hemoptysis in 2 patients. Of the 6 patients, 3 survived, 2 died, and 1 was lost to follow-up. The locations of the ABFs were as follows: 1 in the ascending aorta; 1 in the aortic arch; 2 in the aortic arch leading to the descending aorta; and 2 in the descending aorta. ABFs were directly confirmed by CT in 4/6 (67%) patients. Peri-graft dirty fat (4/6, 67%) and peri-graft ring enhancement (3/6, 50%) were associated with graft infection, endoleaks and pseudoaneurysms were associated with hemoptysis (2/6, 33%). Asymptomatic ABF after thoracic aortic surgery can be confirmed on chest CT. CT is useful for the diagnosis of ABF and its complications.

Clinical and radiological features of a cluster of immunocompetent adolescents with varicella pneumonia: a descriptive study.

Varicella pneumonia is one of the most common and severe complications of chickenpox infection. This study aimed to describe the clinical and radiological features of varicella pneumonia in a cluster of immunocompetent adolescents. A retrospective analysis was conducted on a cohort of adolescent patients diagnosed with varicella pneumonia at Wuhan Jinyintan Hospital between February 2023 and May 2023. The clinical and imaging data were collected and analyzed. A total of 116 patients were divided into two groups by the absence (group 1, n=57) or presence (group 2, n=59) of lower respiratory symptoms for data comparison. Among 116 patients (median age, 16 years; 60 males), rash (100%) was the most prevalent clinical symptom. The most common respiratory symptom and sign were fever (42.2%) and coarse breath sounds (41.4%). Chest computed tomography (CT) performed within five days of symptoms onset revealed multiple (89.7%), peripheral (51.7%), and ill-defined (73.3%) lung nodules in most patients, which gradually improved 6-10 days after symptom onset. Group 2 had higher levels of interleukin-6 (P<0.001), C-reactive protein (P=0.02), serum amyloid-A protein (P=0.002), longer hospital stays (P=0.04), more involved lung lobes (P=0.02), and a higher incidence of multiple nodules (P=0.043) than those of group 1. In immunocompetent adolescents, clustered varicella pneumonia often presents as mild and more uniform in clinical and radiological presentations than sporadic cases. The most common CT findings were multiple pulmonary nodules. Patients with lower respiratory symptoms exhibited more severe clinical and radiological manifestations. Generally, it is not recommended that patients undergo frequent CT scans in a short period.

Laboratory data and broncho-alveolar lavage on Covid-19 patients with no intensive care unit admission: Correlation with chest CT features and clinical outcomes.

Broncho-alveolar lavage (BAL) is indicated in cases of uncertain diagnosis but high suspicion of Sars-Cov-2 infection allowing to collect material for microbiological culture to define the presence of coinfection or super-infection. This prospective study investigated the correlation between chest computed tomography (CT) findings, Covid-19 Reporting and Data System score, and clinical outcomes in Coronavirus disease 2019 (Covid-19) patients who underwent BAL with the aim of predicting outcomes such as lung coinfection, respiratory failure, and hospitalization length based on chest CT abnormalities. Study population included 34 patients (range 38-90 years old; 20 males, 14 females) with a positive nucleic acid amplification test for Covid-19 infection, suitable BAL examination, and good quality chest CT scan in the absence of lung cancer history. Pulmonary coinfections were found in 20.6% of patients, predominantly caused by bacteria. Specific correlations were found between right middle lobe involvement and pulmonary co-infections. Severe lung injury (PaO2/FiO2 ratio of 100-200) was associated with substantial involvement of right middle, right upper, and left lower lobes. No significant correlation was found between chest CT findings and inflammatory markers (C-reactive protein, procalcitonin) or hospitalization length of stay. Specific chest CT patterns, especially in right middle lobe, could serve as indicators for the presence of co-infections and disease severity in noncritically ill Covid-19 patients, aiding clinicians in timely interventions and personalized treatment strategies.

Chest computed tomography manifestations in neonates with chronic granulomatous disease

To study chest computed tomography (CT) manifestations in neonates with chronic granulomatous disease (CGD) to provide clues for early diagnosis of this disease. A retrospective analysis was conducted on the clinical data and chest CT scan results of neonates diagnosed with CGD from January 2015 to December 2022 at Anhui Provincial Children's Hospital. Nine neonates with CGD were included, with eight presenting respiratory symptoms as the initial sign. Chest CT findings included: consolidation in all 9 cases; nodules in all 9 cases, characterized by multiple, variably sized scattered nodules in both lungs; masses in 4 cases; cavities in 3 cases; abscesses in 6 cases; bronchial stenosis in 2 cases; pleural effusion, interstitial changes, and mediastinal lymphadenopathy each in 1 case. CT enhancement scans showed nodules and masses with uneven or ring-shaped enhancement; no signs of pulmonary emphysema, lung calcification, halo signs, crescent signs, bronchiectasis, or scar lesions were observed. There was no evidence of rib or vertebral bone destruction. Fungal infections were present in 8 of the 9 cases, including 6 with Aspergillus infections; three of these involved mixed infections with Aspergillus, with masses most commonly associated with mixed Aspergillus infections (3/4). The primary manifestations of neonatal CGD on chest CT are consolidation, nodules, and/or masses, with Aspergillus as a common pathogen. These features can serve as early diagnostic clues for neonatal CGD.

Chest Computed Tomography Severity Score to Predict Outcome of Patients with COVID 19

Abstract Background The coronavirus disease 2019 (COVID-19) is an acute infectious pneumonia caused by a severe acute respiratory syndrome-coronavirus-2. Some studies have suggested that C-reactive protein, lymphocyte count, and features from CT scoring as predictors of severity and prognosis of COVID-19. Non-contrast chest computed tomography (CT) scan was found to be a useful diagnostic instrument for screening COVID-19 pneumonia. This score uses lung opacification as a surrogate for extension of the disease in the lungs. Aim To assess the prognostic value of chest CT severity score (CSS) to predict the severity of symptoms and outcomes among patients with typical CT findings. Subject and Methods This Prospective Observational study was conducted at Radiology department, faculty of medicine, Ain Shams University on 94 patients. Results There is a significant difference between the groups regarding symptoms severity. there is no significant difference between the groups regarding CT findings. left lung severity scores and total severity score were significantly higher among poor prognosis patients compared to good prognosis patients. mortality rate was significantly higher among poor prognosis patients compared to good prognosis patients. severity score was significantly higher among severe symptoms patients compared to mild symptoms patients in good prognosis patients. Conclusion The current study showed that CT images and CT-severity scores can predict ICU admission and mortality in patients with COVID-19 pneumonia. Clinicians and radiologists can use the CT-severity score as a measure of disease severity and an indicator of poor prognosis, including the need for mechanical ventilation. Also, our findings showed the superiority of CT findings over other clinical information and co-morbidities in predicting the short-term outcome.

Chest Computerized Tomography Findings in COVID-19 Patients Presenting to the ER with Gastrointestinal Symptoms

Abstract Background The world continues to face a life-threatening viral pandemic. SARS-CoV-2 has caused over 98 million cases and 2.2 million deaths since January 2020. Chest Computerized tomography is one of the main modalities in the screening and diagnosis of corona virus disease; yet it must correlate with the clinical and laboratory findings. Among available modalities for detecting COVID19, Chest Computerized tomography was done mainly in symptomatic and in high risk patients showing a sensitivity of 94.6% and specificity of 46.0%. Purpose of the Study Detecting COVID19 patients presenting initially or mainly with Gastrointestinal manifestations and to help preventing misdiagnosis and overlooking these patients. In addition to estimating the prevalence of these COVID19 patients presenting with gastrointestinal symptoms only versus those presenting with combined gastrointestinal and respiratory manifestations. Results This study included 95 patients recruited from the Ain-shams and Souad Kafafi University Hospitals from August 2021 till March 2022. These patients presented with gastrointestinal symptoms as their initial or main symptoms with positive PCR test. They were investigated by Chest CT and were interpreted by experienced radiologists in reading CT chest. From such patients, (32%) presented with gastrointestinal manifestations only. The rest of the patients were presenting mainly with gastrointestinal symptoms and associated with chest symptoms. A recurrently observed pattern of bilateral peripheral Ground glass opacities with basal predominance was found in gastrointestinal only group CT scans. Bilateral involvement, consolidation, crazy paving and multi lobar affection were statistically significantly higher in combined group in comparison to GIT only group. Conclusions Commonest Chest CT pattern was bilateral, peripheral GGO with basal predominance among Gastrointestinal only group. These findings indicate high possibility of COVID 19 even in the absence of chest symptoms. Consequently, a rapid diagnosis and earlier quarantine will assist in better treatment and prognosis.

Chest computed tomography findings among adult Aboriginal Australians with bronchiectasis in the Top End Northern Territory of Australia.

There is limited evidence in the literature illustrating chest computed tomography (CT) characteristics among adult Aboriginal Australians with bronchiectasis. This retrospective study evaluates the radiological characteristics of bronchiectasis in Aboriginal Australians residing in the Top End, Northern Territory of Australia. Patients aged >18 years with chest CT-confirmed bronchiectasis between 2011 and 2020 were included. Demographics and relevant clinical parameters were collected. Alongside confirming bronchiectasis, chest CT reports were assessed for (i) lobar location (ii) unilateral or bilateral involvement and (iii) bronchiectasis type when available. A total of 459 patients were identified with chest CT-confirmed bronchiectasis, with a median age of 47 years, and 55% were females. Bronchiectasis was predominantly recorded in the left lower lobe (LLL) (73%), followed by the right lower lobe (RLL) (62%) and the left upper lobe (LUL) was least common (22%). Females recorded the right middle lobe (RML) affected significantly more often than males (50 vs. 34%, P = 0.012). Bilateral involvement was common (74%), with the strongest pairwise correlation associated between the right upper lobe (RUL) and LUL (P < 0.001). Cylindrical (50%) and cystic (28%) types were most common. The RML and LLL showed positive correlation with cylindrical and LUL with cystic bronchiectasis. Neither lobar location nor bronchiectasis type showed any significant association with lung function parameters other than RML, Lingula and LUL involvement being associated with better percent predicted values of diffusing capacity for carbon monoxide. There were no significant associations between sputum culture and type or lobar locations of bronchiectasis except for non-Aspergillus fungus culture prevalence was higher with cystic or cylindrical types. The results of this study may be an avenue to develop CT bronchiectasis severity scale in the future specific for Aboriginal Australians.

Comparison of radiologic findings between SARS-CoV-2 and other respiratory tract viruses in critically ill children during the COVID-19 pandemic.

This study was planned because the radiological distinction of COVID-19 and respiratory viral panel (RVP)-positive cases is necessary to prioritize intensive care needs and ensure non-COVID-19 cases are not overlooked. With that purpose, the objective of this study was to compare radiologic findings between SARS-CoV-2 and other respiratory airway viruses in critically ill children with suspected COVID-19 disease. This study was conducted as a multicenter, retrospective, observational, and cohort study in 24 pediatric intensive care units between March 1 and May 31, 2020. SARS-CoV-2- or RVP polymerase chain reaction (PCR)-positive patients' chest X-ray and thoracic computed tomography (CT) findings were evaluated blindly by pediatric radiologists. We enrolled 225 patients in the study, 81 of whom tested positive for Coronovirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The median age of all patients was 24 (7-96) months, while it was 96 (17-156) months for COVID-19-positive patients and 17 (6-48) months for positive for other RVP factor (p < 0.001). Chest X-rays were more frequently evaluated as normal in patients with SARS-CoV-2 positive results (p = 0.020). Unilateral segmental or lobar consolidation was observed more frequently on chest X-rays in rhinovirus cases than in other groups (p = 0.038). CT imaging findings of bilateral peribronchial thickening and/or peribronchial opacity were more frequently observed in RVP-positive patients (p = 0.046). Chest X-ray and CT findings in COVID-19 patients are not specific and can be seen in other respiratory virus infections.

Correlation of CT features of lung adenocarcinoma with sex and age

This study aimed to retrospectively examine the computed tomography (CT) features of lung adenocarcinoma across different demographic groups. Preoperative chest CT findings from 1266 surgically resected lung adenocarcinoma cases were retrospectively analyzed. Lung adenocarcinomas were categorized based on CT characteristics into pure ground glass (pGGO), nodule-containing ground glass opacity (mGGO), and pure solid without containing ground glass opacity (pSD). These categories were correlated with sex, age, EGFR status, and five histopathological subtypes. The diameters of pGGO, mGGO, and pSD significantly increased across all patient groups (P < 0.05). Males exhibited a significantly higher proportion of pSD than females (P = 0.002). The mean diameters of pGGO and pSD were significantly larger in males than in females (P = 0.0017 and P = 0.043, respectively). The frequency of pGGO was higher in the younger age group (≤ 60 years) compared to the older group (> 60 years) for both males (P = 0.002) and females (P = 0.027). The frequency of pSD was higher in the older age group for both sexes. A linear correlation between age and diameter was observed in the entire cohort as well as in the male and female groups (P < 0.0001 for all groups). EGFR mutations were less frequent in pSD compared to pGGO (P = 0.0002) and mGGO (P < 0.0001). The frequency of lesions containing micropapillary components increased from pGGO to mGGO and pSD (P < 0.0001 for all). The frequency of lesions containing solid components also increased from pGGO to mGGO and pSD (P = 0.045, P < 0.0001, and P < 0.0001, respectively). The CT features of lung adenocarcinoma exhibit differences across genders and age groups. Male gender and older age are risk factors for lung adenocarcinoma growth.

Progression to ANCA-associated vasculitis in patients with idiopathic interstitial pneumonia and positive ANCA

ObjectiveThis study explored the development of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and its risk factors in patients with idiopathic interstitial pneumonia (IIP) and positive ANCA results. MethodsData of patients diagnosed with IIP with positive ANCA results at a single tertiary center in South Korea were retrospectively reviewed from January 2013 to August 2023. Cox regression analysis was performed to identify variables associated with AAV occurrence following IIP diagnosis. Kaplan–Meier curves were employed to investigate the relationship between autoantibodies and the occurrence of AAV. ResultsIn a cohort of 154 IIP-diagnosed patients with positive ANCA results but without AAV, 10.4 % of them eventually developed AAV. The AAV and non-AAV groups did not significantly differ by sex, age, smoking status, urinalysis, or chest computed tomography findings. All the patients who subsequently developed AAV were anti-myeloperoxidase (MPO) positive, while 48.8 % of the non-AAV patients were anti-MPO positive (P < 0.001). Rheumatoid factor (RF) positivity differed significantly (62.5 % vs. 29.2 %, P = 0.007) between the AAV and non-AAV groups. Multivariate Cox regression and Kaplan–Meier analyses revealed RF (HR 4.02; P = 0.004) and anti-MPO (HR 38.10; P < 0.001) positivity as risk factors associated with AAV occurrence. ConclusionApproximately 10 % of ANCA-positive IIP patients developed AAV after an IIP diagnosis. Anti-MPO or co-occurring positive RF poses a significant risk for subsequent AAV occurrence. This emphasizes the importance of careful monitoring in patients with high-risk antibody profiles, even if the complete features of AAV are not present at IIP diagnosis.

Lung T1 MRI assessments in children with mild cystic fibrosis lung disease.

Lung T1 MRI is a potential method to assess cystic fibrosis (CF)lung disease that is safe, quick, and widely available, but there are no data in children with mild CF lung disease. Assess the ability of lung T1 MRI to detect abnormalities in children with mild CF lung disease. We performed T1 MRI, multiple breath washout (MBW),chest computed tomography (CT),and spirometry in a cohort of 45 children with mild CF lung disease (6-11 years of age). Despite mean normal ppFEV1 values, the majority of children with CF in this study exhibited mild lung disease evident in lung clearance index (LCI)measured by MBW, chest CT Brody scores, and percent normal lung perfusion (%NLP)measured by T1 MRI. The %NLP correlated with chest CT Brody scores, as did LCI, but %NLP and LCI did not correlate with each other. Analysis of the Brody subscores showed that %NLP and LCI largely correlated with different Brody subscores. T1 MRI can detect mild CF lung disease in children and correlates with chest CT findings. The %NLPfrom T1 MRI and LCI correlate with different chest CT Brody subscores, suggesting they provide complementary information about CF lung disease.

Chronic Chest Computed Tomography Findings Following COVID-19 Pneumonia

Respiratory symptoms are a frequent manifestation of patients with post-acute sequela of SARS-CoV-2 (PASC), also known as long-COVID. Many cohorts of predominantly hospitalized patients have shown that a significant subset may have persistent chest CT findings for more than 12 months after the acute infection. Proper understanding of the evolving long-term imaging findings and terminology is crucial for accurate imaging interpretation and patient care. The goal of this article is to review the chronic chest CT findings of patients with PASC and common pitfalls.