Chest CT In COVID-19 Pneumonia Research Articles

Chest CT in covid-19 pneumonia's follow-up: A 30 patients case series.

Lung abnormalities do not fully resolve in all Covid-19 survivors and may progress to fibrosis. Understanding post-COVID lung changes helps identify patients susceptible of post-COVID-19 sequelae. We analyzed scannographic residual lung abnormalities and the full resolution percentage on intermediate- and long-term follow-up (3 months or more). Data from 30 RT-PCR positive COVID-19 patients undergoing at least one follow-up chest CT at Ibn Sina Hospital, with a minimal time interval of 3 months between the RT-PCR and the CT performance were gathered retrospectively. The following elements were analyzed: (1) lung opacities, (2) distribution, (3) dominant lung opacity, (4) Sub-pleural bands, (5) Interlobular septal thickening, (6) Vascular dilatation, (7) Bronchiectasis, (8) Honey combing, (9) Architectural distortion, (10) mosaic attenuation, and (11) Additional findings: Enlarged lymph nodes, Pleural and Pericardial fluid. To evaluate the degree of lung opacification, a score founded on visual evaluation of the lung involvement's percentage was employed. Patients were then subdivided into two categories: (1) no residual opacities and (2) remaining pulmonary opacities. 30 patients were enrolled. The age ranged between 40 and 87 years. CT was indicated for symptoms or functional impairment. The time range between the positive RT-PCR and Follow-up CT varied between 3 and 12 months. CT severity score ranged between o and 23. Residual lung opacities were present in 24 cases (80%). The dominant lung opacities were Ground glass (46.7%), and linear/curvilinear opacities (23.3%). Signs of fibrosis were present in 9 patients (30%). CT abnormalities following Covid-19 pneumonia's prevalence varies based on the extent of the original lung affection and the time gap since the acute phase. Residual anomalies' effects on respiratory physiology, symptoms, and quality of living are unknown. Maintained monitoring of COVID-19 survivors with clinical examination, iterative pulmonary function tests, and HRCT is advised.

PATTERNS OF CHEST COMPUTED TOMOGRAPHY FINDINGS IN COVID-19 PATIENTS IN PORT HARCOURT RIVERS STATE, NIGERIA

Background: The novel coronavirus disease (COVID-19) is usually under diagnosed in resource-constrained countries as Africa. Although Real-time-reverse-transcription polymerase chain reaction (RT-PCR) testing is considered to be the gold standard tool to diagnose or screen for COVID-19, chest imaging is a valuable tool to support the diagnosis of COVID-19 pneumonia. Therefore, Radiologists usually play an important role in the diagnosis of COVID-19 pneumonia, especially in resource-constrained environments. This study aimed to evaluate the patterns of chest CT findings in covid-19 pneumonia and to emphasize its diagnostic value in coronavirus disease. Materials and Method: This study was a retrospective cross-sectional study conducted in a reputable diagnostic center in Port Harcourt and comprised of 13 chest CT images diagnosed of Covid-19 pneumonia that met the inclusion criteria set for this study. All the chest CT examinations were performed by registered radiographers on a 64-slice CT scanner (GE Optima CT660, GE medical systems). Results: Chest CT findings in patients with confirmed covid-19 infection was evaluated and the results revealed that 13 (100%) had GGO. Out of 13 patients with GGO, bilateral distribution of the opacities was found in 11(84.62%), followed by peripheral opacities 9(69%) and the least 2 (15.38%) was unilateral distribution. Conclusion: The commonest chest CT appearance of covid-19 pneumonia is bilateral GGO with a predilection for the lower lobes of the lungs. Radiologists and clinicians should take cognizance of imaging appearances and diagnostic capabilities of Chest CT in covid-19 pneumonia, especially in the context of the current pandemic.

Chest CT in COVID-19 pneumonia: correlations of imaging findings in clinically suspected but repeatedly RT-PCR test-negative patients

BackgroundTo emphasize the importance of CT in the diagnosis of COVID-19 disease by comparing the thoracic CT findings of COVID-19 patients with positive RT-PCR results and patients with clinical suspicion of COVID-19 but with negative RT-PCR results.ResultsIn our study, COVID-19 patients with positive RT-PCR results (RT-PCR (+) group) and patients with clinical suspicion of COVID-19 but negative RT-PCR results (RT-PCR (−) group) were compared in terms of CT findings. In CT images, ground-glass opacity and ground-glass opacity + patchy consolidation were the most common lesion patterns in both groups. No statistically significant differences in the rates and types of lesion patterns were observed between the two groups. In both groups, lesion distributions and distribution patterns were similarly frequent in the bilateral, peripheral, and lower lobe distributions. Among the 39 patients who underwent follow-up CT imaging in the first or second month, a regression in lesion number and density was detected in 18 patients from both groups. Consolidations were completely resorbed in 16 of these patients, and five patients had newly developed fibrotic changes. The follow-up CT examination of 16 patients was normal.ConclusionsDue to the false-negative rate of RT-PCR tests caused by various reasons, clinically suspected COVID-19 patients with a contact history should be examined with CT scans, even if RT-PCR tests are negative. If the CT findings are positive, these patients should not be removed from isolation.

Investigating centering, scan length, and arm position impact on radiation dose across 4 countries from 4 continents during pandemic: Mitigating key radioprotection issues.

PurposeOptimization of CT scan practices can help achieve and maintain optimal radiation protection. The aim was to assess centering, scan length, and positioning of patients undergoing chest CT for suspected or known COVID-19 pneumonia and to investigate their effect on associated radiation doses.MethodsWith respective approvals from institutional review boards, we compiled CT imaging and radiation dose data from four hospitals belonging to four countries (Brazil, Iran, Italy, and USA) on 400 adult patients who underwent chest CT for suspected or known COVID-19 pneumonia between April 2020 and August 2020. We recorded patient demographics and volume CT dose index (CTDIvol) and dose length product (DLP). From thin-section CT images of each patient, we estimated the scan length and recorded the first and last vertebral bodies at the scan start and end locations. Patient mis-centering and arm position were recorded. Data were analyzed with analysis of variance (ANOVA).ResultsThe extent and frequency of patient mis-centering did not differ across the four CT facilities (>0.09). The frequency of patients scanned with arms by their side (11–40% relative to those with arms up) had greater mis-centering and higher CTDIvol and DLP at 2/4 facilities (p = 0.027–0.05). Despite lack of variations in effective diameters (p = 0.14), there were significantly variations in scan lengths, CTDIvol and DLP across the four facilities (p < 0.001).ConclusionsMis-centering, over-scanning, and arms by the side are frequent issues with use of chest CT in COVID-19 pneumonia and are associated with higher radiation doses.

Chest CT in COVID-19 pneumonia: a correlation of lung abnormalities with duration and severity of symptoms

BackgroundAfter the spread of COVID-19 pneumonia, chest CT examination was used as a substantial non-invasive complement to RT-PCR for diagnosing and as a rapid screening tool when RT-PCR results are unavailable. Our study aimed at the analysis of the lung abnormalities detected by chest CT in COVID-19 pneumonia according to the severity and duration of symptoms.ResultsIn the early phase (n = 60), 32 patients had negative CT findings and 28 patients had positive findings with a mean total lung severity score of 2.13. In the intermediate phase (n = 116), 4 patients had negative CT findings and 112 patients had positive findings with a mean total lung severity score of 16.08. In the late phase (n = 36), all patients had positive findings with a mean total lung severity score of 17.83. CT lung abnormalities were progressed on follow-up CT studies. We found a high total lung severity score in many patients with mild symptoms with a mean of 14.77 and a low total lung severity score in many patients with moderate to severe symptoms with a mean of 9.14.ConclusionChest CT should be used as a routine examination for diagnosing COVID-19 pneumonia and follow-up of disease advance. The progression of lung abnormalities was related to the duration more than the severity of symptoms.

Multiple Reversed Halo Sign on Chest CT in COVID-19 Pneumonia

Multiple Reversed Halo Sign on Chest CT in COVID-19 Pneumonia

Structured reporting of chest CT in COVID-19 pneumonia: a consensus proposal

ObjectivesThe need of a standardized reporting scheme and language, in imaging of COVID-19 pneumonia, has been welcomed by major scientific societies. The aim of the study was to build the reporting scheme of chest CT in COVID-19 pneumonia.MethodsA team of experts, of the Italian Society of Medical and Interventional Radiology (SIRM), has been recruited to compose a consensus panel. They used a modified Delphi process to build a reporting scheme and expressed a level of agreement for each section of the report. To measure the internal consistency of the panelist ratings for each section of the report, a quality analysis based on the average inter-item correlation was performed with Cronbach’s alpha (Cα) correlation coefficient.ResultsThe overall mean score of the experts and the sum of score were 3.1 (std.dev. ± 0.11) and 122 in the second round, and improved to 3.75 (std.dev. ± 0.40) and 154 in the third round. The Cronbach’s alpha (Cα) correlation coefficient was 0.741 (acceptable) in the second round and improved to 0.789 in the third round. The final report was built in the management of radiology report template (MRRT) and includes n = 4 items in the procedure information, n = 5 items in the clinical information, n = 16 in the findings, and n = 3 in the impression, with overall 28 items.ConclusionsThe proposed structured report could be of help both for expert radiologists and for the less experienced who are faced with the management of these patients. The structured report is conceived as a guideline, to recommend the key items/findings of chest CT in COVID-19 pneumonia.