Positive Computed Tomography Research Articles

The severity of clinical symptoms and paranasal sinuses CT-scan finding in COVID-19 patients in Kirkuk Province

Introduction: COVID-19, first detected in Wuhan, China in December 2019, fast spread across the globe, causing a pandemic affecting many countries around the world. Objectives: The aim of this study was to assess the severity of clinical features and paranasal sinuses computed tomography (CT)-scan findings in COVID-19 patients and find the relationship between smoking and severity of COVID-19 symptoms. Materials and Methods: A cross-sectional study was achieved on a cohort of 399 patients, who clinically suffer from COVID-19 symptoms. The collected data for those patients included COVID-19 polymerase chain reaction (PCR) tests, presence of the IgG and IgM antigens, and paranasal sinuses CT-scan images. Results: This was a cross-sectional study of 399 patients infected with COVID-19. The mean age of the patients was 39 ± 11 years. Approximately 53.6% of them were males, whereas 46.4% were females. 55.6% of them performed CT scan for sinuses. 28.6% of the patients were with severe clinical features. 51.1% of them were smoking. 77.4% of them were of positive PCR, 57.9% positive IgG, and 86.7% positive IgM. 27.8% of patients were of the age group of 40–49 years. There was a significant association between the severity of COVID infection and age group. There was a significant association between the severity of COVID infection and sinus CT-scan findings. There was a significant association between the severity of COVID infection and positive PCR. There was a significant association between the severity of COVID infection and positive IgM. There was a significant association between smoking and sinus CT-scan findings. Conclusion: At the time of COVID infection, the severity of infection ranged from mild to moderate. More severe infection with COVID-19 associated with significant finding in sinus CT scan in patients at age group 50–59 years, and sinus also more severe COVID infection associate with positive CT scan finding that occur more in smocking patients.

Alert Germ Infections: Chest X-ray and CT Findings in Hospitalized Patients Affected by Multidrug-Resistant Acinetobacter baumannii Pneumonia.

Acinetobacter baumannii (Ab) is an opportunistic Gram-negative pathogen intrinsically resistant to many antimicrobials. The aim of this retrospective study was to describe the imaging features on chest X-ray (CXR) and computed tomography (CT) scans in hospitalized patients with multidrug-resistant (MDR) Ab pneumonia. CXR and CT findings were graded on a three-point scale: 1 represents normal attenuation, 2 represents ground-glass attenuation, and 3 represents consolidation. For each lung zone, with a total of six lung zones in each patient, the extent of disease was graded using a five-point scale: 0, no involvement; 1, involving 25% of the zone; 2, 25–50%; 3, 50–75%; and 4, involving >75% of the zone. Points from all zones were added for a final total cumulative score ranging from 0 to 72. Among 94 patients who tested positive for MDR Ab and underwent CXR (males 52.9%, females 47.1%; mean age 64.2 years; range 1–90 years), 68 patients underwent both CXR and chest CT examinations. The percentage of patients with a positive CT score was significantly higher than that obtained on CXR (67.65% > 35.94%, p-value = 0.00258). CT score (21.88 ± 15.77) was significantly (p-value = 0.0014) higher than CXR score (15.06 ± 18.29). CXR and CT revealed prevalent bilateral abnormal findings mainly located in the inferior and middle zones of the lungs. They primarily consisted of peripheral ground-glass opacities and consolidations which predominated on CXR and CT, respectively.

Multicenter and prospective trial of anti-epileptics for early seizure prevention in mild traumatic brain injury with a positive computed tomography scan.

Background: Posttraumatic seizures (PTSs) are a major source of disability after traumatic brain injury (TBI). The Brain Trauma Foundation Guidelines recommend prophylactic anti-epileptics (AEDs) for early PTS in severe TBI, but high-quality evidence is lacking in mild TBI.Methods: To determine the benefit of administering prophylactic AEDs, we performed a prospective and multicenter study evaluating consecutive patients who presented to a Level 1 trauma center from January 2017 to December 2020. We included all patients with mild TBI defined as Glasgow Coma Scale (GCS) 13–15 and a positive head computed tomography (CT). Patients were excluded for previous seizure history, current AED use, or a neurosurgical procedure. Patients were given a prophylactic 7-day course of AEDs on a week-on versus week-off basis and followed with in-person clinic visits, in-hospital evaluation, or a validated phone questionnaire.Results: Four hundred and ninety patients were enrolled, 349 (71.2%) had follow-up, and 139 (39.8%) were given prophylactic AEDs. There was no difference between seizure rates for the prophylactic AED group (0.7%) and those without (2.9%; P = 0.25). Patients who had a PTS were on average older (81.4 years) than patients without a seizure (64.8 years; P = 0.02). Seizure rate increased linearly by age groups: <60 years old (0%); 60–70 years old (1.7%); 70–80 years old (2.3%); and >80 years old (4.6%).Conclusion: Prophylactic AEDs did not provide a benefit for PTS reduction in mild TBI patients with a positive CT head scan.

Comparing blood biomarkers to clinical decision rules to select patients suspected of traumatic brain injury for head computed tomography.

Traumatic brain injury (TBI) is a major public health concern in the U.S. Recommendations for patients admitted in the emergency department (ED) to receive head computed tomography (CT) scan are currently guided by various clinical decision rules. To compare how a blood biomarker approach compares with clinical decision rules in terms of predicting a positive head CT in adult patients suspected of TBI. We retrospectively identified patients transported to our emergency department and underwent a noncontrast head CT due to suspicion of TBI and who had blood samples available. Published thresholds for serum and plasma glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1), and serum S100β were used to make CT recommendations. These blood biomarker-based recommendations were compared to those achieved under widely used clinical head CT decision rules (Canadian, New Orleans, NEXUS II, and ACEP Clinical Policy). Our study included 463 patients, of which 122 (26.3%) had one or more abnormalities presenting on head CT. Individual blood biomarkers achieved high negative predictive value (NPV) for abnormal head CT findings (88%-98%), although positive predictive value (PPV) was consistently low (25%-42%). A composite biomarker-based decision rule (GFAP+UCH-L1)'s NPV of 100% and PPV of 29% were comparable or better than those achieved under the clinical decision rules. Blood biomarkers perform at least as well as clinical rules in terms of selecting TBI patients for head CT and may be easier to implement in the clinical setting. A prospective study is necessary to validate this approach.

Thoracic imaging tests for the diagnosis of COVID-19.

Thoracic imaging tests for the diagnosis of COVID-19.

Rapid Screening: Post Computerized Tomography Incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Features in Asymptomatic Patients

Background: It is to document the frequency of incidental Corona Virus Disease-2019 (COVID-19) specific findings in patients imaged after the initial ten days of lockdown relief and the sensitivity of computed tomography (CT) in picking unknown ongoing disease processes. Case presentations: In this study, we presented seven cases—three cases in plain CT pyelogram and four cases of post-contrast scans. Post-contrast scans of chest findings in case 1 showed few pre-vascular, pre-tracheal, and sub-carinal lymph nodes with calcified granuloma in the left lower zone accompanied by extensive bilateral peripheral Ground Glass Haze with alveolar opacification. In Case 2, multiple non-homogeneous areas of ground-glass haze diffusely involving both lung fields were seen. Case 3 showed a few sub-centimeters mediastinal lymph nodes with diffuse mosaic attenuation patterns in both lung fields along with multiple soft tissues density nodules in both lungs. While in Case 4, Patchy areas of alveolar opacification with surrounding ground-glass haze were noted in lower lobes. Management and Results: Total 64 CT C/A/P (chest/abdomen/pelvis) with contrast scans and 120 plain pyelograms were done within ten days after lockdown relief, and it was observed that during the stricken lockdown, no incidental case of positive CT finding was observed. However, afterward, within this time, 44 cases (23.9%) were recorded in asymptomatic patients of COVID-19. Conclusions: CT chest is highly sensitive in detecting COVID-19 with high accuracy of featuring progress in the disease and associated findings even in the initial stages.

Diagnostic Performance of Standard and Inverted Grey-Scale CXR in Detection of Lung Lesions in COVID-19 Patients: A Single Institute Study in the Region of Abu Dhabi

Purpose: This study aimed at evaluating the diagnostic performance of standard greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard. Methods: In this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19th to May 23rd, 2020, in a single tertiary care center were reviewed. PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of standard greyscale and inverted greyscale chest radiographs (CXR) when images are viewed on high-specification viewing systems using a primary display monitor and compared to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients. Results: Ninety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detecting lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women. Conclusion: The sensitivity of detecting lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans. CXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients. Better detection of lesions was noted in the inverted greyscale CXR in 20.8% of cases, with positive findings in standard greyscale CXR. Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans.

Evaluation of a Year During the COVID-19 Pandemic in a Private Healthcare Facility: Retrospective Cross-Sectional Study.

Aims and Objectives: To examine the impact of the workforce crisis on healthcare service delivery for a year during the coronavirus disease 2019 (COVID-19) pandemic on healthcare service delivery and hospital economy in a healthcare facility.Materials and Methods: An examination was conducted of employees who were issued with a report for incapacity to work due to the pandemic between March 2020 and March 2021. A record was made of the employees' ages, genders, fields of work and lost workdays. The employees were classified as physicians, nursing services, guest services, hotel services, and support services. Diagnoses were made of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on computed tomography (CT) and polymerase chain reaction (PCR) test results. Employees diagnosed with SARS-CoV-2 infection were put into isolation in the hospital during the first months of the pandemic, and treatment was initiated in accordance with the protocols. By contrast, during the last eight months, our personnel who were not indicated for hospitalization completed their treatment in a home isolation setting. According to the Turkish Ministry of Health COVID-19 (SARS-CoV-2 Infection) Scientific Advisory Board Study Guide, the isolation period was initially 14 days, before being reduced to 7-10 days, in line with the revised guide. Employees with at least one negative PCR test result following isolation were allowed to return to work.Results: The study included 575 individuals who were employed at our hospital between March 2020, when the first case was identified in Turkey, and March 2021. Among these employees, 257 were issued with a report for incapacity to work due to COVID-19. Of these, 239 had a positive PCR test result. There were 11 individuals who just had symptoms and/or positive CT findings but a negative PCR test result. There were only seven individuals who were put into isolation due to high-risk contact. The combined lost workdays of the employees totaled 3792. The highest lost workday rate (52%) was in nursing services (1973 days, n = 126). There was no mortality. Conclusion: Lost workdays due to the pandemic in the midsize healthcare facility severely affected the morale and motivation of both the diagnosed and the remaining employees. Hospital administrations also had difficulties in maintaining the quality and continuity of the services provided.

Evaluation of Glial and Neuronal Blood Biomarkers Compared With Clinical Decision Rules in Assessing the Need for Computed Tomography in Patients With Mild Traumatic Brain Injury

In 2018, the combination of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase (UCH-L1) levels became the first US Food and Drug Administration-approved blood test to detect intracranial lesions after mild to moderate traumatic brain injury (MTBI). How this blood test compares with validated clinical decision rules remains unknown. To compare the performance of GFAP and UCH-L1 levels vs 3 validated clinical decision rules for detecting traumatic intracranial lesions on computed tomography (CT) in patients with MTBI and to evaluate combining biomarkers with clinical decision rules. This prospective cohort study from a level I trauma center enrolled adults with suspected MTBI presenting within 4 hours of injury. The clinical decision rules included the Canadian CT Head Rule (CCHR), New Orleans Criteria (NOC), and National Emergency X-Radiography Utilization Study II (NEXUS II) criteria. Emergency physicians prospectively completed data forms for each clinical decision rule before the patients' CT scans. Blood samples for measuring GFAP and UCH-L1 levels were drawn, but laboratory personnel were blinded to clinical results. Of 2274 potential patients screened, 697 met eligibility criteria, 320 declined to participate, and 377 were enrolled. Data were collected from March 16, 2010, to March 5, 2014, and analyzed on August 11, 2021. The presence of acute traumatic intracranial lesions on head CT scan (positive CT finding). Among enrolled patients, 349 (93%) had a CT scan performed and were included in the analysis. The mean (SD) age was 40 (16) years; 230 patients (66%) were men, 314 (90%) had a Glasgow Coma Scale score of 15, and 23 (7%) had positive CT findings. For the CCHR, sensitivity was 100% (95% CI, 82%-100%), specificity was 33% (95% CI, 28%-39%), and negative predictive value (NPV) was 100% (95% CI, 96%-100%). For the NOC, sensitivity was 100% (95% CI, 82%-100%), specificity was 16% (95% CI, 12%-20%), and NPV was 100% (95% CI, 91%-100%). For NEXUS II, sensitivity was 83% (95% CI, 60%-94%), specificity was 52% (95% CI, 47%-58%), and NPV was 98% (95% CI, 94%-99%). For GFAP and UCH-L1 levels combined with cutoffs at 67 and 189 pg/mL, respectively, sensitivity was 100% (95% CI, 82%-100%), specificity was 25% (95% CI, 20%-30%), and NPV was 100%; with cutoffs at 30 and 327 pg/mL, respectively, sensitivity was 91% (95% CI, 70%-98%), specificity was 20% (95% CI, 16%-24%), and NPV was 97%. The area under the receiver operating characteristic curve (AUROC) for GFAP alone was 0.83; for GFAP plus NEXUS II, 0.83; for GFAP plus NOC, 0.85; and for GFAP plus CCHR, 0.88. The AUROC for UCH-L1 alone was 0.72; for UCH-L1 plus NEXUS II, 0.77; for UCH-L1 plus NOC, 0.77; and for UCH-L1 plus CCHR, 0.79. The GFAP biomarker alone (without UCH-L1) contributed the most improvement to the clinical decision rules. In this cohort study, the CCHR, the NOC, and GFAP plus UCH-L1 biomarkers had equally high sensitivities, and the CCHR had the highest specificity. However, using different cutoff values reduced both sensitivity and specificity of GFAP plus UCH-L1. Use of GFAP significantly improved the performance of the clinical decision rules, independently of UCH-L1. Together, the CCHR and GFAP had the highest diagnostic performance.

Vibrational Spectroscopy for the Triage of Traumatic Brain Injury Computed Tomography Priority and Hospital Admissions.

Computed tomography (CT) brain imaging is routinely used to support clinical decision-making in patients with traumatic brain injury (TBI). Only 7% of scans, however, demonstrate evidence of TBI. The other 93% of scans contribute a significant cost to the healthcare system and a radiation risk to patients. There may be better strategies to identify which patients, particularly those with mild TBI, are at risk of deterioration and require hospital admission. We introduce a blood serum liquid biopsy that utilizes attenuated total reflectance (ATR)-Fourier transform infrared (FTIR) spectroscopy with machine learning algorithms as a decision-making tool to identify which patients with mild TBI will most likely present with a positive CT scan. Serum samples were obtained from patients (n = 298) patients who had acquired a TBI and were enrolled in CENTER-TBI and from asymptomatic control patients (n = 87). Injury patients (all severities) were stratified against non-injury controls. The cohort with mild TBI was further examined by stratifying those who had at least one CT abnormality against those who had no CT abnormalities. The test performed exceptionally well in classifications of patients with mild injury versus non-injury controls (sensitivity = 96.4% and specificity = 98.0%) and also provided a sensitivity of 80.2% when stratifying mild patients with at least one CT abnormality against those without. The results provided illustrate the test ability to identify four of every five CT abnormalities and show great promise to be introduced as a triage tool for CT priority in patients with mild TBI.

Prediction of Gastric Gastrointestinal Stromal Tumors before Operation: A Retrospective Analysis of Gastric Subepithelial Tumors.

Gastrointestinal stromal tumors (GISTs), leiomyomas, and schwannomas are the most common gastric subepithelial tumors (GSETs) with similar endoscopic findings. Preoperative prediction of GSETs is difficult. This study analyzed and predicted GSET diagnosis through a retrospective review of 395 patients who underwent surgical resection of GISTs, leiomyomas, and schwannomas measuring 2–10 cm. GSETs were divided by size (group 2–5, >2 and ≤5 cm; group 5–10, >5 and ≤10 cm) for analysis. Demographics, clinical symptoms, and images were analyzed. A recursive partitioning analysis (RPA) was used to identify optimal classifications for specific GSET diagnoses. GIST patients were relatively older than other patients. Both groups had higher proportions of UGI bleeding, lower hemoglobin (Hb) levels, and a higher ratio of necrosis on their computed tomography (CT) scans. The RPA tree showed that (a) age ≤ 55, Hb ≥ 10.7, and CT necrosis; (b) age ≤ 55 and Hb < 10.7; (c) age >55 and Hb < 12.9; and (d) age >55 and CT hetero-/homogeneity can predict high GIST risk in group 2–5. Positive or negative CT necrosis, with age >55, can predict high GIST risk in group 5–10. GIST patients were older and presented with low Hb levels and tumor necrosis. In RPA, the accuracy reached 85% and 89% in groups 2–5 and 5–10, respectively.

Does Vestibulo-Ocular Reflex (VOR) Gain Correlate With Radiological Findings in the Semi-Circular Canals in Patients Carrying the p.Pro51Ser (P51S) COCH Variant Causing DFNA9? Relationship Between the Three-Dimensional Video Head Impulse Test (vHIT) and MR/CT Imaging.

The primary aim was to determine whether 3D video-head-impulse-test vestibulo-ocular reflex (vHIT VOR)-gains correlate with computed tomography (CT) and magnetic resonance (MR) lesions in a series of carriers of the p.(Pro51Ser)-variant (P51S) in the COCH-gene (DFNA9). Secondary aim was to compare routine imaging with second peer review radiologic lecture. Analytical cross-sectional study. Secondary referral center. Twenty-four p.P51S carriers with MR and CT images. Eighteen carriers were selected of whom both 3D-vHIT and imaging data were available within a time interval of 24 months. All imaging data were reassessed by two independent neuroradiologists. vHIT VOR-gains were correlated with semi-circular canal (SCC) lesions. Correlation between vHIT VOR-gains and SCC lesions, and additional lesions detected during scientific lecture of imaging data. The average gain of the ipsilateral labyrinth was significantly lower when positive CT (0.3215; p = 0.0122) and MR results (0.3215; p = 0.0134).92% of ears presented MR lesions on at least one SCC, whereas this was 75% on CT. The posterior SCC is the most frequently affected on MR and CT. Second lecture led to nine additional MR and 16 CT lesions. Significant correlation was observed between radiological lesions at any SCC and lower average gain of the three ipsilateral SCC. The substantially larger number of lesions during scientific assessment stresses the need to fully inform radiologists concerning differential diagnosis to facilitate accurate diagnosis when planning imaging. Focal sclerosis and narrowing of SCC in DFNA9 represent a possible biomarker of advanced stages of otovestibular deterioration.

Accuracy of Pediatric Emergency Care Applied Research Network Rules in Predicting Brain Injuries

Background and Objectives: Head trauma is one of the most important causes of emergency department (ED) visits and the leading cause of disability and mortality in children. The aim of this study was to evaluate the Pediatric Emergency Care Applied Research Network (PECARN) rules to predict brain injuries in pediatrics with head trauma. Materials and Methods: This descriptive–analytic study was performed on 250 pediatric patients with head trauma referred to Imam Reza Hospital in Tabriz City from August to September 2020. All patients were evaluated in the ED for the existing of any rules of the PECARN, then the results of the PECARN rules and brain computed tomography (CT) scan findings were compared in these patients. According to the PECARN rules, patients were classified into three categories, namely low, moderate, and high risk. For all three groups, if there is an indication of brain CT scan, it was performed and reported by an emergency medicine specialist. Results: The mean age of the patients was 88 months. In this study, 162 (64.8%), 42 (16.8%), and 46 (18.4%) patients were in the low-risk, moderate-risk, and high-risk groups, respectively. Death was occurred in 18 (12.8%) patients. Results showed a statistically significant association between positive CT findings and some variables, such as behavioral change, vomiting, severe headache, LOC over 5 s, confusion, palpable skull fracture, skull base fracture, and the severe mechanism of injury (P < 0.05). Furthermore, a statistically significant association was found between PECARN rules and CT findings (P < 0.001). Conclusions: According to the results of the present study, PECARN rules have a significant association with brain CT scan findings. Therefore, using these rules is recommended to reduce the number of brain CT scan requests for pediatric patients.

High Resolution Computed Tomography findings and Computed Tomography severity index in COVID-19 Infection Correlated with Age and Gender

Introduction: The new coronavirus disease -19 (COVID-19) is caused by SARS-CoV2 strain of coronavirus. The Computed tomography (CT) severity index is a scoring system used to assess the lung changes and involvement by COVID-19 based on approximate estimation of pulmonary involved areas. This study was done to identify the spectrum of CT chest findings and CT severity index in COVID-19 infection and its correlation with age and gender.&#x0D; Methods: Patients with COVID-19 infection with positive PCR results and positive pulmonary CT findings were included in the study. All these patients underwent high-resolution computed tomography (HRCT) of the chest. The CT scan severity score in all of these patients was calculated and the results were analyzed by SPSS version 21.&#x0D; Results: A total of 104 patients with confirmed COVID-19 infection were included in this study. There were 59 males (56.73%) and 45 females (43.3%) in this study. There was a higher chest severity score in males compared to females. However, there was no significant correlation between the age and CT chest severity score.&#x0D; Conclusion: HRCT chest can help in the early identification of the patients who need intensive care. Early admission and intensive care of the patients with high CT severity scores may help to reduce the mortality of COVID-19 patients.

Developing a Screening Procedure During the COVID-19 Pandemic: Process and Challenges Faced by a Low-Incidence Area.

Purpose: To summarize the imaging results of COVID-19 pneumonia and develop a computerized tomography (CT) screening procedure for patients at our institution with malignant tumors.Methods: Following epidemiological investigation, 1,429 patients preparing to undergo anti-tumor-treatment underwent CT scans between February 17 and April 16, 2020. When CT findings showed suspected COVID-19 pneumonia after the supervisor radiologist and the thoracic experience radiologist had double-read the initial CT images, radiologists would report the result to our hospital infection control staff. Further necessary examinations, including the RT-PCR test, in the assigned hospital was strongly recommended for patients with positive CT results. The CT examination room would perform sterilization for 30 min to 1 h. If the negative results of any suspected COVID-19 pneumonia CT findings were identified, the radiologists would upload the results to our Hospital Information Systems and inform clinicians within 2 h.Results: Fifty (0.35%, 50/1,429) suspected pneumonia cases, including 29 males and 21 females (median age: 59.5 years old; age range 27–79 years), were identified. A total of 34.0% (17/50) of the patients had a history of lung cancer and 54.0 (27/50) underwent chemotherapy or targeted therapy. Forty-six patients (92.0%) had prior CT scans, and 35 patients (76.1%) with suspected pneumonia were newly seen (median interval time: 62 days). Sub-pleura small patchy or strip-like lesions most likely due to fibrosis or hypostatic pneumonia and cluster of nodular lesions were the two main signs of suspected cases on CT images (34, 68.0%). Twenty-seven patients (54.0%) had, at least once, follow-up CT scan (median interval time: 18.0 days). Only one patient had an increase in size (interval time: 8 days), the immediately RT-PCR test result was negative.Conclusion: CT may be useful as a screening tool for COVID-19 based on imaging features. But the differential diagnosis between COVID-19 and other pulmonary infection and/or non-infectious disease is very difficult due to its overlapping imaging features.The confirmed diagnosis of the COVID-19 infection should be based on the etiologic eventually. The cancer patients at a low-incidence area would continue treatment by screening carefully before admission.

Short Observation Period and Aggressive Discharge of Patients With Head Injury and Serial CT Scans.

Background: Many patients undergo two head computed tomography (CT) scans after mild traumatic brain injury (TBI). Radiographic progression without clinical deterioration does not usually alter management. Evidence-based guidelines offer potential for limited repeat imaging and safe discharge. This study characterizes patients who had two head CTs in the Emergency Department (ED), determines the change between initial and repeat CTs, and describes timing of repeat scans.Methods: This retrospective series includes all patients with head CTs during the same ED visit at an urban trauma center between May 1st, 2016 and April 30th, 2018. Radiographic interpretation was coded as positive, negative, or equivocal.Results: Of 241 subjects, the number of positive, negative, and equivocal initial CT results were 154, 50, and 37, respectively. On repeat CT, 190 (78.8%) interpretations were congruent with the original scan. Out of the 21.2% of repeat scans that diverged from the original read, 14 (5.8%) showed positive to negative conversion, 1 (.4%) showed positive to equivocal conversion, 2 (.88%) showed negative to positive conversion, 20 (8.3%) showed equivocal to negative conversion, and 14 (5.8%) showed equivocal to positive conversion. Average time between scans was 4.4 hours, and median length of stay was 10.2 hours.Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.

Diagnostic Accuracy of CT Scans in Blunt Abdomical Trauma

Background and Aim: Blunt abdominal trauma may lead to a serious situation that necessitates prompt diagnosis and treatment. The intra-abdominal injury effective diagnosis is difficult in patient’s management in such cases. The present study aims to evaluate the diagnostic accuracy of computed tomography scans in active internal bleeding following abdominal trauma. Materials and Methods: This cross-sectional study was carried out on 84 blunt abdominal trauma patients in the Department of Radiology Hayatabad Medical Complex, Peshawar for duration of six months from January 2021 to June 2021. All the patients with no clinical manifestations underwent diagnostic CT scans. Those who had a positive CT scan underwent laparotomy. The remaining patients were monitored for 24 hours and were discharged in case of no serious issues. Demographic details, patient information, trauma mechanism, CT scan indications, and findings, and laparotomy results were recorded. Regarding injured organs, specificity, sensitivity, and diagnostic accuracy of CT scans were determined. For individual cases, CT scans specificity, sensitivity, and accuracy were calculated. SPSS version 20 was used for data analysis. Results: This study included 84 patients, out of which 73 (86.9%) were male and 11(13.1%) were female. Patients aged 20-40 years were more prevalent 47 (56%), followed by those aged over 40 years were 20 (23.8%) and 10 to 19 years old were 17 (20.2%). Liver and spleen injuries had the highest CT scan sensitivity of 87.5% and 96.7% respectively. On the other hand, The CT scan's specificity was high in the injured kidneys (94%) and retroperitoneal hematoma 97.3% compared to other organ’s injuries. The diagnostic accuracy of CT scans in the identification of liver, kidney injuries, spleen, and retroperitoneal hematoma injuries was 93.7%, 92.3%, 96.2%, and 92.3% respectively. Conclusion: Our study found that CT scans are capable of detecting a wide range of injuries. CT scans are exceptionally valuable for assessing blunt abdominal injuries with active internal bleeding patients Furthermore, CT investigation is quick and extensively accessible. CT can produce high-resolution images with MPR and scanning protocol. Keywords: Diagnostic Accuracy; Abdominal Trauma Injuries, Computed Tomography (CT)

Chest CT Scan Findings in Symptomatic Patients Infected with COVID-19 in Norvic International Hospital, Nepal

Background Coronavirus disease (COVID-19) is the recent global health emergency making it crucial for rapid diagnosis and intervention. Computed tomography (CT) is important for screening, diagnosis and evaluating severity and disease progress.&#x0D; Objective To assess the CT changes in COVID patients and study its relationship with various factors.&#x0D; Method A retrospective study was conducted at Norvic International hospital from August 2020 to November 2020 among RT-PCR positive symptomatic COVID cases who had positive CT changes. CT imaging data were analyzed by radiology expertise. Statistical analysis was carried out with the help of SPSS 16.&#x0D; Result Out of 120 patients, 75% were males and mean age was 54.70±15.56 years. The mean CT severity score was 18.35±6.87. Pure ground glass opacities was seen in 74(61.7%), reticulations 89(74.2%) and crazy-paving pattern 28(23.3%). CT scans with bilateral 118(98.3%) and peripheral involvement 109(90.8%) in all five lobes. CT- severity score was positively correlated with oxygen and mechanical ventilation requirement (P-value &lt; 0.05 and 0.011 respectively).&#x0D; Conclusion CT findings including pure ground glass opacities, reticulations, bilateral and peripheral involvement involving all five lobes were more frequent. Our data suggest that CT-severity score significantly correlates with oxygen and mechanical ventilation requirements.

Geleneksel Pişirme Tekniklerinin Koronavirüse Yakalanma Üzerine Etkisi

Many factors are effective in catching coronavirus disease. These include not wearing masks, not following social distance rules, and not paying attention to hygiene rules. This study, it was aimed to reveal the situation of individuals catching coronavirus disease depending on food preparation, cooking, and storage practices. The sample set of the study consists of 625 individuals who take an active role in food applications. It was revealed that 30% (n=189) of the individuals participating in the study had positive PCR (Polymerase Chain Reaction) screening test or CT (Computerized Tomography) method test results. Research data of the individuals participating in the study were collected by online survey method. The data were evaluated in the SPSS 23.0 package data program, ANOVA Test, and Chi-square (X2) significance test were used to statistical analysis, and a p-value less than 0.05 was considered statistically significant. The correct answers given by the individuals participating in the study to the applications related to foods were scaled as 1 Point and the wrong answers as 0 Points. According to the results of the analysis, the individual with the lowest score received 3 points, and the individual with the highest score received 14 points. The average correctness of individuals is 8.88. According to the results of the study, a significant difference was found between the decrease in the rate of catching coronavirus disease and the application of the right methods for food (p<0.05). In addition, a significant difference was found between the rate of contracting coronavirus disease and gender and monthly income levels (p<0.05). Among the issues to be considered to protect from infectious diseases, especially coronavirus, the application of the right methods during the purchasing, preparation, cooking, and storage stages of foods can be shown.

BT Görüntüleme Bulgularına Göre Tanı Alan COVID-19 Pozitif ve Olası Hastaları Karşılaştırarak Klinik Karar Vermede BT'nin Kullanılabilirliğinin Araştırılması

Aim: In this study, the usability of thoracic computed tomography (CT) in clinical decision making was investigated by comparing laboratory results of patients with probable and definite coronavirus disease 2019 (COVID-19) diagnosis according to CT imaging features. Material and Methods: Within the scope of this single-center retrospective clinical study, data of possible and definite cases of COVID-19 were scanned from the hospital electronic database and patient files. Laboratory and CT imaging results of the patients were obtained. Patients were divided into two groups as positive and negative according to their CT imaging results, and compared. Results: Of the 995 patients included in the study, 57% (n=567) were male, and the mean age was 45.7±20.2 years. It was found that 65.1% (n=648) of the patients had positive CT. Real-time polymerase chain reaction (RT-PCR) test result was found positive in 22.2% (n=144) of the CT positive patients, and 32.0% (n=111) of the CT negative patients, and it was statistically significant (p&amp;lt;0.001). In the logistic regression analysis, it was determined that C-reactive protein (CRP), lymphocyte count, ferritin, procalcitonin, D-dimer, lactate and RT-PCR were statistically significant with CT positivity. Conclusion: In this study, COVID-19 positive and probable patients were compared according to thoracic CT findings and the usability of CT for clinical decision making was investigated. It has been determined that thorax CT can be used to initiate the treatment of COVID-19 in patients with negative RT-PCR test results but positive CT findings and high biochemical parameters such as CRP, D-dimer, ferritin and lactate.