Koronavirüs hastalığı 2019 nedeniyle acil serviste toraks bilgisayarlı tomografi çekilen hastalarda saptanan rastlantısal bulgular: kesitsel çalışma

Year 2022, Volume: 27 Issue: 3, 260 - 267, 27.09.2022

Sunay Yıldırım Özgür Söğüt Adem Az Hüseyin Ergenç Sevim Özdemir

https://doi.org/10.21673/anadoluklin.1019180

Abstract

Amaç: Çalışmamızda Koronavirüs hastalığı (COVID-19) şüphesiyle acil servise başvuran hastalara çekilen toraks bilgisayarlı tomografi (BT) görüntülemelerinde tespit edilen rastlantısal bulguların prevelansını belirlemek ve klinik önemini değerlendirmeyi amaçladık.

Yöntemler: Retrospektif, kesitsel, gözlemsel ve tek merkezli olarak planlanan çalışmamıza hastanemiz Acil Tıp Kliniği’ne Mayıs-Temmuz 2020 tarihleri arasında, COVID-19 bulguları nedeniyle başvuran ve toraks BT çekilen yetişkin hastalar (≥18 yaş) dâhil edildi. BT görüntülemelerinde insidental bulguya sahip olan hastalar uluslararası sınıflandırmalara göre üç grup olarak değerlendirildi. Hasta grupları ve insidental bulgu saptanan hastalar ile insidental bulgu saptanmayan hastalar yaş, cinsiyet ve yaş dağılımı açısından karşılaştırıldı.

Bulgular: COVID-19 semptom ve bulguları ile acil servise başvuran ve toraks BT çekilen 5,667 hastanın %41,8’inde tesadüfi bulgular olduğu saptandı. İnsidental bulgu saptanmayan hasta grubu ile karşılaştırıldığında, insidental bulgu saptanan hasta grubunda ortalama yaş anlamlı yüksek olarak gözlemlendi. Ancak, gruplar arasında cinsiyet bakımından anlamlı bir fark bulunmadı. Hastaların %11,8’lik (n=670) bölümünde klinik olarak yüksek düzeyde önemli bulgular saptandı. Toraks BT’de en sık rastlanan insidental bulgu %27,7’lik (n=655) oran ile mediastinal ana vasküler yapılarda aterosklerotik değişiklikler olarak saptandı. Klinik olarak yüksek düzeyde önemli insidental bulgu olarak en sık %13,7’lik (n=325) oran ile kardiyomegali tespit edildi.

Sonuç: Toraks BT çekilen hastaların büyük bir kısmında insidental bulguya rastlanmadı. Diğer yandan yaş arttıkça özellikle insidental bulgunun saptanma olasılığında artış gözlemlendi. İnsidental bulgusu bulunan hastaların çoğunluğunda ise klinik olarak önemsiz bulgulara rastlandı.

Keywords

tesadüfi bulgular, COVID-19, kardiyomegali, tesadüfi bulgular, tomografi, toraks

Incidental findings detected in coronavirus disease 2019 patients who underwent thorax computed tomography in the emergency department: a cross-sectional study

Abstract

Aim: Our study aimed to determine the prevalence and clinical significance of incidental findings detected in thorax computed tomography (CT) scans of patients who were admitted to the emergency department (ED) due to Coronavirus disease 2019 (COVID-19).

Methods: In this retrospective, cross-sectional, observational, and single-center study, we included adult (≥18 years old) patients who were admitted to the emergency department with symptoms of COVID-19 and underwent thoracic CT between May-July 2020. Patients with incidental findings on CT scans were evaluated in three groups according to international classifications. Patient groups and patients with and without incidental findings were compared in terms of age, gender, and age distribution.

Results: Incidental findings were found in 41.8% of 5,667 patients who were admitted to ED with COVID-19 symptoms and underwent thoracic CT. The mean age was significantly higher among the patients with incidental findings than among the patients without incidental findings. However, there was no significant difference between the groups in terms of gender. Clinically significant findings were observed in 11.8% (n=670) of the patients. The most common incidental finding on thorax CT was atherosclerotic changes in the mediastinal main vascular structures with a rate of 27.7% (n=655). The most common clinically significant finding was cardiomegaly, with a rate of 13.7% (n=325).

Conclusion: No incidental finding was found in most of the patients. On the other hand, as the age increased, the probability of detecting an incidental finding increased. Clinically insignificant findings were found in the majority of patients with incidental findings.

Keywords

COVID-19, cardiomegaly, incidental findings, thorax, tomography

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