Measurement of Tracheobronchial Angles of COVID-19 Patients on Computed Tomography and Correlation with Pneumonia Severity in Turkish Population

Abstract

Aim: This study aimed to evaluate the values of tracheobronchial angles on computed tomography (CT) and to investigate the relationship between angles and CT severity scores (CT-SS) of coronavirus disease 2019 (COVID-19) patients. There is no available literature measuring tracheobronchial angles of adult COVID-19 patients and investigating the relationship of angles with pneumonia severity. Material and Methods: This study was a single-center retrospective analysis of 92 RT-PCR positive patients, aged between 18-40 years, who underwent CT between May and October 2020. The right bronchial angles (RBA), left bronchial angles (LBA), subcarinal angles (SCA), and interbronchial angles (IBA) were measured by a radiologist on coronal CT images with the measurement model used in past. CT-SS was calculated by using a visual scoring system with a global score of 0-25. Results: Thirty-seven (40.2%) patients had normal CT imaging and 55 (59.8%) patients had pulmonary involvement. The CT-SS were ranged from 0 to 24, with a median value of 2.5. The mean IBA was calculated as 81.67±15.20°, mean SCA 77.65±15.78°, mean RBA 39.26±7.51°, and mean LBA 43.35±8.43°. No statistically significant difference was found in SCA, IBA, RBA, and LBA between the groups with and without COVID-19 pneumonia (p=0.277, p=0.389, p=0.218, and p=0.227, respectively). Also, no significant correlation was found between tracheobronchial angles and pneumonia CT-SS of the patients. Conclusion: We calculated the distribution range of tracheobronchial angle values in the adult Turkish COVID-19 patients. According to our study, tracheobronchial angles don’t affect the disease severity and clinical outcome of COVID-19 patients.

Keywords

• COVID-19
• computed tomography
• chest CT severity score
• bronchial angle
• subcarinal angle
• interbronchial angle

Türk Popülasyonunda Bilgisayarlı Tomografide COVID-19 Hastalarının Trakeobronşiyal Açılarının Ölçümü ve Pnömoni Şiddeti ile Korelasyonu

Abstract

Amaç: Bu çalışma, koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) hastalarının bilgisayarlı tomografide (BT) trakeobronşiyal açı değerlerini hesaplamayı ve bu açılar ile BT şiddet skorları (BT-ŞS) arasındaki ilişkiyi araştırmayı amaçlamaktadır. Yetişkin COVID-19 hastalarının trakeobronşiyal açılarını ölçen ve açıların pnömoni şiddeti ile ilişkisini araştıran mevcut bir literatür bulunmamaktadır. Gereç ve Yöntemler: Bu çalışma, Mayıs ve Ekim 2020 arasında BT çekilen 18-40 yaş arasında 92 RT-PCR testi pozitif hastanın tek merkezli retrospektif analizidir. Sağ bronş açıları (sağ BA), sol bronş açıları (sol BA), subkarinal açılar (SKA) ve interbronşiyal açılar (İBA), geçmişte kullanılan ölçüm modeli ile koronal BT görüntülemelerinde bir radyolog tarafından ölçüldü. BT-ŞS, global skoru 0-25 olan bir görsel skorlama sistemi kullanılarak hesaplandı. Bulgular: Otuz yedi (%40,2) hastanın BT görüntülemeleri normal iken, 55 (%59,8) hastada akciğer tutulumu vardı. BT-ŞS 0 ile 24 arasında olup ortanca değeri 2,5 idi. Ortalama İBA 81,67±15,20°, ortalama SKA 77,65±15,78°, ortalama sağ BA 39,26±7,51° ve ortalama sol BA 43,35±8,43° olarak hesaplandı. SKA, İBA, sağ BA, sol BA değerleri bakımından COVID-19 pnömonisi olan ve olmayan gruplar arasında istatiksel olarak anlamlı bir farklılık saptanmadı (sırsıyla, p=0,277; p=0,389; p=0,218 ve p=0,227). Ayrıca trakeobronşiyal açılar ile pnömoni BT-ŞS arasında istatiksel olarak anlamlı bir korelasyon bulunmadı. Sonuç: Çalışmamızda, erişkin Türk COVID-19 hastalarında trakeobronşiyal açı değerlerinin dağılım aralığını hesapladık. Çalışmamıza göre trakeobronşiyal açılar, COVID-19 hastalarında, hastalığın şiddetini ve klinik sonucunu etkilememektedir.

Keywords

• COVID-19
• bilgisayarlı tomografi
• toraks BT şiddet skoru
• bronş açısı
• subkarinal açı
• interbronşiyal açı

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