Fırat Üniversitesi Hastanesine Başvuran Koronavirüs Hastalığı-2019 (Covid-19) Ön Tanılı Hastaların İlk Bakı Toraks Bilgisayarlı Tomografi Bulguları

Yıl 2022, Cilt: 17 Sayı: 2, 73 - 82, 15.07.2022

Serpil Ağlamış , Yeşim Eroğlu

https://doi.org/10.17517/ksutfd.993267

Öz

Amaç: COVID-19 ön tanısı ile toraks bilgisayarlı tomografi (BT) incelemesi yapılan hastaların ilk bakıdaki radyolojik bulgularını değerlendirmektir.
Gereç ve Yöntemler: COVID-19 ön tanılı 90 hastanın ilk bakı toraks BT incelemesinin görüntüleme verileri retrospektif analiz için toplandı. Hastaların demografik özellikleri, semptomları ve ek hastalıkları kaydedildi. İlk bakı toraks BT incelemesinin görüntüleme bulguları ve takip BT görüntülemesi yapılan
hastaların takip BT bulguları analiz edildi.
Bulgular: COVID-19 ön tanılı hastaların ilk toraks BT bulgularında buzlu cam dansiteleri (%59), konsolidasyon (%34), kaldırım taşı manzarası (%5), hava bronkogramı (%18), vasküler genişleme (%6), bronşektazi-bronş duvar kalınlaşması (%7), air bubble (%7), subplevral çizgi ( %10), plevral kalınlaşma-plevral sıvı (%8), halo işareti (%5), düzensiz kenarlı nodül (%9) ve ters halo işareti (%4) mevcuttu. Takip BT görüntülerinde dikkat çeken bulgular progresyon evresinde yeni konsolidasyon alanlarının ortaya çıkması, buzlu cam dansitelerinin konsolidasyona dönüşmesi, bilateral plevral effüzyon, traksiyon bronşektazileri ve hiler lenfadenopati gelişmesiydi. Regresyona uğrayan olgularda ise ilk BT görüntülemesinde izlediğimiz konsolidasyonun buzlu cam dansitelerine dönüştüğü görüldü.
Sonuç: COVID-19 ön tanılı hastaların ilk bakı toraks BT görüntülemelerinde en sık izlenen bulgu buzlu cam dansiteleriydi. Progresyon evresinde, ilk bakıda izlenen buzlu cam dansiteleri veya konsolidasyon alanlarında artış, bilateral plevral effüzyon, traksiyon bronşektazileri ve hiler lenfadenopatiler izlendi.

Anahtar Kelimeler

Buzlu cam dansiteleri, COVID-19, Konsolidasyon, Toraks bilgisayarlı tomografisi

Initial Screening Chest Computed Tomography Findings of Patients Who Were Admitted to Fırat University Hospital with Pre-diagnosis of Coronavirus Disease 2019 (COVID-19)

Öz

Objective: To evaluate radiological findings on initial screening of the patients who had chest computed tomography (CT) with the pre-diagnosis of coronavirus disease-2019 (COVID-19).
Material and Methods: Chest CT images of 90 patients with a pre-diagnosis of COVID-19 were retrospectively analyzed. Demographic characteristics, symptoms, and comorbid conditions of the patients were recorded. The chest CT findings on initial screening and follow-up were analyzed.
Results: The chest CT findings on the initial screening of the patients with a pre-diagnosis of COVID-19 included ground-glass opacities (GGOs) (59%), consolidation (34%), crazy-paving pattern (5%), air bronchogram (18%), vascular dilation (6%), bronchiectasis-bronchial wall thickening (7%), air bubble (7%), subpleural line (10%), halo sign (5%), nodule with irregular borders (9%) and reverse halo sign (%4). The predominant findings in the follow-up CT images included newly developing consolidations in the progression stage, GGOs converting to consolidations, bilateral pleural effusion, traction bronchiectasis, and hilar lymphadenopathy. In the regressed cases, it was observed that the consolidation we observed in the first CT imaging turned into GGOs.
Conclusion: Ground-glass opacities were the most common finding in initial screening thorax CT scans of patients with pre-diagnosis of COVID-19. An increase in the ground-glass densities or consolidation areas identified upon initial examination, bilateral pleural effusion, traction bronchiectasis, and hilar lymphadenopathies were observed in the progression stage

Anahtar Kelimeler

Chest computed tomography, Consolidation, COVID-19, Ground-glass opacities

Kaynakça

• Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433.
• Moorthy V, Henao Restrepo AM, Preziosi MP, Swaminathan S. Data sharing for novel coronavirus (COVID-19). Bull World Health Organ. 20201;98(3):150.
• Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A et al. World Health Organization declares Global Emergency: A review of the 2019 Novel Coronavirus (COVID-19). Int J Surg. 2020;76:71-76.
• Guan WJ, Ni ZY, Hu Y, WH Liang, CQ Ou, JX He et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
• Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 202015;395(10223):497-506.
• Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L et al. Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features. Invest Radiol. 2020;55(5):257- 261.
• Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: A descriptive study. Lancet Infect Dis. 2020;20(4):425-434.
• Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H et al. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020;295(1):210-217.
• Pan F, Ye T, Sun P, Gui S, Liang B, Li L et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715-721.
• Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N et.al. Chest CT Findings in Coronavirus Disease-19 (COVID- 19): Relationship to Duration of Infection. Radiology. 2020;295(3):200463.
• Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J et.al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-523.
• Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? Eur J Radiol. 2020;126:108961.
• Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020;296(2):41-45.
• Huang P, Liu T, Huang L, Liu H, Lei M, Xu W et al. Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology. 2020;295(1):22-23.
• Wang S, Kang B, Ma J, Zeng X, Xiao M, Guo J et al. A deep learning algorithm using CT images to screen for Corona virus disease (COVID-19). Eur Radiol. 2021;31(8):6096-6104.
• Li Y, Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. AJR Am J Roentgenol. 2020;214(6):1280-1286.
• Cui N, Zou X, Xu L. Preliminary CT findings of coronavirus disease 2019 (COVID-19). Clin Imaging. 2020;65:124-132.
• Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR Am J Roentgenol. 2020;214(5):1072-1077.
• Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
• Caruso D, Zerunian M, Polici M, Pucciarelli F, Polidori T, Rucci C et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):79-85.
• Zhu Y, Liu YL, Li ZP, Kuang JY, Li XM, Yang YY et al. WITHDRAWN: Clinical and CT imaging features of 2019 novel coronavirus disease (COVID-19). J Infect. 2020;81(1):147-178.
• Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): A pictorial review. Eur Radiol. 2020;30(8):4381-4389.
• Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X et al. CT Imaging Features of 2019 Novel Coronavirus (2019- nCoV). Radiology. 2020;295(1):202-207.
• Kay FU, Abbara S. The Many Faces of COVID-19: Spectrum of Imaging Manifestations. Radiol Cardiothorac Imaging. 2020;2(1):e200037.
• Dai WC, Zhang HW, Yu J, Xu HJ, Chen H, Luo SP et al. CT Imaging and Differential Diagnosis of COVID-19. Can Assoc Radiol J. 2020;71(2):195-200.
• Ghosh S, Deshwal H, Saeedan MB, Khanna VK, Raoof S, Mehta AC. Imaging algorithm for COVID-19: A practical approach. Clin Imaging. 2021;72:22-30.
• Zheng Y, Wang L, Ben S. Meta-analysis of chest CT features of patients with COVID-19 pneumonia. J Med Virol. 2021 Jan;93(1):241-249.
• Yu M, Xu D, Lan L, Tu M, Liao R, Cai S et al. Thin-Section Chest CT Imaging of COVID-19 Pneumonia: A Comparison Between Patients with Mild and Severe Disease. Radiol Cardiothorac Imaging. 2020;2(2):e200126.