COVID -19 Pnömonisinin Atipik Toraks BT Bulguları ve Klinik Korelasyonu

Year 2020, Volume: 8 Issue: 3, 489 - 498, 20.12.2020

Gülcan Gücer Şahin Tuğba İlkem Kurtoğlu Özçağlayan Ayhan Şahin Ömer Özçağlayan Hadi Sasani

https://doi.org/10.37696/nkmj.790186

Abstract

Amaç: Çalışmamızın amacı COVİD-19 pnömonisinin atipik BT bulgularını, eşlik eden ek patolojileri klinik ve laboratuvar bulgularıyla birlikte değerlendirmek ve tipik BT bulguları ile karşılaştırmaktır.
Materyal ve Metot: Çalışmamıza 14’ü atipik (%20,2), 55’i tipik (%79) toraks BT bulguları olan COVID-19 tanısı almış toplam 69 hasta dahil edildi. Toraks BT görüntüleri, atipik bulguları olan hastaların klinik ve laboratuvar verileri retrospektif incelendi. Tipik ve atipik grubun lezyonları ve BT şiddet skoru karşılaştırıldı.
Bulgular: Atipik BT bulguları sentrilobüler nodül, tomurcuklanmış ağaç, plevral efüzyon, lober/segmenter konsolidasyon, bronşiektazi, pulmoner emboli ve mozaik atenüasyon olup, periferik dağılım gösteren buzlu cam opasitesi (BCO) ve/veya konsolidasyon gibi tipik lezyonlara eşlik etmekteydi. BT şiddet skoru atipik grupta belirgin yüksekti (p<0,001). BT şiddet skoru yüksek olguların CRP, prokalsitonin, nötrofil oranı artmış, lenfosit sayısı azalmıştı. Atipik grupta komorbidite daha sık görüldü (%50).
Sonuç: Atipik BT bulguları olan hasta grubunun yüksek BT şiddet skoru ve yaygın akciğer tutulumu hastalığın progresyonu ya da eşlik eden diğer hastalıklara bağlı olabilir. Tipik lezyonlara atipik lezyonların eşlik etmesi raporlamada yanlış negatifliğe neden olabilir. Radyologların COVID-19 pnömonisi ile deneyimi arttıkça bu görüntüleri tipik veya atipik olarak katagorize etmeleri gelişebilir.

Keywords

COVID-19, koronavirüs hastalığı, buzlu cam opasitesi, toraks BT, atipik görünüm.

Atypical Chest CT Findings and Clinical Correlation of COVID-19 Pneumonia

Abstract

Abstract
Aim: The aim of our study was to evaluate the atypical CT findings and concomitant pathologies of COVID-19 pneumonia together with clinical and laboratory findings and to compare them with typical CT findings.
Materials and Methods: A total of 69 patients were diagnosed with COVID-19, 14 of which were atypical (20.2%) and 55 of which were typical (79%) chest CT findings. CT images and clinical and laboratory data of patients with atypical findings were retrospectively analyzed. Lesions of the typical and atypical group and CT severity score were compared.
Results: Atypical CT findings were centrilobular nodule, tree in bud, pleural effusion, lobar / segmental consolidation, bronchiectasis, pulmonary embolism, and mosaic attenuation, accompanied by typical lesions with ground glass opacity (GGO) with/without consolidation. CT severity score was significantly higher in the atypical group (p <0.001). CRP, procalcitonin, neutrophil rate increased and lymphocyte count decreased in patients with high CT severity score. Comorbidity was more common in the atypical group (50%).
Conclusion: High CT severity score and widespread lung involvement of the patient group with atypical CT findings may be due to disease progression or other concomitant diseases. Atypical lesions accompanying typical lesions may cause false negativity in reporting. As the experience of radiologists with COVID-19 pneumonia increases, it may improve that they categorize these images as typical or atypical.

Keywords

COVID-19, coronavirus disease, ground glass opacity, chest CT Scan, atypical image

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