Computed Tomography Results of Patients with COVID-19: Typical and Atypical Findings

Yıl 2020, , 109 - 116, 12.12.2020

Muhammed Alpaslan , Sercan Özkaçmaz , Yeliz Dadalı , İlyas Dündar

https://doi.org/10.46332/aemj.792717

Öz

Purpose: We aimed to investigate typical and atypical thorax computed tomography (CT) findings of COVID-19 pa-tients.

Material and Methods: Thorax CT scans of the patients with reverse-transcriptase polymerase chain reaction (RT-PCR) confirmed diagnosis of COVID-19 between March 2020 and April 2020 were reviewed retrospectively. The frequencies of ground-glass opacity, consolidation, prominence of bronchovascular marking, fibrosis, nodule, septal thickening, reversed halo, pleural effusion and, mediastinal lymphadenopathy were examined. Lesions were classified into the following categories: bilateral/unilateral involvement, peripheral/central involvement, upper/middle/lower lobe involvement.

Results: A total of 53 patients (Mean age 48,38±20,97) with RT-PCR confirmed COVID-19 was enrolled in the study. 14 (26%) patients showed no finding on Thorax CT. Among the remaining 39 patients (74%) with findings on CT, ground-glass opacity was detected in 85%, consolidation in 56%, ground glass density consolidation in 59%, promi-nent bronchovascular markings in 28% who have findings on computed tomography. Among atypical findings, nodule was seen in 20 %, septal thickening in 30%, fibrosis in 10%, pleural effusion in 8%, air bronchograms in 18%, re-versed halo sign in 5% of the patients. Mediastinal lymphadenopathy was not observed. Lesions tended to be multifo-cal and peripheral as they commonly located bilaterally in middle and lower lobes.

Conclusion: Thorax CT is a very important diagnostic aid for COVID-19 patients. Categorizing parenchymal involve-ment into typical and atypical findings may facilitate the diagnostic process.

Anahtar Kelimeler

ground-glass opacity, Computed Tomography, coronavirus

COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular

Öz

Amaç: Bu çalışmada COVID-19 tanısı alan hastaların toraks bilgisayarlı tomografi (BT) sonuçlarını inceleyip, tipik ve atipik bulguları literatür eşliğinde sunmayı amaçladık.

Araçlar ve Yöntem: Hastanemize mart ve nisan aylarında başvuran ve reverse transkriptaz-polimeraz zincir reaksiyo-nu (RT-PZR) ile COVID-19 tanısı alan hastaların toraks BT’leri retrospektif olarak değerlendirildi. Akciğer parankim bulgularından buzlu cam sahaları, konsolidasyon, vasküler genişleme, fibrozis, nodül, septal kalınlaşma (crazy pa-ving), ters halo, plevral effüzyon ve mediastinal LAP bulguları araştırıldı. Parankimdeki tutulum yerine göre bilateral-unilateral, periferik-santral, üst-orta-alt loblardaki odak sayılarına göre lezyonların dağılımı değerlendirildi.

Bulgular: PCR pozitif olan 53 hastanın (ortalama yaş 48,38±20,97) 14’ünde (% 26) toraks BT’de bulgu yoktu. BT’de bulgusu olan 39 hastada (%74), tipik bulgulardan buzlu cam sahası (%85), konsolidasyon (%56), buzlu cam ve konso-lidasyon birlikteliği (%59), vasküler genişleme (%28) izlendi. Atipik bulgulardan nodül (%20), septal kalınlaşma (%30), fibrozis (%10), plevral efüzyon (%8), hava bronkogramı (%18), ters halo bulgusu (%5) saptandı. Hastalarımız-da mediastinal LAP saptanmadı. Toraks BT’de bilateral, orta ve alt zonlarda periferik yerleşimli multifokal odaklar tipik tutulum şekliydi. 14 hastada toraks BT negatif olup herhangi bir bulguya rastlanmadı.

Sonuç: Toraks BT, COVID-19 hastaları için tanıya yardımcı çok önemli bir yöntem olup parankim tutulumunun tipik ve atipik bulgular şeklinde kategorize edilerek değerlendirilmesi tanı sürecini kolaylaştırabilir.

Anahtar Kelimeler

buzlu cam sahası, Bilgisayarlı Tomografi, koronavirüs

Kaynakça

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