SARS-COV-2 PNÖMONİSİNDE TORAKS BT ÖZELLİKLERİ

Öz

Amaç SARS-CoV-2’nin tanısında; altın standartın RT-PCR testi olmasına ragmen, RT-PCR testinin yüksek yalancı negatiflik oranı ve BT!nin daha hızlı sonuç vermesi nedeniyle, BT de önemli bir yere sahiptir.Bu çalışmanın amacı RT-PCR ile kanıtlanmış SARS-CoV-2 hastalarında toraks BT özelliklerinin ve dağılımının değerlendirilmesidir. Gereç ve Yöntem Bu çalışmaya hastaneye başvuran, SARS-CoV-2 tanısı RT-PCR ile doğrulanan, 100 yetişkin hasta dahil edilmiştir. Bu hastaların toraks BT bulguları retrospektif olarak kaydedilmiştir. BT bulguları, Kuzey Amerika Radyoloji Topluluğu tarafından SARS-CoV-2 için yayınlanan klavuza göre değerlendirilmiştir. Bulgular RT-PCR ile doğrulanan 100 SARS-CoV-2 hastasının, 79’unda pnömoni mevcut olup yaş ortalaması (54.0216.99) iken pnömoni bulgusu olmayan 21 hastanın yaş ortalaması (42.4717.78) olarak bulunmuştur. Buzlu cam dansitesi, konsolidasyon, posterior ağırlıklı tutulum, bilateral tutulum, periferik dağılım, multifokalite, vasküler genişleme, plevral efüzyon, lenfadenopati, tomurcuk ağaç paterni, halo işareti ve ters halo işareti prevalansları sırasıyla % 74,68,% 3,79,% 17,72, % 43.03,% 70.88,% 84.81,% 84.81,% 12.65,% 2.53,% 1.26,% 2.53,% 8.86 ve % 3.79 olarak bulundu. Sonuç SARS-CoV-2 pnömonisinde sık görülen göğüs BT bulguları multifokal, multilobar, periferik ve bilateral tutulumlu buzlu cam opasiteleridir. Posterior ya da alt lob hakimiyeti lehine anlamlı sonuç gösterilememiştir. Bu çalışmaya göre, SARS-CoV-2 hastalarının yaşlandıkça pnömoni olma olasılığı artmaktadır.

Anahtar Kelimeler

• SARS-CoV-2
• toraks bilgisayarlı tomografisi
• pnömoni
• covid-19

CHEST CT FEATURES OF SARS-COV-2 PNEUMONIA

Öz

Aim CT has an important place in diagnosing SARS-CoV-2 due to the RT-PCR test's high false-negative rate and the faster evaluation of CT, although the RT-PCR test is the gold standard. This study aims to understand chest CT features and distributions in patients with SARS-CoV-2 proven by RT-PCR. Materials and Methods This study is retrospective and includes one hundred adult patients with confirmed SARS-CoV-2 infection who admitted to the hospital. The Chest CT findings of these patients were retrospectively recorded. Radiological Society of North America reporting guidelines for SARS-CoV-2 pneumonia was referenced to classify chest CT findings. Results In SARS-CoV-2 patients confirmed by RT-PCR, the mean age of 79 pneumonia patients (54.0216.99) was higher than age of patients without pneumonia (42.4717.78). Prevalences of ground-glass opacity, consolidation, posterior dominance, bilaterality, peripheral distribution, multifocality, vascular enlargement, pleural effusion, lymphadenopathy, tree-in-bud pattern, halo sign and reverse halo sign were 74.68%, 3.79%, 17.72%, 43.03%, 70.88%, 84.81%, 84.81%, 12.65%, 2.53%, 1.26%, 2.53%, 8.86%, and 3.79%, respectively. Conclusion This study's findings indicate that common chest CT findings in SARS-CoV-2 pneumonia are ground glass opacities with multifocal, multilobar, peripheral and bilateral involvement. No significant result was shown in favor of posterior or lower lobe dominance. According to the present study, SARS-CoV-2 patients are more likely to get pneumonia as they get older.

Anahtar Kelimeler

• SARS-CoV-2
• coronavirus disease-19
• chest computed tomography
• pneumonia
• covid-19

Kaynakça

1. 1. Çinkooğlu A, Hepdurgun C, Bayraktaroğlu S et al. CT imaging features of COVID-19 pneumonia: initial experience from Turkey. Diagnostic and Interventional Radiology. 2020;26(4):308.
2. 2. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
3. 3. World Health Organization G. World Health Organization (2020) Coronavirus disease 2019 (COVID-19) situation report–51. 2020.
4. 4. Bayraktaroğlu S, Çinkooğlu A, Ceylan N et al. The novel coronavirus pneumonia (COVID-19): a pictorial review of chest CT features. Diagn Interv Radiol. 2021 Mar;27(2):188-194
5. 5. Kuzan TY, Altıntoprak KM, Çiftçi HÖ et al. A comparison of clinical, laboratory and chest CT findings of laboratory-confirmed and clinically diagnosed COVID-19 patients at first admission. Diagn Interv Radiol. 2020 Sep 2.
6. 6. Güneyli S, Atçeken Z, Doğan H et al. Radiological approach to COVID-19 pneumonia with an emphasis on chest CT. Diagn Interv Radiol. 2020;26(4):323.
7. 7. Watson J, Whiting PF, Brush JE. Interpreting a covid-19 test result. Bmj. 2020;369.
8. 8. Xu B, Xing Y, Peng J et al. Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy. Eur radiol. 2020;30(10):5720-7.

9. 9. Adams HJ, Kwee TC, Yakar D et al. Chest CT imaging signature of coronavirus disease 2019 infection: in pursuit of the scientific evidence. Chest. 2020;158(5):1885-95.
10. 10. Byrne D, O’Neill SB, Müller NL et al. RSNA expert consensus statement on reporting chest CT findings related to COVID-19: interobserver agreement between chest radiologists. Can Assoc Radiol J. 2020:0846537120938328.
11. 11. Ai T, Yang Z, Hou H et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32-E40.
12. 12. Tekcan Şanlı DE, Yıldırım D. A new imaging sign in COVID-19 pneumonia: vascular changes and their correlation with clinical severity of the disease. Diagn Interv Radiol. 2021 Mar;27(2):172-180.
13. 13. Bai HX, Hsieh B, Xiong Z et al. Performance of radiologists in differentiating COVID-19 from non-COVID-19 viral pneumonia at chest CT. Radiology. 2020;296(2):E46-E54.
14. 14. Caruso D, Zerunian M, Polici M et al. Chest CT features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):E79-E85.
15. 15. Eslambolchi A, Maliglig A, Gupta A et al. COVID-19 or non-COVID viral pneumonia: How to differentiate based on the radiologic findings? World J Radiol. 2020;12(12):289-301.
16. 16. Atalar M, Çaylak H, Atasoy D et al. Thorax CT Findings in Novel Coronavirus Disease 2019 (COVID-19). Erciyes Med J 2020;43(2):110-5
17. 17. Pan F, Ye T, Sun P et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology. 2020;295(3):715-21.
18. 18. Bernheim A, Mei X, Huang M et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020:200463.
19. 19. Kanne JP, Little BP, Chung JH et al. Essentials for radiologists on COVID-19: an update—radiology scientific expert panel. Radiology. 2020 Aug;296(2):E113-E114.
20. 20. Dane B, Brusca-Augello G, Kim D et al. Unexpected findings of coronavirus disease (COVID-19) at the lung bases on abdominopelvic CT. AJR Am J Roentgenol. 2020 Sep;215(3):603-606.
21. 21. Wu J, Wu X, Zeng W et al. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Invest Radiol. 2020;55(5):257.
22. 22. Aslan S, Bekçi T, Çakır İM et al. Diagnostic performance of low-dose chest CT to detect COVID-19: A Turkish population study. Diagn Interv Radiol. 2021 Mar;27(2):181-187.
23. 23. Simpson S, Kay FU, Abbara S et al. Radiological society of north America expert consensus document on reporting chest CT findings related to COVID-19: endorsed by the society of thoracic Radiology, the American college of Radiology, and RSNA. Radiology: Cardiothoracic Imaging. 2020;2(2):e200152.