The comparison of chest X-ray and CT visibility according to size and lesion types in the patients with COVID-19

Yıl 2022, , 1151 - 1155, 20.07.2022

Emrah Doğan , Canan Gürsoy , Özge Oral Tapan , Cenk Elibol , Turhan Togan , Semra Demirbilek

https://doi.org/10.32322/jhsm.1100231

Cited By: 1

Öz

Introduction: Chest X-ray (CXR) is one of the routinely used radiological examinations in COVID-19. However, the lesion detectability level of CXR is low. To date, to the best of our knowledge, the visualization quality of X-ray in COVID-19 has not been specifically evaluated in different lesions. Our study aims to determine the visualization quality of CXR in COVID-19 patients according to elementary lesions.
Material and Method: 52 COVID-positive patients (26 Males and 26 Females); 69,6346±15,14250 (32-89) years [mean±SD age (range)] were included in the study. 98 different elementary lesions of lung detected on CT were evaluated in six different groups (consolidation, indeterminate ground-glass opacity (IGGO), dense GGO (DGGO), reversed halo, parenchymal band and curvilinear band). Lesions were compared with CXR taken on the same day. The detectability rates of the lesions on CXR were evaluated.
Results: The mean sizes of CXR negative and CXR positive lesions for every group (consolidations, IGGO, DGGO, reversed halo sign, parenchymal band, curvilinear band) were respectively 1.36 cm -5.75 cm, 3.44 cm -5.50 cm, 2.25 cm -5.06 cm, 2.5cm -4.09 cm, N/A -3.14 cm and 1 cm -4.5 cm. According to Mann-Whitney U analysis, p values were found as (respectively in consolidations, IGGO, DGGO, reversed halo sign, and curvilinear band) 0.0001p, 0.145, 0.0001 p, 0.143 and 0.286. Given consolidation and DGGO groups, there was a statistically significant difference between non-visualized and visualized groups. According to ROC analysis, cut-off values were respectively 3 cm and 3.5 cm for consolidation and DGGO.
Conclusion: Our study showed that consolidations smaller than 3 cm and DGGO smaller than 3.5 cm are difficult to visualize with CXR. Although there is no definite cut-off value in other elementary lesions, the visualization ratio of parenchymal bands and curvilinear bants on chest X-rays is quite high. IGGOs may not be detected even at higher dimensions. Reversed halos less than 3 cm can rarely be detected on CXR.

Anahtar Kelimeler

COVID-19, Chest X-Ray, computed tomography, thorax radiology

Kaynakça

• Sayar M S, Bulut D, Çelik S, Burulday V, Sarikaya R, Kurt N. The impact and relationship of inflammatory markers and radiologic involvement in the COVID-19 patients. J Health Sci Med 2021; 4: 416-21.
• Doğan E, Tapan U, Tapan ÖO, Alaşan F, Olcay SS, Olcay TÇ. A case of B. 1.1. 7 SARS-CoV-2 UK strain with an atypical radiological presentation. Monaldi Arch Chest Dis 2021; 91: 1840.
• Doğan E, Olcay SS, Olcay TÇ, Tapan U, Tapan OO, Alaşan F. A case of post-COVID-19 fibrosis mimicking Thoracic Manifestation of Ankylosing Spondylitis. Acta Medica Lituanica 2022; 29: 10.
• Gürsoy C, Tapan ÖO, Dogan E, Togan T, Demirbilek SG. COVID-19 Pneumonia during Hydroxychloroquine Treatment of Rheumatoid Arthritis. J Coll Physicians Surg Pak 2020;30:168-170.
• Ayyıldız A, Çobaner N, Yelken B. Sepsis induced coagulopathy score and D-dimer levels in COVID-19 patients followed in intensive care; what has changed in COVID era? J Health Sci Med 2022; 5: 94-8.
• Ufuk F, Savaş R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci 2020; 50: 664-78.
• Tenda ED, Yulianti M, Asaf MM, et al. The importance of chest CT scan in COVID-19. Acta MedIndones 2020; 52: 68-73.
• Mutlu P, Mirici A, Gönlügür U, et al. Evaluating the clinical, radiological, microbiological, biochemical parameters and the treatment response in COVID-19 pneumonia. J Health Sci Med 2022; 5: 544-51. 
• Öztürk Durmaz Ş, Sümer Coşkun A, Yalçın AN. Clinical and prognostic evaluation of patients admitted to the COVID-19 pandemic unit of the emergency department. J Health Sci Med 2021; 4: 835-9.
• Sathi S, Tiwari R, Verma S, et al. Role of chest X-Ray in coronavirus disease and correlation of radiological features with clinical outcomes in Indian patients. Can J Infect Dis Med Microbiol 2021; 2021: 6326947.
• Yasin R, Gouda W. Chest X-ray findings monitoring COVID-19 disease course and severity. The Egyptian J Radiol Nuclear Med 2020; 51: 193.
• Ulgen A, Çetin Ş, Balcı P, et al. COVID-19 outpatients and surviving inpatients exhibit comparable blood test results that are distinct from non-surviving inpatients. J Health Sci Med 2021; 4: 306-313.
• Durmuş E, Guner NG, Güneysu F, Aslan N, Yurumez Y. Review of COVID-19 vaccinated patients' emergency room admissions. J Health Sci Med 2022; 5: 18-21.
• Özdemirel ŞT, Akkurt ES, Ertan Ö, Gökler ME, Özyürek BA. Complications with moderate-to-severe COVID-19 during hospital admissions in patients with pneumonia. J Health Sci Med 2021; 4: 766-71.
• Martínez Chamorro E, Díez Tascón A, Ibáñez Sanz L, Ossaba Vélez S, Borruel Nacenta S. Radiologic diagnosis of patients with COVID-19. Radiologia (Engl Ed) 2021; 63: 56-73.
• Nava-Muñoz Á, Gómez-Peña S, Fuentes-Ferrer ME, et al. COVID-19 pneumonia: relationship between initial chest X-rays and laboratory findings. Radiologia 2021; 63: 484-94.
• Akçay MŞ, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci 2020; 50: 604-10.
• Cozzi D, Cavigli E, Moroni C, et al. Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19. Jpn J Radiol 2021; 39: 721-32.
• Han X, Fan Y, Alwalid O, et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology 2021; 299: 177-86.
• Mehrabi S, Fontana S, Mambrin F, et al. Pitfalls of computed tomography in the coronavirus 2019 (COVID-19) era: a new perspective on ground-glass opacities. Cureus 2020; 12: e8151.
• Parekh M, Donuru A, Balasubramanya R, Kapur S. Review of the cChest CT differential diagnosis of ground-glass opacities in the COVID era. Radiology 2020; 297: E289-E302.
• Dogan E, Tapan U, Tapan, OO, Togan T, Çelik ÖI. Idiopathic focal organizing pneumonia mimicking malignancy. Pan African Med J 2020; 36: 1-7
• Gürbüz D, Tunç MK, Yıldız H, Kalkan A, Yıldırmak MT, Önder H. “Reversed Halo” sign on chest computed tomography in COVID-19 pneumonia. Eur Arch Med Res 2021: 261-7.
• Samir A, Elabd AM, Mohamed W, Baess AI, Sweed RA, Abdelgawad MS. COVID-19 in Egypt after a year: the first and second pandemic waves from the radiological point of view; multi-center comparative study on 2000 patients. Egyptian J Radiol Nuclear Med 2021; 52: 1-13.
• Vijayakumar B, Tonkin J, Devaraj A, et al. CT Lung abnormalities after COVID-19 at 3 months and 1 year after hospital discharge. Radiology 2021; 211746.