COVID-19 PNÖMONİSİNİN TORAKS BT BULGULARI VE KLİNİK SEMPTOMLAR İLE İLİŞKİSİ

Yıl 2022, , 88 - 94, 17.01.2022

Nurdan Fidan , Esra Ümmühan Mermi Yetiş , Alev Günaldı , Mehmet Atasoy

https://doi.org/10.18229/kocatepetip.885860

Öz

AMAÇ: Bu çalışmada koronavirüs hastalığı 2019 (COVID-19) ile enfekte 185 hastanın ilk başvuru sırasındaki toraks bilgisayarlı tomografi (BT) bulgularının değerlendirilmesi ve demografik veriler ile ilişkisinin sunulması amaçlandı.
GEREÇ VE YÖNTEM: Mart - Temmuz 2020 tarihleri arasında, başvuru esnasında çekilmiş toraks BT incelemesi olan, gerçek zamanlı ters transkriptaz-polimeraz zincir reaksiyonu (RT-PCR) testi ile COVID-19 tanısı doğrulanmış, hastanemizde yatırılarak takip ve tedavi edilen 185 ardışık hasta çalışmaya alındı. Hastaların demografik verileri, başvuru sırasındaki şikayetleri, RT-PCR sonuçları elektronik tıbbi kayıtlarından ve BT incelemeleri PACS sisteminden retrospektif olarak tarandı. Lezyon paterni olarak buzlu cam alanı, konsolidasyon ya da buzlu cam görünümü ile birlikte konsolidasyon bulgusu olması tutulum varlığı olarak kabul edildi. Tutulum tarafı, dağılımı, yaygınlığı, plevraya uzaklığı değerlendirildi. Hava bronkogramı, vasküler dilatasyon, subplevral bant formasyonu, kaldırım taşı bulgusu, traksiyon bronşektazisi, fibroatelektazi, ters halo işareti, tomurcuklu ağaç görünümü, komşu plevrada kalınlaşma, plevral effüzyon, kavitasyon, mediastinal lenfadenopati gibi diğer ek bulguların varlığı kaydedildi.
BULGULAR: Olguların yaşları 18 ile 87 arasında değişmekte olup 86’sı (%46,5) kadın ve 99’u (%53,5) erkekti. Olguların %69’unda buzlu cam görünümü ve/veya konsolidasyon bulgusu varken %31’inde BT tutulum bulgusu yoktu ve %28 olguda BT tamamen normaldi. %80’inde bilateral, %87’sinde multilober tutulum görüldü. Buzlu cam görünümü ve/veya konsolidasyona eşlik eden en sık bulgular subplevral bant (%27) ve fibroatelektazi (%25) iken, tomurcuklu ağaç görünümü, kavitasyon, ters halo işareti ve plevral kalınlaşma en az görülen BT bulgularıdır.
SONUÇ: Bizim çalışmamız semptomların başlangıç evresinde toraks BT’de bilateral ,periferal veya yamalı multilober buzlu cam alanlarının yaygın olduğunu ancak buna azımsanmayacak oranda konsolidasyonların eşlik ettiğini göstermiştir. Bu bulgulara en sık subplevral bant, fibroatelektazi, kaldırım taşı bulgusu ve vasküler dilatasyon gibi daha geç dönem bulguları eşlik etmektedir. RT-PCR testi sonuçlanmamış olduğunda ya da yanlış negatiflik durumunda bu bulgular COVID-19 lehine yüksek şüpheli olarak değerlendirilmeli, gerekli izolasyon ve erken tedaviye başlanmalıdır.

Anahtar Kelimeler

COVID-19, Toraks BT, Pnömoni, Buzlu cam alanı

Destekleyen Kurum

yok

Teşekkür

yok

RELATİON BETWEEN CHEST CT FİNDİNGS AND CLİNİCAL SYMPTOMS OF COVID-19 PNEUMONİA

Öz

OBJECTIVE: In this study, it was aimed to evaluate the f chest computed tomography (CT) findings of 185 patients infected with the coronavirus disease 2019 (COVID-19) at the first admission and to present their relationship with demographic data.
MATERIAL AND METHODS: Between March and July 2020, 185 consecutive patients who were hospitalized, followed up and treated in our hospital, who were diagnosed with COVID-19 by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test and who had a chest CT examination taken at the time of admission were included in the study. The demographic data of the patients, complaints at the time of admission, RT-PCR results from their electronic medical records and chest CT examinations from the PACS system were scanned retrospectively. The presence of ground glass opacities, consolidation or both were accepted as the lesion pattern and as the presence of the involvement. The side, distribution, extent, and distance to the pleura of the involvement were evaluated. Other additional findings such as air bronchogram, vascular dilatation, subpleural band formation, crazy paving , traction bronchiectasis, fibroatelectasis, inverted halo sign, tree in bud appearance, pleural thickening, pleural effusion, cavitation, and mediastinal lymphadenopathy were recorded.
RESULTS: The ages of the cases ranged from 18 to 87 and 86 (46.5%) of them were female and 99 (53.5%) of them were male. While 69% of the cases had a ground-glass opacities and / or signs of consolidation, 31% of them did not have any involvement findings in the CT and CT was completely normal in 28% of the cases. Bilateral involvement was observed in 80% and multilobar involvement in 87%. The most common findings accompanying the ground glass opacities and/or consolidation are subpleural band (27%) and fibroatelectasis (25%), while the tree in bud appearance, cavitation, inverted halo sign and pleural thickening are the least common CT findings.
CONCLUSIONS: Our study has shown that bilateral, peripheral, multilobar ground glass opacities are common in chest CT in the initial phase of symptoms. However this is accompanied by consolidations to a considerable extent. These findings are most often accompanied by later findings such as subpleural band, fibroatelectasis, crazy paving finding and vascular dilatation. When the RT-PCR test is not completed or in case of false negativity, these findings should be considered as highly suspicious in favor of COVID-19, and necessary isolation and early treatment should be initiated.

Anahtar Kelimeler

COVID-19, Chest CT, Pneumonia, Ground glass opacity

Kaynakça

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