COVID-19 pnömonisinin akciğer hacmi üzerindeki etkilerinin kantitatif bilgisayarlı tomografi ile değerlendirilmesi

Amaç: Bu çalışmanın amacı COVID-19 pnömonisi olan hastalarda erken dönemde akciğer hacim azalması ile bilgisayarlı tomografi (BT) bulguları arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmaya inceleme kriterlerini karşılayan elli dört hasta dahil edildi. Hastaların her bir akciğeri için yazılım tabanlı kantitatif BT ile ölçüm yapılarak akciğer hacimleri hesaplandı. Hastalara ait demografik veriler, komorbidite ve sigara içme durumu, BT'deki inflamasyon bulguları, akciğer parankimindeki tutulum miktarını gösteren BT şiddet skorlaması ile ilk ve takip BT'lerindeki akciğer hacmindeki değişiklikler (azalma) arasındaki ilişki değerlendirildi. Bulgular: Hacim azalma oranı, yaş, cinsiyet, sigara içme veya hastanede yatış durumu ile istatistiksel olarak ilişkili değildi. Takip BT lerinde akciğer hacmi ve ciddiyet skorlaması arasındaki korelasyon incelendiğinde, sağ akciğerde (r = -0.583; p = 0.001) ve sol akciğerde (r = -0.478; p = 0.001) iyi derecede ters korelasyon vardı. Sağ akciğer hacmindeki azalma oranı komorbiditesi olan hastalarda diğer hastalara göre anlamlı derecede yüksekti. Sağ akciğerde hacim kaybı ile ciddiyet skoru arasında istatistiksel olarak orta derecede ters korelasyon varken (r = -0.294; p = 0.031) ve sol akciğerde anlamlı bir korelasyon bulunmadı (r = -0.096; p = 0.489). Sonuç: COVID-19 pnömonisi olan hastalarda parankimal tutulum miktarı ile birlikte akciğer hasarı oranı ve buna bağlı hacim azalması artar. Bu değişiklik komorbiditesi olanlarda daha sık görülmektedir. BT bulgularının nicel verilerle doğru yorumlanması, hekimlerin hastalığı yönetmesine yardımcı olabilir.

Anahtar Kelimeler:

• COVID-19 virüs, Akciğer volüm ölçümleri, Çok kesitli bilgisayarlı tomografi, Kantitatif, Pulmoner fibrozis

Quantitative computerized tomography evaluation of the effects of COVID-19 pneumonia on lung volume

Purpose: The aim of this study was o assess the relationship between lung volume decrease and computed tomography (CT) findings in patients with COVID-19 pneumonia in early period. Materials and Methods: Fifty-four patients were included in the study. The lung volume (LV) was calculated separately for each lung by software-based quantitative CT (QCT). Patient demographics, comorbidity and smoking status, CT findings, visual semi-quantitative CT severity scoring (CT-SS), and decrease of LV were analyzed. Results: The rate of volume decrease was not statistically related to, age, gender, smoking, or hospitalization status. When the correlation between follow-up CT (FUCT) LV and CT-SS was examined there were good inverse correlation on the right lung (r = -0.583; p = 0.001) and left lung (r = -0.478; p = 0.001). The rate of decrease in the right LV was significantly higher in patients with comorbidities compared to other patients. There was a statistically moderate inverse correlation between decrease of LV and CT-SS in the right lung (r = -0.294; p = 0.031), and no significant correlation was found between the decrease of LV and CT-SS in the left lung (r = -0.096; p = 0.489). Conclusion: The rate of lung damage and associated volume decrease both increase with the amount of parenchymal involvement in patients with COVID-19 pneumonia. This change is more frequent in patients with multiple comorbidities. Accurate interpretation of CT findings with quantitative data can help physicians to manage the disease.

Keywords:

COVID-19, lung volume measurements, multidetector computed tomography, quantitative, pulmonary fibrosis.,

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