Hadi SASANİ, Ömer ÖZÇAĞLAYAN, Tuğba İlkem KURTOĞLU ÖZÇAĞLAYAN, Ayhan ŞAHİN, Gülcan GÜCER ŞAHİN

Covid -19 Pnömonisinin Atipik BT Bulguları ve Klinik Korelasyonu

Amaç: Çalışmamızın amacı COVİD-19 pnömonisinin atipik BT bulgularını, eşlik eden ek patolojileri klinik ve laboratuar bulgularıyla birlikte değerlendirmek ve tipik BT bulguları ile karşılaştırmaktır.Materyal ve Metot: Çalışmamıza 14’ü atipik (%20,2), 55’i tipik (%79) toraks bilgisayarlı tomografi (BT) bulguları olan COVID-19 tanısı almış toplam 69 hasta dahil edildi. Toraks BT görüntüleri, atipik bulguları olan hastaların klinik ve laboratuar verileri retrospektif incelendi. Tipik ve atipik grubun lezyonları ve BT şiddet skoru karşılaştırıldı.Bulgular: Atipik BT bulguları sentrilobüler nodül, tomurcuklanmış ağaç, plevral effüzyon, lober/segmenter konsolidasyon, bronşiektazi, pulmoner emboli ve mozaik atenüasyon olup, periferik dağılım gösteren buzlu cam opasitesi ve/veya konsolidasyon gibi tipik lezyonlara eşlik etmekteydi. BT şiddet skoru atipik grupta belirgin yüksekti (p

ATYPICAL CT FINDINGS AND CLINICAL CORRELATION OF COVID-19 PNEUMONIA

Aim: Our study aimed to evaluate the atypical CT findings and concomitant pathologies of COVID-19 pneumonia and clinical and laboratory findings and compare them with typical CT findings.Materials and Methods: A total of 69 patients were diagnosed with COVID-19, 14 of which were atypical (20.2%), and 55 of which were typical (79%) chest computed tomography (CT) findings. CT images and clinical and laboratory data of patients with atypical findings were retrospectively analyzed. Lesions of the typical and atypical group and CT severity scores were compared.Results: Atypical CT findings were centrilobular nodule, tree in bud, pleural effusion, lobar/segmental consolidation, bronchiectasis, pulmonary embolism, and mosaic attenuation by typical lesions with ground-glass opacity with/without consolidation. CT severity score was significantly higher in the atypical group (p

PDF

___

1. Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4.
2. "WHO Director-General's opening remarks at the media briefing on COVID-19". World Health Organization website (İnternet yayını). 2020 March 11. Erişim: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarksat- the-media-briefing-on-covid 19--march-2020.
3. "ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection". ACR (internet yayını). 2020 March 22. Erişim: https://www.acr.org/Advocacy-and-Economics/ ACR-Position- Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection.
4. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020; 295(1): 202‐207.
5. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology 2020; 295 (3).
6. Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus Disease-19 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. American Journal of Roentgenology. 2020; 215: 87-93.
7. Ng M, Lee E, Yang J, et al. Imaging profile of the COVID-19 infection: radiologic findings and literature review. Radiol Cardiothorac Imaging 2020; 2(1): e200034.
8. Simpson S, Kay FU, Abbara S, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology , and RSNA. Journal of Thoracic Imaging. 2020; 35 (4): 219-227.
9. Kim D, Quinn J, Pinsky B, et al. Rates of co-infection between SARS-CoV-2 and other respiratory pathogens. JAMA. 2020; 323 (20): 2085-2086.
10. Li K, Fang Y, Li W, et al. CT image visual, quantitative evaluation, and clinical classification of coronavirus disease (COVID-19). Eur Radiol. 2020; 30 (8): 4407–16.
11. Li K, Wu J, Wu F, et al. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020; 55 (6): 327-331.
12. Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases Radiology. 2020; 296 (2): 32-40.
13. Lei J, Li J, Li X, et al. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020; 295 (1): 18
14. Xiong Y, Sun D, Liu Y, et al. Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes. Invest Radiol. 2020; 55 (6): 332-339.
15. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. 2020; 30 (6): 3306-3309.
16. Wu J, Wu X, Zeng W, Guo D, Fang Z et al. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Investigative Radiology 2020; 55(5): e257261.
17. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR American Journal of Roentgenology 2020; 214(5): 1072-1077.
18. Guan CS, Wei LG, Xie RM, et al. CT findings of COVID-19 in follow-up: comparison between progression and recovery. Diagn Interv Radiol. 2020; 26: 301-307.
19. Leonard-Lorant I, Delabranche X, Severac F, et al. Acute Pulmonary Embolism in COVID-19 Patients on CT Angiography and Relationship to D-Dimer Levels. Radiology. 2020; 296 (3): 189-191.
20. Yang R, Li X, Liu H, et al. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiology Cardiothoracic Imaging. 2020; 2(2). e200047.
21. Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8(4): 420-422.
22. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395 (10223): 507-513.