An 84-Year-Old Man With Progressive Dyspnea and an Abnormal Chest CT Scan

Sarcoidosis and Crohn’s disease are systemic granulomatous disorders affecting the lung and the intestine, respectively, with variable involvement of other organs and are seldom associated. While anti-TNFαis a recognized treatment of Crohn’s disease, its usage is discussed in sarcoidosis. A 42-year-old man presented with an 11-year-long history of Crohn’s disease; upon discovery of an abnormal chest CT scan the diagnosis of multivisceral sarcoidosis was made and, later, a treatment with an anti-TNFαagent, infliximab, was started, because of worsening Crohn’s disease recurrences. CT scan demonstrated net regression of pulmonary opacities and hepatosplenic lesions. Pathologies obtained from the intestinal tract and the bronchi of the patient were, respectively, characteristic of Crohn’s disease and sarcoidosis leading to the diagnosis of both diseases. We report a rare case of steroid resistant Crohn’s disease associated with multivisceral sarcoidosis, treated successfully by an anti-TNFαagent, infliximab.

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Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia

10.21203/rs.3.rs-45829/v1 ◽

2020 ◽

Author(s):

Liqa A Rousan ◽

Eyhab Elobeid ◽

Musaab Karrar ◽

Yousef Khader

Keyword(s):

Ct Scan ◽

Chest Ct ◽

Common Finding ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Abnormal Chest ◽

Chest X Ray ◽

Chest Ct Scan

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

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A 42-Year-Old Woman With Abnormal Chest CT Scan and Chylous Ascites

CHEST Journal ◽

10.1016/j.chest.2015.10.032 ◽

2016 ◽

Vol 149 (1) ◽

pp. e25-e28 ◽

Cited By ~ 1

Author(s):

Tanmay S. Panchabhai ◽

Debabrata Bandyopadhyay ◽

Ruchi Yadav ◽

Andrea V. Arrossi ◽

Atul C. Mehta ◽

...

Keyword(s):

Ct Scan ◽

Chylous Ascites ◽

Chest Ct ◽

Abnormal Chest ◽

Chest Ct Scan

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Clinical predictors of abnormal chest CT scan findings following blunt chest trauma: A cross-sectional study

Chinese Journal of Traumatology ◽

10.1016/j.cjtee.2019.07.007 ◽

2020 ◽

Vol 23 (1) ◽

pp. 51-55

Author(s):

Saeed Safari ◽

Melina Farbod ◽

Hamidreza Hatamabadi ◽

Mahmoud Yousefifard ◽

Navid Mokhtari

Keyword(s):

Ct Scan ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Cross Sectional Study ◽

Chest Ct ◽

Sectional Study ◽

Clinical Predictors ◽

Cross Sectional ◽

Abnormal Chest ◽

Chest Ct Scan

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Patient With Advanced Anal Cancer and Abnormal Chest CT Scan: Thrombotic Pulmonary Embolism or Tumor Emboli?

CHEST Journal ◽

10.1378/chest.2270744 ◽

2015 ◽

Vol 148 (4) ◽

pp. 537A

Author(s):

Miguel Rondinel Robles ◽

David Appel ◽

Thomas Aldrich

Keyword(s):

Pulmonary Embolism ◽

Ct Scan ◽

Anal Cancer ◽

Chest Ct ◽

Abnormal Chest ◽

Tumor Emboli ◽

Chest Ct Scan

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Cancer surgery during the COVID‐19 pandemic: The experience of a comprehensive cancer center performing preoperative screening by RT‐PCR and chest CT scan

Journal of Surgical Oncology ◽

10.1002/jso.26335 ◽

2021 ◽

Vol 123 (4) ◽

pp. 815-822

Author(s):

Joanne Guerlain ◽

Fabienne Haroun ◽

Alexandra Voicu ◽

Charles Honoré ◽

Franck Griscelli ◽

...

Keyword(s):

Ct Scan ◽

Chest Ct ◽

Cancer Surgery ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Preoperative Screening ◽

Rt Pcr ◽

Chest Ct Scan

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A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Scientific Reports ◽

10.1038/s41598-020-80061-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

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The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital

Insights into Imaging ◽

10.1186/s13244-020-00957-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Vikram rao Bollineni ◽

Koenraad Hans Nieboer ◽

Seema Döring ◽

Nico Buls ◽

Johan de Mey

Keyword(s):

Ct Scan ◽

Predictive Value ◽

Ct Imaging ◽

Chest Ct ◽

University Hospital ◽

Rt Pcr ◽

Ct Findings ◽

Epidemic Area ◽

Chest Ct Scan ◽

Pcr Test

Abstract Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.

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