Serial computed tomography findings of Coronavirus disease 2019 (COVID-19) pneumonia treated with favipiravir and steroid therapy: report of 11 cases

Abstract Background This study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy. Results Eleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015). Conclusions At 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.

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Computed Tomography in Adults with Bronchiectasis and Nontuberculous Mycobacterial Pulmonary Disease: Typical Imaging Findings

Journal of Clinical Medicine ◽

10.3390/jcm10122736 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2736

Author(s):

Sabine Dettmer ◽

Felix C. Ringshausen ◽

Jan Fuge ◽

Hannah Louise Maske ◽

Tobias Welte ◽

...

Keyword(s):

Computed Tomography ◽

Pulmonary Disease ◽

Statistical Significance ◽

Ground Glass ◽

Wall Thickening ◽

Imaging Features ◽

Imaging Findings ◽

Ct Findings ◽

Microbiological Cure

Among patients with bronchiectasis, nontuberculous mycobacterial pulmonary disease (NTM-PD) ranged between 1 and 6% and it is suspected that its prevalence is underestimated. Our aim was to evaluate differences in computed tomography (CT) features in patients with bronchiectasis, with and without NTM-PD, in order to facilitate earlier diagnosis in the future. In addition, we evaluated longitudinal changes after successful NTM-PD treatment. One hundred and twenty-eight CTs performed in adults with bronchiectasis were scored for the involvement, type, and lobar distribution of bronchiectasis, bronchial dilatation, and bronchial wall thickening according to Reiff. In addition, associated findings, such as mucus plugging, tree-in-bud, consolidations, ground-glass opacities, interlobular thickening, intralobular lines, cavities, and atelectasis, were registered. Patients with NTM-PD (n = 36), as defined by ATS/IDSA diagnostic criteria, were compared to bronchiectasis patients without NTM-PD (n = 92). In twelve patients with an available consecutive CT scan after microbiological cure of NTM-PD imaging findings were also scored according to Kim and compared in the course. In patients with NTM-PD, there was a higher prevalence of bronchiectasis in the middle lobes (p < 0.001), extended bronchiolitis (p = 0.032) and more small and large nodules (p < 0.001). Furthermore, cavities turned out to be larger (p = 0.038), and walls thickened (p = 0.019) and extended (p = 0.016). Patients without NTM more often showed peripheral ground-glass opacities (0.003) and interstitial changes (p = 0.001). CT findings decreased after successful NTM-PD treatment in the follow-up CT; however, without statistical significance for most features (p = 0.056), but bronchiolitis was the only significantly reduced score item (p = 0.043). CT patterns in patients with bronchiectasis and NTM-PD differ from those of patients with bronchiectasis without NTM-PD, although the findings are non-specific radiological features. Follow-up CT findings after microbiological cure differed interindividual regarding the decline in imaging features. Our findings may help practitioners to identify NTM-PD in patients with bronchiectasis. Further research is needed regarding the use of CT as a potential imaging biomarker for the evaluation of treatment response.

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Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192526 ◽

2019 ◽

Vol 7 (6) ◽

pp. 2350

Author(s):

Puran . ◽

Narendra Kumar Kardam

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Abdominal Trauma ◽

Imaging Modality ◽

Abdominal Injury ◽

Male Predominance ◽

Ct Findings ◽

Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

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Do Serial Lung Ultrasound Scores Predict Prolonged Mechanical Ventilation in Patients With Severe COVID-19? A Single-centre Retrospective Cohort Study

10.21203/rs.3.rs-614493/v1 ◽

2021 ◽

Author(s):

Hayato Taniguchi ◽

Aimi Ohya ◽

Hidehiro Yamagata ◽

Masayuki Iwashita ◽

Takeru Abe ◽

...

Keyword(s):

Mechanical Ventilation ◽

Lung Ultrasound ◽

Prolonged Mechanical Ventilation ◽

X Rays ◽

C Reactive Protein ◽

Time Points ◽

Reactive Protein ◽

Bedside Test ◽

Successful Extubation

Abstract Background: Some patients with severe coronavirus disease (COVID-19) who present with fibrosis on computed tomography (CT) require prolonged mechanical ventilation (PMV). Lung ultrasound (LUS), a rapid, bedside test, has been reported to have findings consistent with those of CT. Thus, this study aimed to assess whether serial LUS scores could predict PMV or successful extubation in severe COVID-19 patients.Methods: LUS was performed for 20 consecutive severe COVID-19 patients at three time points: admission (day 1), after 48 h (day 3), and seventh-day follow-up (day 7). We compared the LUS score with the results of chest X-rays and laboratory tests at three time points. Moreover, we assessed LUS score to determine the inter-rater reliability (IRR) of the results among examiners.Results: While there were no significant differences in mortality in each PMV and successful extubation groups, there were significant differences in LUS scores on day 3 and day 7; XP score on day 7; and P/F ratio on day 7 in the PMV group (p<0.05). There were significant differences in LUS scores on days 3 and 7, C-reactive protein (CRP) levels on day 7, and P/F ratio on day 7 in the successful extubation group (p<0.05). The areas under the curves (AUCs) of LUS score on days 3 and 7, XP score on day 7, and P/F ratio were 0.88, 0.98, 0.77, and 0.80, respectively in the PMV group; and the AUCs of LUS score on days 3 and 7, CRP levels on day 7, and P/F ratio 0.79, 0.90, 0.82, and 0.79, respectively, in the successful extubation group. Variations in serial LUS scores exhibited significant differences between the groups. The serial LUS score on day 7 was higher than that on day 1 in the PMV group but lower in the successful extubation group (p<0.05). However, there was slight IRR agreement in the LUS score changes on days 1 to 7 (κ= 0.15 [95% CI: 0-0.31]). Conclusions: The serial LUS score of severe COVID-19 patients could predicted PMV and successful extubation. To overcome IRR disagreement, the automatic ultrasound judgement, such as deep learning, would be needed.

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Impact of Initial Computed Tomography Findings on Management of Atypical Urinary Cytology of the Upper Urinary Tract

Urologia Internationalis ◽

10.1159/000512978 ◽

2021 ◽

pp. 1-5

Author(s):

Kotaro Takemura ◽

Taketo Kawai ◽

Yusuke Sato ◽

Jimpei Miyakawa ◽

Satoru Taguchi ◽

...

Keyword(s):

Computed Tomography ◽

Urinary Tract ◽

Upper Urinary Tract ◽

Wall Thickening ◽

Urinary Cytology ◽

Class Iii ◽

Ct Findings ◽

Retrograde Ureteropyelography ◽

Tumor Like Lesions

Introduction: Management of patients with atypical urinary cytology (class III) of the upper urinary tract is often complicated because some patients develop upper urinary tract urothelial carcinoma (UTUC). Here, we aimed to help define the optimal management of these patients. Methods: We investigated 31 patients who underwent retrograde ureteropyelography (RP) and were diagnosed with atypical findings of upper urinary tract cytology. Results: UTUC was revealed in 17 of 31 patients during the follow-up period of 1 year or longer. Tumor-like lesions and wall thickening in the upper urinary tract on initial computed tomography (CT) were significant predictors of UTUC (p = 0.0002 and p = 0.012, respectively). All 11 patients with tumor-like lesions and 3 of 8 patients with wall thickening on initial CT underwent nephroureterectomy, and UTUC was confirmed histologically. Moreover, 3 of 12 patients with hydronephrosis only or with normal findings later went on to develop UTUC. Repeated RP performed within 6 months from the initial RP was able to distinguish patients with UTUC from those without, even in individuals with normal CT findings. Discussion/Conclusion: Repeated RP based on initial CT findings is recommended in patients with atypical urinary cytology of the upper urinary tract. Nephroureterectomy without repeated RP may be warranted in patients with tumor-like lesions on initial CT findings.

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Computed Tomography in Primary and Secondary Adrenal Tumours

Acta Radiologica ◽

10.1177/028418518802900505 ◽

1988 ◽

Vol 29 (5) ◽

pp. 519-522 ◽

Cited By ~ 11

Author(s):

M. Päivänsalo ◽

S. Lähde ◽

J. Merikanto ◽

M. Kallionen

Keyword(s):

Computed Tomography ◽

Diagnostic Procedures ◽

Hormonal Activity ◽

Malignant Tumours ◽

Adrenal Metastases ◽

Adrenal Tumours ◽

Ct Findings ◽

Adrenal Masses

The purpose of the study was to find out how reliably benign and malignant adrenal tumours can be differentiated on the basis of CT characteristics. The material included 86 adrenal tumours with the following confirmed diagnoses: 48 primary adrenal tumours (8 carcinomas, 1 neuroblastoma, 4 pheochromocytomas, 31 adenomas, 3 cysts, 1 haemangioma) and 38 metastases. The size, density, homogeneity, enhancement and growth of the tumours were evaluated. No specific CT findings could separate benign from malignant tumours. Coexistence of cancer and bilateral non-homogeneous adrenal masses is probably sufficient for the diagnosis of adrenal metastases. In cases of coincidental small (<3 cm), homogeneous and relatively hypodense masses with no signs of hormonal activity, a follow-up examination of the lesion within three months is recommended. Other masses may indicate further diagnostic procedures.

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Subacromial Erosion after Hook Plate Fixation in Acute Acromioclavicular Joint Dislocation

10.21203/rs.3.rs-125960/v1 ◽

2020 ◽

Author(s):

Jung Youn Kim ◽

Yong Girl Rhee ◽

Young Wan Ko ◽

Sung Min Rhee

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Unaffected Side ◽

Ct Findings ◽

Ucla Score ◽

The Mean

Abstract Background: This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors. Methods: The study was conducted on 35 patients who underwent the locking hook plate fixation for acute ACJ joint injury. The clinical outcomes were evaluated measuring the visual analog scale (VAS) for pain, and the University of California at Los Angeles (UCLA) score. The computed tomography (CT) was conducted to measure the subacromial erosion. The acromioclavicular slope (AC slope) of the unaffected side, the acromion-hook angle (AH angle), the acromioclavicular anteroposterior distance (AC-AP distance), and the preoperative acromioclavicular interval (ACI) of the affected side were analyzed to identify the risk factors of subacromial erosion. Results: The mean preoperative VAS score was 7.6 points, which improved by a significant level of 0.3 at the final follow-up (P <0.001). The UCLA score at the last follow-up was 32.3 points, which was higher than the preoperative average of 15.2 points (P = 0.003). According to the computed tomography (CT) findings, subacromial erosion was found in all cases, and the mean value was 5.0mm, which is 53% of the entire acromion thickness. The AC slope (B=-0.159, P<0.001) and AC-AP distance (B=0.233, P=0.004) were found to have a significant influence on postoperative subacromial erosion. The AC slope showed a negative correlation with the amount of erosion, while the AC-AP distance showed a positive correlation with erosion. onclusion: The study was able to obtain satisfactory clinical and radiological results after locking hook plate fixation for acute ACJ injury. The CT findings revealed that subacromial erosion occurred in all cases, and the mean erosion depth was about 50% of the acromial thickness. If the preoperative AC slope of the unaffected side was more acute and the AC-AP distance was larger, the incidence of subacromial erosion was higher. Level of evidence: Therapeutic Level IV Retrospectively registered study: This study was retrospective in nature, and final approval of informed consent exemption by the institutional review board was obtained (KHUH IRB 2019-04-079)

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Early Computed Tomography Findings of Novel Coronavirus Disease 2019 (COVID-19) Pneumonia

Archives of Clinical Infectious Diseases ◽

10.5812/archcid.106868 ◽

2020 ◽

Vol 15 (5) ◽

Author(s):

Pinar Diydem Yilmaz ◽

Cengiz Kadiyoran ◽

Suleyman Bakdik ◽

Necdet Poyraz ◽

Hulya Vatansev

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Imaging Modality ◽

Ground Glass Opacity ◽

Ground Glass ◽

Pleural Thickening ◽

Halo Sign ◽

Ct Findings ◽

Novel Coronavirus ◽

Ct Features

Background: Novel coronavirus disease (COVID-19) pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and threatens human health. Chest computed tomography (CT) is an accurate imaging modality for diagnosis and follow-up. Objectives: To investigate early CT features of COVID-19 pneumonia. Methods: Retrospective study. Sixty-three patients with COVID-19 pneumonia (28 men, 35 women; age range, 21 - 85 years; mean, 59 years) confirmed by reverse transcription-polymerase chain reaction (RT-PCR) were enrolled in this retrospective study and CT findings were evaluated. Patients were classified into three groups for estimating COVID-19 pneumonia, according to CT features. Results: Nineteen (30%) patients classified as out of COVID-19 pneumonia had normal CT findings. Twenty-eight (44%) patients, classified as highly suggestive for COVID-19 pneumonia, had typical findings for COVID-19 pneumonia. In highly suggestive for COVID-19 pneumonia group most common CT features were peripheral (64%), multilobar (96%), patchy, and round (54%) ground-glass opacity (GGO) (57%). Air bronchogram (93%), crazy-paving patterns (79%), and vascular thickening (61%) were the most common special findings. We only detected these rare findings such as halo sign, reverse halo sign, lymphadenopathy, pleural and pericardial effusion, pleural thickening, and fibrotic lines in patients with COVID-19 with chronic diseases. Conclusions: The early CT findings are peripheral, multilobar, patchy, and round ground glass opacities accompanied by vascular thickening, crazy-paving pattern, or air bronchogram sign. Rare findings are only seen in the presence of concomitant diseases.

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Case Report: Disappearance of Coronary Anastomotic Aneurysm by Steroid Therapy in Takayasu Arteritis: Pseudorepair of Pseudoaneurysm?

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.683216 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shuichi Naraoka ◽

Hiroki Uchiyama ◽

Toshiyuki Yano ◽

Takuma Mikami ◽

Ryo Harada ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Steroid Therapy ◽

Takayasu Arteritis ◽

Sinus Of Valsalva ◽

Anastomotic Aneurysm

Background: Takayasu arteritis (TA) is a large vessel vasculitis of unknown etiology characterized by chronic inflammatory changes of the aorta and its major branches. Complications such as anastomotic aneurysm and valve detachment have been reported in active TA patients who received aortic valve replacement and graft replacement of aorta.Case Summary:A 61-year-old man with a history of emergency aortic valve replacement and patch closure of the noncoronary sinus of Valsalva due to acute heart failure induced by acute aortic regurgitation and ruptured sinus of Valsalva 4 years ago was referred for exertional dyspnea. Dilatation of the sinus of Valsalva together with protrusion of the right sinus of Valsalva and ostial stenosis of the left coronary artery were newly found by computed tomography (CT). A Bentall operation with concomitant coronary artery bypass grafting was successfully performed with a composite graft. Diagnosis of TA was made on the basis of histological analyses of the resected sinus of Valsalva, though other arterial manifestations were not detected by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography. Three months later, a follow-up study revealed left coronary ostial pseudoaneurysm at the anastomotic site together with strong 18F-FDG uptake, leading to commencement of steroid therapy. Eight months later, disappearance of left coronary ostial pseudoaneurysm was found by a follow-up CT scan.Conclusion: This is a rare TA case in whom spontaneous resolution of coronary anastomotic aneurysm by steroid therapy was found without reconstructive surgery.

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Chest Computed Tomography Findings in a Case Series of Coronavirus Disease 2019 (COVID-19) Patients at Siriraj Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.05.12395 ◽

2021 ◽

Vol 104 (5) ◽

pp. 866-871

Keyword(s):

Computed Tomography ◽

Medical Records ◽

Case Series ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Chest Computed Tomography ◽

Ct Findings ◽

Siriraj Hospital ◽

Chest Ct Scan

Background: Recent evidence has demonstrated the high sensitivity of chest computed tomography (CT) in coronavirus disease 2019 (COVID-19) case detection. However, considering the cost and infection control issues, the experience of chest CT for COVID-19 diagnosis in Thailand is still limited. Objective: To present the characteristics of chest CT findings in COVID-19 patients at Siriraj Hospital and compare them with other reports. Materials and Methods: The authors retrospectively reviewed the COVID-19 patients’ medical records between April and May 2020. All cases with the presence of chest CT performed during admission were recruited. Clinical data were retrieved from the patients’ medical records. All chest imaging results were reported by consensus between the authors. Results: From 103 cases, four cases with a chest CT scan during the admission were recruited. Consistent with previous reports, the common chest CT findings included a ground-glass opacity and consolidation with bilateral involvement. A round-shaped ground-glass opacity or consolidation was evidenced in half of the cases. The only case with the presence of chest CT scan, which was done 77 days after the onset of COVID-19 symptoms, revealed resolution of the abnormal findings. Conclusion: Chest CT findings in four COVID-19 cases at Siriraj Hospital are consistent with previous reports. Common findings include bilateral ground-glass opacity and consolidation. Keywords: COVID-19, SARS-CoV-2, Computed tomography, Case series

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