Role of CT Chest in the Diagnosis and Management of SARS-Cov-2 Pneumonia Patients - Hospital Based Descriptive Study, Hyderabad

2021 ◽  
Vol 8 (19) ◽  
pp. 1446-1452
Author(s):  
P.M.T. Mahidhar ◽  
Gayathri Gadiyaram ◽  
Rakhee Kumar Paruchuri
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Descriptive Study ◽  
Middle Lobe ◽  
Chest Ct ◽  
Response To Treatment ◽  
Ground Glass ◽  
Ct System ◽  
The Right

BACKGROUND The computerised tomography (CT) characteristics of COVID-19 are reported and compared with the CT characteristics of other viruses to familiarise radiologists with potential CT trends and to determine the effectiveness of chest CT in the diagnosis and treatment of COVID-19. METHODS This was a hospital based descriptive study which involved the first 324 patients with a finding of severe acute respiratory syndrome (SARS-CoV-2) infection validated by real-time reverse transcription-polymerase chain reaction (RT – PCR). Monitoring patients (198 males, 126 females with a mean age of 46.50 years ± 8.96 [SD] and age range of 21 - 76 years) from April 2020 to July 2020. We correlated the image reports from the initial CT analysis with the findings of the laboratory studies and established possible CT patterns for viral infection. RESULTS The initial chest CT studies of the 324 SARS-CoV-2 patients showed that the disease affected all 'five lobes' in 248 (76.54 percent) patients, both 'lower lobes' in 49 (15.12 percent) patients, the right lower lobe in 23 patients (7.10 percent), and the left lower lobe and right middle lobe in 2 patients (0.62 percent). In 303 (93.52 percent) patients, the lesions were primarily peripheral and subpleural; and there were fewer lesions along the bronchovascular bundles. Two major patterns of SARS-CoV-2 lesions on CT images are GGO (ground - glass opacity) and consolidation. In 303 of the 324 patients (93.52 percent), CT showed single or multiple abnormal GGO or consolidation, or both. In the remaining 21 (6.48 percent) cases, neither GGO nor consolidation was observed on CT. Follow-up CT showed moderate or pronounced disease worsening in 12 out of 58 (20.69 percent) cases and follow-up CT showed improvement with the appearance of fibrosis and GGO resolution. CONCLUSIONS In conclusion, the use of a chest CT system in SARS-CoV-2 patients can accurately evaluate pneumonia. Most notably follow-up CT scans may help assess patients with SARS-CoV-2 pneumonia in their response to treatment. KEYWORDS SARS-CoV-2, Pneumonia, Chest Computed Tomography, Ground-Glass Opacities

scholarly journals Spectrum of Chest Computerised Tomography (CT) findings of Covid 19 in Indian Population

2021 ◽  
Vol 9 (1) ◽  
pp. 43-49
Author(s):  
Shravya Boini ◽  
Vikas Chennamaneni ◽  
Vamshi Kiran Diddy ◽  
Momin Sayed Kashif
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ct Images ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Study Cohort ◽  
Study Population ◽  
Ct Features

Background: To analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia. Methods: This was a prospective descriptive study comprising 202 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and CT severity scoring was done Results: Among the total study cohort of 202 patients, 152 were males and 50 were females .From July 07, 2020, to september07, 2020, totally 202 laboratory-confirmed patients with COVID-19 underwent chest CT. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared. Results were patients (98.5%) had two or more opacities in the lung and 3 (1.5%) patients has negative chest CT. 183 (90.6%) patients had only ground-glass opacities; 13 patients (6.4%) had ground-glass and consolidative opacities; and 3 patients (1.5%) had only consolidation. A total 192 of patients (96.5%) showed two or more lobes involved. The opacities tended to be both in peripheral and central 7 (3.5%) or purely peripheral distribution 192 (96.5%). 177 patients (88.9%) had the lower lobe involved.8 patients showed complete resolution of lung findings. Conclusion: In this study population, the typical CT features of COVID 19 pneumonia are ground glass opacity with or without consolidation, which is patchy and peripheral, predominantly in lower lobes.

scholarly journals Investigation of high-resolution computed tomographic (HRCT) outcomes associated with chronic pulmonary microaspiration (CPM) in Tehran and Zahedan, Iran

2020 ◽  
Vol 20 (4) ◽  
pp. 1710-5
Author(s):  
Bahareh Heshmat Ghahderijani ◽  
Fatemeh Hosseinabadi ◽  
Shahram Kahkouee ◽  
Mohamad Kazem Momeni ◽  
Samira Salajeghe ◽  
...  
Keyword(s):  
High Resolution ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Descriptive Study ◽  
Left Lower Lobe ◽  
Ground Glass ◽  
High Tendency ◽  
Computed Tomographic ◽  
Keywords Imaging

Background: In patients with chronic pulmonary microaspiration (CPM) the recognition of high-resolution computed tomographic (HRCT) findings and their pattern is important. Objective: To investigate the HRCT detections in patients with CPM. Materials and Methods: This descriptive study enrolled 100 consecutive patients with CPM underwent HRCT of the lungs between 2017 and 2018 in Tehran and Zahedan Hospitals and private centers. The required variables were recorded for each patient with a questionnaire. Subsequently, HRCT was performed and abnormalities were then reported by two radiologists. Results: Most of patients exhibited bronchial thickening in 33.6% of cases, followed by ground-glass opacity (12.4%), em- physema (11.1%), and bronchiectasis (8.5%). In addition, the most common HRCT findings were found in left lower lobe (LLL) (37.1%), followed by right lower lobe (RLL) (35.9 %), right upper lobe (RUL ) (6,2%), and left upper lobe (LUL) (6%). Conclusion: Our data showed the most common findings in HRCT were bronchial thickening ground-glass opacity, em- physema, and bronchiectasis, where these findings was dominantly found in LLL, RLL, RUL, and LUL, indicating its high tendency to dependent areas. Keywords: Imaging; high-resolution computed tomographic; chronic lung microaspiration.

scholarly journals Analysis of Chest CT Results of Coronavirus Disease 2019 (COVID-19) Patients at First Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Lingshan Zhong ◽  
Shuo Zhang ◽  
Jigang Wang ◽  
Xinqian Zhao ◽  
Kai Wang ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Imaging Data ◽  
Exclusion Criteria ◽  
Pulmonary Lesions ◽  
Normal Chest ◽  
Time Of Admission ◽  
Better Than

Objective. To investigate the dissipation and outcomes of pulmonary lesions at the first follow-up of patients who recovered from moderate and severe cases of COVID-19. Methods. From January 21 to March 3, 2020, a total of 136 patients with COVID-19 were admitted to our hospital. According to inclusion and exclusion criteria, 52 patients who recovered from COVID-19 were included in this study, including 33 moderate cases and 19 severe cases. Three senior radiologists independently and retrospectively analyzed the chest CT imaging data of 52 patients at the last time of admission and the first follow-up after discharge, including primary manifestations, concomitant manifestations, and degree of residual lesion dissipation. Results. At the first follow-up after discharge, 16 patients with COVID-19 recovered to normal chest CT appearance, while 36 patients still had residual pulmonary lesions, mainly including 33 cases of ground-glass opacity, 5 cases of consolidation, and 19 cases of fibrous strip shadow. The proportion of residual pulmonary lesions in severe cases (17/19) was statistically higher than in moderate cases (19/33) ( χ 2   =   5 . 759 , P < 0.05 ). At the first follow-up, residual pulmonary lesions were dissipated to varying degrees in 47 cases, and lesions remained unchanged in 5 cases. There were no cases of increased numbers of lesions, enlargement of lesions, or appearance of new lesions. The dissipation of residual pulmonary lesions in moderate patients was statistically better than in severe patients (Z = −2.538, P < 0.05 ). Conclusion. Clinically cured patients with COVID-19 had faster dissipation of residual pulmonary lesions after discharge, while moderate patients had better dissipation than severe patients. However, at the first follow-up, most patients still had residual pulmonary lesions, which were primarily ground-glass opacity and fibrous strip shadow. The proportion of residual pulmonary lesions was higher in severe cases of COVID-19, which required further follow-up.

scholarly journals Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

2020 ◽  
Author(s):  
Nian Liu ◽  
Guanghong He ◽  
Xiongxiong Yang ◽  
Jianxin Chen ◽  
Jie Wu ◽  
...  
Keyword(s):  
Severity Score ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Critical Group ◽  
Occurrence Rate ◽  
Dynamic Changes ◽  
Pleural Thickening ◽  
The Third ◽  
The Right

Abstract Background To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p < 0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2 = 0.137, p = 0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p > 0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p > 0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p < 0.05). Conclusions The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

scholarly journals Acute Pulmonary Embolism Mimicking Covid-19 Pneumonia

2020 ◽  
Vol 2 (6) ◽  
pp. 1-2
Author(s):  
Benslima N ◽  
◽  
Kacimi M ◽  
Berrada S ◽  
◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Rt Pcr ◽  
Severe Respiratory Distress ◽  
Thoracic Ct ◽  
History Of ◽  
The Right ◽  
Contrast Ct

We report the case of a 21 years old male patient, with a history of asthma since the age of 8 months, without follow-up, presenting a severe respiratory distress appeared suddenly, associated with a right basithoracic pain, and moderate hemoptysis. The non-contrast CT-chest scan showed a basal ground-glass opacity of the right lung leading to suspicion of Covid 19s’ pneumonia. Laboratory tests reveal an elevated levels of D-dimers (D-D), a thrombocytopenia, a neutrophilic leukocytosis and a hyper eosinophilia. The molecular test RT-PCR is negative. With the persistence of the right-side basithoracic pain and the presence of a hyper eosinophilia and increased levels of D-Dimers. A thoracic CT angiography was indicated that shows a bilateral distal pulmonary embolism with a right-sided basal sub segmental ischemia. We discuss a fortuitous discovery of an idiopathic pulmonary embolism associated to peripheral basal ground-glass opacities similar to the radiological findings found in the case of a SARS-Cov-2 pneumonia.

scholarly journals Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

2020 ◽  
Author(s):  
Nian Liu ◽  
Guanghong He ◽  
Xiongxiong Yang ◽  
Jianxin Chen ◽  
Jie Wu ◽  
...  
Keyword(s):  
Severity Score ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Critical Group ◽  
Occurrence Rate ◽  
Dynamic Changes ◽  
Pleural Thickening ◽  
The Third ◽  
The Right

Abstract Background: To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods: This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results: There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p <0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2=0.137, p=0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p >0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p >0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p <0.05). Conclusions: The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

scholarly journals Overuse of Follow-up Chest Computed Tomography in Patients With Incidentally Identified Nodules Suspicious for Lung Cancer

2021 ◽  
Author(s):  
Ran Guo ◽  
Yang Zhang ◽  
Zelin Ma ◽  
Chaoqiang Deng ◽  
Fangqiu Fu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Nodules ◽  
Ground Glass Opacity ◽  
Cost Effective ◽  
Chest Ct ◽  
Ground Glass ◽  
Ct Screening ◽  
Effective Care ◽  
Mixed Ground

Abstract Purpose: Regardless of professional societies agreed that CT screening inconsistent with recommendation leads to radiation-related cancer and unexpected cost, many patients undergo unnecessary chest CT before treatment. The goal of this study was to assess the overuse of Chest CT in different type of patients.Methods: Data on 1853 patients who underwent pulmonary resection from May 2019 to May 2020 were retrospectively analyzed. Data collected include age, sex, follow-up time, density and size of nodules and frequency of undergoing Chest CT. Pearson χ2 test and logistic regression were conducted to compare the receipt of CT screening.Results: Among 1853 patients in the study, 689 (37.2%) had overused Chest CT during follow-up of the lung cancer. This rate was 16.2% among patients with solid nodules, 57.5% among patients with pure ground glass opacity (pGGO), and 41.4% among patients with mixed ground glass opacity (mGGO) (P<.001). 50.7% in the “age ≤40” group, 39.8% in the “41≤age ≤50” group, 38.7% in the “51≤age ≤60” group, 32.3% in the “61≤age ≤70” group, 27.8% in the “>70” group underwent unnecessary CT (P<.001). Female get more unnecessary CT than male (40.6% vs 32.8%, P<.001). Factors associated with a greater likelihood of Chest CT is the density of nodules (odds ratios [ORs] of 0.53 for mGGO; 0.15 for solid nodule, P<.0001, vs patients with pGGO).Conclusion: roughly 37% patients with pulmonary nodules received Chest CT too frequently despite national recommendations against the practice. Closer adherence to clinical guidelines is likely to result in more cost-effective care.

Upper segmentectomy of the right lower lobe: growing ground glass opacity of the lower lobe

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 404-404
Author(s):  
Alessandro Pardolesi ◽  
Luca Bertolaccini ◽  
Filippo Tommaso Gallina ◽  
Barbara Bonfanti ◽  
Sergio Nicola Forti Parri ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
The Right

scholarly journals Clinicoradiological course in coronavirus disease-19 (COVID-19) patients who are asymptomatic at admission

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20200033 ◽  
Author(s):  
Arshed Hussain Parry ◽  
Abdul Haseeb Wani ◽  
Mudasira Yaseen ◽  
Naveed Nazir Shah ◽  
Khurshid Ahmad Dar
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Hospital Stay ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
The Other ◽  
Ground Glass ◽  
Chain Reaction ◽  
Polymerase Chain

Objective: The study aimed to describe the clinical and imaging course of reverse transcriptase polymerase chain reaction) confirmed coronavirus disease (COVID-19) patients who are asymptomatic at admission. Methods: This was a retrospective observational study. Severe acute respiratory syndrome coronavisrus-2 (SARS-CoV-2) positive cases that were asymptomatic at admission were retrospectively enrolled. Specific clinical information, laboratory test results, chest CT imaging features and outcome data during hospital stay were collected and analyzed. Results: 137 non-consecutive asymptomatic patients with reverse transcriptase polymerase chain reaction confirmed COVID-19 were enrolled in the present study. On admission, patients had no symptoms but chest CT findings were present in 61/137 (44.5%). Ground glass opacity (48, 78.7%) followed by ground glass opacity with crazy-paving pattern (9, 14.7%) were the commonest type of opacities with posterior, peripheral predominance and lower zone predilection. Among the initial CT positive group of 61 patients, follow-up imaging revealed progression of pulmonary opacities in 13/61 (21.4%), complete resorption in 21/61 (34.4%), partial resolution in 22/61 (36%) and no change in 5/61 (8.2%). The patients in progression group (54 ± 19.7 years) were older and had higher frequency of co-morbidities (46.2%) compared to the other three groups (10.4%). The patients in progression group had a significantly higher C-reactive protein, higher lactate dehydrogenase and lower lymphocyte count than the other groups (all p-values < 0.05). The duration of hospital stay was longer in the progression group (27.1 ± 11.4 days) compared to the other three groups (16.12 ± 5.8) (p =< 0.05). Conclusion: Nearly half of the asymptomatic cases with confirmed COVID-19 had abnormal chest CT imaging. Asymptomatic infections can have a variable clinicoradiological course. Clinically, some recover without developing symptoms, some present few mild symptoms whereas some deteriorate. Similarly, imaging follow-up may reveal resolution (partial or complete), progression or no change. Advances in knowledge: Clinicoradiological course of asymptomatic COVID-19 cases is diverse.

scholarly journals Evaluation of dynamic lung changes during coronavirus disease 2019 (COVID-19) by quantitative computed tomography

2020 ◽  
Vol 28 (5) ◽  
pp. 863-873
Author(s):  
Cong Shen ◽  
Nan Yu ◽  
Shubo Cai ◽  
Jie Zhou ◽  
Jiexin Sheng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Quantitative Computed Tomography ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Middle Lobe ◽  
Lesion Volume ◽  
Dynamic Changes ◽  
Initial Symptoms ◽  
Right Middle Lobe ◽  
The Right

OBJECTIVES: This study aims to trace the dynamic lung changes of coronavirus disease 2019 (COVID-19) using computed tomography (CT) images by a quantitative method. METHODS: In this retrospective study, 28 confirmed COVID-19 cases with 145 CT scans are collected. The lesions are detected automatically and the parameters including lesion volume (LeV/mL), lesion percentage to lung volume (LeV%), mean lesion density (MLeD/HU), low attenuation area lower than – 400HU (LAA-400%), and lesion weight (LM/mL*HU) are computed for quantification. The dynamic changes of lungs are traced from the day of initial symptoms to the day of discharge. The lesion distribution among the five lobes and the dynamic changes in each lobe are also analyzed. RESULTS: LeV%, MLeD, and LM reach peaks on days 9, 6 and 8, followed by a decrease trend in the next two weeks. LAA-400% (mostly the ground glass opacity) declines to the lowest on days 4–5, and then increases. The lesion is mostly seen in the bilateral lower lobes, followed by the left upper lobe, right upper lobe and right middle lobe (p < 0.05). The right middle lobe is the earliest one (on days 6–7), while the right lower lobe is the latest one (on days 9–10) that reaches to peak among the five lobes. CONCLUSIONS: Severity of COVID-19 increases from the day of initial symptoms, reaches to the peak around on day 8, and then decreases. Lesion is more commonly seen in the bilateral lower lobes.

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