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

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.

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

10.21203/rs.3.rs-25791/v2 ◽

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.

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

10.21203/rs.3.rs-25791/v3 ◽

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

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

10.21203/rs.3.rs-20399/v1 ◽

2020 ◽

Author(s):

Nian Liu ◽

Guanghong He ◽

Xiongxiong Yang ◽

Jianxin Chen ◽

Jie Wu ◽

...

Keyword(s):

Retrospective Study ◽

Severity Score ◽

Chest Ct ◽

Critical Group ◽

Occurrence Rate ◽

Dynamic Changes ◽

The Third ◽

Quadratic Relationship

Abstract ObjectivesTo investigate the CT changes of different clinical types of COVID-19 pneumonia.MethodsThis retrospective study included 50 confirmed patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical and CT characteristics 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.ResultsThere were no differences in the occurrence rate of CT characteristics between the moderate group (n=34) and the severe and critical group (n=16) in the initial CT (all p >0.05). There were differences in the CT score of right lung and total CT score at the initial CT between the two groups (all p <0.05). There was a quadratic relationship between total CT 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 score and CT follow-up time in the moderate group (p >0.05). The total CT score of the severe and critical group was different between the initial and first follow-up, the second and third follow-ups, the third and fourth follow-ups, and the fourth and fifth follow-ups CT (all p<0.05). The total CT score of the moderate group was different between the second and third follow-ups CT (p<0.05).ConclusionsCOVID-19 pneumonia with the severe and critical types progressed rapidly with the greatest severity at the second follow-up CT, and the moderate type was relatively stable.

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Study on the Dynamic Changes in Chest CT Findings of COVID-19 Rehabilitated Patients

Journal of Cardiology Research ◽

10.36879/jcr.20.000132 ◽

2020 ◽

pp. 1-7

Keyword(s):

Disease Progression ◽

Onset Time ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Dynamic Changes ◽

Course Of Disease ◽

Pleural Thickening ◽

Ct Findings ◽

Interlobular Septal Thickening

Objective: To study the dynamic changes in CT findings in COVID-19 (coronavirus disease-19, COVID-19) rehabilitated patients. Methods: A total of 148 chest CT images of 37 patients with COVID-19 were collected. In the first 21 days of the course of disease, 7 stages were performed every 3 days, and the eighth stage was performed after 21 days. Results: In the first chest CT examination, 19 cases were ground glass opacity, and 18 cases were high-density shadows with consolidation. The lesion shape was flaky and patchy in 33 cases. The percentage of consolidation, air bronchogram, fiber cord, interlobular septal thickening, subpleural line and pleural thickening were the highest on days 4-6, 7-9, 7-9, 10-12, 19-21 and 19-21, respectively. The highest percentage of disease progression was 80.00% on days 4-6, and then the percentage of disease progression gradually decreased with the extension of the onset time. The percentage of patients with improvement gradually increased from days 4-6, reaching 83.33% on days 16-18 and 100.00% on day 21. The percentage of lesion range enlargement and density increase was the highest on days 4-6, both of which were 60.00%，Then the percentage of both decreased gradually. The percentage of patients with lesion range reduction and density absorption dilution increased gradually with the onset time. There was no obvious regularity in the number of lesions. Conclusion: Patients with COVID-19 have regular changes in their lung conditions.

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/274 ◽

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

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AYURVEDIC UNDERSTANDING AND MANAGEMENT OF CEREBROVASCULAR ACCIDENT (STROKE WITH ISCHEMIAAND HEMORRHAGE): A CASE STUDY

10.36106/ijsr/7203034 ◽

2020 ◽

pp. 1-3

Author(s):

Anoop. A. S ◽

Anupama. A. S ◽

Kannan Sagar

Keyword(s):

Cerebrovascular Accident ◽

Heart Diseases ◽

The Third ◽

Oral Medications ◽

Chief Complaints ◽

The Right ◽

Inpatient Department

Stroke or cerbreovascular accidents are the leading cause of morbidity and mortality across the world.Infact the third leading cause after heart diseases and cancer.Strokes can be classied broadly as ischemic and hemorrhagic which accounts for 80% and 20% of the total cases.The prognosis of CVA depends on the type and its fast and appropriate management.A 50 year old male patient who is k/c/o type 2 diabetes mellitus,hypertension and hypercholistremia was admitted to the inpatient department of Sri Jayendra Saraswathi Ayurveda College and Hospital,Chennai on 20.01.2020 with the conrmed diagnosis of stroke(CVA) having both infarct and hemorrhage.The chief complaints were difculty in walking without support,reduced strength, stiffness and heaviness in the right hand and leg, difculty in speech, pain in right shoulder joint and knee joint since 4 months.This condition can be understood as Pakshaghata in Ayurveda.After proper evaluation of the avastha of the patient,Avarana chikitsa along with the Pakshaghata chikitsa was adopted in this case,Signicant improvements were observed on various subjective and objective parameters.The patient was discharged after 10 days of treatment with oral medications and advised for a follow up after 1 month.

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SUN-932 Successful Response of Temozolomide (TMZ) in two Patients with Metastatic Pheochromocytoma/Paragangliomas (PPGLs)

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1949 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Tobias Skrebsky de Almeida ◽

Roberta P Borges ◽

Janeczko Laís ◽

Giovana Caroline Marx Becker ◽

Ticiana Costa Rodrigues ◽

...

Keyword(s):

Lung Metastases ◽

Left Lung ◽

Vena Cava ◽

Lung Lesion ◽

Chest Ct ◽

Complete Regression ◽

Lung Lesions ◽

The Right ◽

Urinary Metanephrines

Abstract Introduction: PPGLs are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla or their neural crest progenitors, being able to secrete catecholamines. Its treatment is primarily surgical; however, for metastatic/inoperable tumors, effective treatments are lacking. The use of TMZ, an oral alkylating agent, has been scarcely reported with variable response rates. We report 2 patients with reasonable clinical, biochemical and structural responses. Case Reports: Case 1) A 14-year old girl presented with neck pain, sweating, hypertension and tachycardia. Urinary hormonal profile revealed metanephrines 80 (up to 320 ug/24h) and normetanephrines 2983 (up to 390 ug/24h). Abdominal MRI showed a 10x6x5 cm retroperitoneal lesion in close contact with celiac trunk, superior mesenteric artery, renal arteries, aorta, left renal vein and vertebral bodies of T10, T11 and T12. A chest CT revealed multiple lung metastases. After 11 months, both the primary abdominal lesion and lung metastases increased in size.. Due to disease severity, after excluding surgical possibilities and confirming diagnosis by lesion biopsy, rescue treatment with TMZ was started for 5 days on a 28-day cycle. After 11 cycles, lung and abdominal lesions decreased more than 30% in size, and urinary metanephrines decreased 53.4%. After 21 cycles, there is no evidence of disease progression. Case 2) A 44-year old female was first diagnosed at the age of 31 with a right adrenal mass invading the kidney and the inferior vena cava associated with hypertension, sweating, headaches and palpitations. She underwent right adrenalectomy and nephrectomy. Immunohistochemistry confirmed the diagnosis of pheochromocytoma. Seven years later, follow-up CT`s showed a 3 x 2 cm liver metastasis, which was resected, and two lung lesions, one located at the right inferior lobe (1.6 cm) and the other at the left superior lobe (0.9 cm), which initially were just followed-up. At this time, a 7-month sorafenib trial was performed but the drug was stopped due to intolerable side effects. After 3 years of follow-up, the lung lesions increased in size and the right lesion was resected, but the patient refused surgery for the remainder left lung lesion. After 1 year, left lung lesion increased to 2.4 cm and mediastinal and paratracheal lymphadenomegaly developed. TMZ in the same aforementioned schedule was prescribed and after 7 cycles a new chest CT revealed complete regression of the lung and lymph node metastases.. Urinary metanephrines were 2.1 times the upper limit of normal before TMZ and decreased to normal range. Conclusion: These cases highlight the promising role of a well-tolerated single drug chemotherapy regimen in severe cases of metastatic and inoperable PPGLs. TMZ could be considered an alternative strategy for the treatment of these cases and, if possible, should be tested in adequate clinical trials.

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

Canadian Respiratory Journal ◽

10.1155/2020/5328267 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 1

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.

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Incidental finding of bronchial diverticula in a non-smoker population: evaluation on thin-section CT

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2015.743 ◽

2016 ◽

Vol 81 (1-2) ◽

Author(s):

Federica Ciccarese ◽

Giorgio Garzillo ◽

Anna Maria Chiesa ◽

Antonio Poerio ◽

Serena Baroncini ◽

...

Keyword(s):

Thin Section ◽

Healthy Subjects ◽

Respiratory Symptoms ◽

Incidental Finding ◽

Radiological Finding ◽

Chest Ct ◽

Lobe Bronchus ◽

Significant Difference ◽

The Right

Bronchial diverticula have been described as a common radiological finding in smoker patients with COPD, but the specificity of this sign should be further investigated. Thus, the aim of our study was to evaluate the prevalence of diverticula in a cohort of non-smoker subjects. Between February and July 2012, 2438 patients were admitted to our Radiology Unit to undergo a chest CT. Among them, we enrolled 121 non-smoking patients (78/121-64.5% females, 43/121-35.5% males), of different age (57.0±20.7 years-range: 12-88), without any respiratory symptoms, submitted to chest CT for several reasons (oncologic evaluation: 59/121-48.8%; follow up of lung nodules: 27/121-22.3%; screening in connectivitis: 12/121-9.9%; others: 23/121-19.0%). We considered thin-section CT scan on axial, coronal and sagittal plans to evaluate prevalence, numbers and level of bronchial diverticula. Diverticula were found in 41/121-33.9% patients, with a slight major prevalence in males (p=0.048), but no significant difference on age. In 31/41-75.6% the number was <3, whereof 17/31-54.8% with just one diverticulum assessed. Regarding the level, in 30/41-73.2% they were subcarinal, but they were also detected in mainstem (2/41-4.9%) and lobar bronchi (with the right upper lobe bronchus most frequently involved- 12/41-29.3%). Bronchial diverticula can be observed in non-smokers, as well as in smoker patients with COPD. However, their prevalence seems to be lower than in smokers and they tend to be isolated and subcarinal. The age of patients does not influence their finding. More studies should be proposed to better define a cut-off between smokers and healthy subjects.

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Chest Computed Tomography Findings in Asymptomatic Patients with COVID-19

Respiration ◽

10.1159/000509334 ◽

2020 ◽

Vol 99 (9) ◽

pp. 748-754 ◽

Cited By ~ 3

Author(s):

Min Cheol Chang ◽

Wonho Lee ◽

Jian Hur ◽

Donghwi Park

Keyword(s):

Computed Tomography ◽

South Korea ◽

Respiratory System ◽

Ground Glass Opacity ◽

Chest Ct ◽

Effective Management ◽

Radiographic Findings ◽

Chest Computed Tomography ◽

Asymptomatic Patients ◽

The Right

Background: Little is known about the damage to the respiratory system in asymptomatic patients with coronavirus disease (COVID-19). Objective: Herein, we evaluate the findings of chest computed tomography (CT) and radiography in patients with COVID-19 who were asymptomatic. Methods: We retrospectively investigated patients with a confirmed diagnosis of COVID-19 but who did not show any symptoms. Among the 139 patients with COVID-19 who were hospitalized in Yeungnam University Hopistal in Daegu, South Korea, 10 (7.2%) were asymptomatic. Their chest CT and radiographic findings were analyzed. Results: In the results, all patients (100%) had ground-glass opacity (GGO) on chest CT. Further, the GGO lesions were predominantly distributed peripherally and posteriorly in all patients. In 9 (90%) patients, the GGO lesions were combined with reticular opacity. Air bronchogram due to bronchiolectasis surrounded by GGO was observed in 8 patients (80%). Additionally, the lung lesions were dominant on the right side in all patients. Conclusions: In conclusion, considering our results that the lung is affected in asymptomatic patients, it will be necessary to extend the indications of COVID-19 testing for effective management of COVID-19 during the pandemic.

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