Comparisons of chest computed tomography patterns between survivors and non-survivors with Coronavirus Disease 2019 (COVID-19): a case-control study

2020 ◽  
Author(s):  
Feng Pan ◽  
Chuansheng Zheng ◽  
Tianhe Ye ◽  
Lingli Li ◽  
Dehan Liu ◽  
...  

Abstract Objectives To compare the chest computed tomography (CT) findings between survivors and non-survivors with Coronavirus Disease 2019 (COVID-19).Materials and Methods Between 12 January 2020 to 20 February 2020, the records of 124 consecutive patients diagnosed with COVID-19 were retrospectively reviewed and divided into survivor (83/124) and non-survivor (41/124) groups. Chest CT findings were qualitatively compared on admission and serial chest CT scans were semi-quantitively evaluated between two groups using curve estimations.Results Elder age (median: 69 vs. 43y, p<0.001), higher male ratio (31/41 vs. 32/83, p<0.001), and more comorbidities were observed in non-survivor group. On admission, significantly more bilateral (97.6% vs. 73.5%, p=0.005) and diffuse lesions (39.0% vs. 8.4%, p<0.001) with higher total CT score (median: 10 vs. 4) were observed in non-survivor group compared with survivor group. Besides, crazy-paving pattern was more predominant in non- survivor group than survivor group (39.0% vs. 12.0%, p=0.004). From the prediction of curve estimation, in survivor group total CT score increased in the first 20 days reaching the peak of 6 points and then gradual decreased for more than other 40 days (R2=0.545, p<0.001). In non- survivor group, total CT score rapidly increased over 10 points in the first 10 days and gradually increased afterwards until ARDS occurred with following death events (R2=0.711, p<0.001).Conclusions Persistent progression with predominant crazy-paving pattern was the major manifestation of COVID-19 in non-survivors. Understanding this CT feature could help the clinical physician to predict the prognosis of the patients.

2009 ◽  
Vol 29 (5) ◽  
pp. 517-522 ◽  
Author(s):  
Anniek Vlijm ◽  
Jaap Stoker ◽  
Shandra Bipat ◽  
Anje M. Spijkerboer ◽  
Saffire S.K.S. Phoa ◽  
...  

Background Computed tomography (CT) is often used to confirm the diagnosis of encapsulating peritoneal sclerosis (EPS) but there is no consensus on specific CT abnormalities. To establish CT findings characteristic for EPS, we compared CT findings between EPS patients and long-term peritoneal dialysis (PD) patients without EPS. Methods We included as cases all EPS patients in our center from 1996 to 2008 that underwent a CT scan at the time of diagnosis. Controls were all other long-term PD patients (PD duration ≥ 4 years) without EPS that had a CT scan for different reasons. The CT scans were blindly and independently reviewed by 3 radiologists: 2 abdominal radiologists with PD knowledge (Observers 1 and 2) and 1 radiologist without PD experience (Observer 3). Results We included 15 EPS patients and 16 controls. Observer 1 found 6 CT findings that were significantly more often present in EPS than in controls ( p ≤ 0.05): peritoneal enhancement, thickening, and calcifications; adhesions of bowel loops; signs of obstruction; and fluid loculation/septation. Observer 2 scored almost identically but Observer 3 scored differently. The sensitivity and specificity of a combination of specific CT findings were, respectively, 100% and 94% for Observers 1 and 2, and 79% and 88% for Observer 3. Conclusion CT scans showed characteristic abnormalities that were significantly more often present in EPS patients compared to long-term PD control patients. CT can be used to confirm the diagnosis of EPS when experienced radiologists apply a combination of specific CT findings.


2015 ◽  
Vol 9 (1) ◽  
pp. 22 ◽  
Author(s):  
Brett A Freedman ◽  
C Edward Hoffler ◽  
Brian M Cameron ◽  
John M Rhee ◽  
Maneesh Bawa ◽  
...  

2020 ◽  
Vol 61 (11) ◽  
pp. 1444-1451
Author(s):  
Henning Mothes ◽  
Vetlana Mueller-Mau ◽  
Lukas Lehmkuhl ◽  
Thomas Lehmann ◽  
Utz Settmacher ◽  
...  

Background Computed tomography (CT) can be used as the primary screening modality for the evaluation of patients suspected of having acute mesenteric ischemia known to show high sensitivity and specificity rates. Purpose To prove the value of CT in patients with pathological abdominal findings following cardiac surgery. Material and Methods In a retrospective case-control study, 12 different CT scan parameters of patients with or without mesenteric ischemia following cardiac surgery were compared using univariate and logistic regression analyses. Results Of 14,176 patients, 133 (0.9%) received an abdominal CT scan during postoperative care due to pathological abdominal findings. Sixty-eight patients were diagnosed with acute mesenteric ischemia. In-hospital mortality was 73.5% for this group. CT parameters with the highest specificity for indicating colonic ischemia were intestinal (99%) or porto-venous (96%) pneumatosis, abnormal contrast medium enhancement (89%), and occlusion of the proximal inferior mesenteric artery (81%). All of those parameters showed low sensitivity levels in the range of 15%–23%. A statistically significant association between acute mesenteric ischemia and CT appearance was obtained for contrast medium enhancement (odds ratio [OR] 12.2, 95% confidence interval [CI] 1.5–99.2) and intestinal pneumatosis (OR 21.0, 95% CI 2.7–165.2) only. Conclusion The typical CT criteria indicating mesenteric ischemia lose their accuracy in patients under critical clinical conditions. As CT remains the first-line diagnostic imaging modality for abnormal abdominal findings following cardiac surgery, negative signs should not prevent early laparotomy if clinical suspicion remains high.


2020 ◽  
Vol 134 (5) ◽  
pp. 409-414
Author(s):  
C Meerwein ◽  
S Pazahr ◽  
T M Stadler ◽  
N Nierobisch ◽  
A Dalbert ◽  
...  

AbstractObjectiveTo investigate the prevalence of bony dehiscence in the tympanic facial canal in patients with acute otitis media with facial paresis compared to those without facial paresis.MethodA retrospective case–control study was conducted on acute otitis media patients with facial paresis undergoing high-resolution temporal bone computed tomography.ResultsForty-eight patients were included (24 per group). Definitive determination of the presence of a bony dehiscence was possible in 44 out of 48 patients (91.7 per cent). Prevalence of bony dehiscence in acute otitis media patients with facial paresis was not different from that in acute otitis media patients without facial paresis (p = 0.21). Presence of a bony dehiscence was associated with a positive predictive value of 66.7 per cent in regard to development of facial paresis. However, an intact bony tympanic facial canal did not prevent facial paresis in 44.8 per cent of cases (95 per cent confidence interval = 34.6–55.6).ConclusionPrevalence of bony dehiscence in acute otitis media patients with facial paresis did not differ from that in acute otitis media patients without facial paresis. An intact tympanic bony facial canal does not protect from facial paresis development.


2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Junichi Ochi ◽  
Minoru Ohkouchi ◽  
Yoshikazu Tsukada ◽  
Shinichiro Tominaga ◽  
Satoshi Takayama ◽  
...  

Amiodarone-induced pulmonary toxicity is a critical and potentially fatal side effect of amiodarone. Our study was designed to reveal its clinical features, including KL-6, as an interstitial marker. The medical records of eight patients (five men and three women) with amiodarone-induced pulmonary toxicity, who had been referred to our hospital, were examined. The mean age at the initiation of amiodarone was 48 years (range, 54-87 years) and mean duration of medication prior to the development of pulmonary toxicity was 18 months (range, 7-33 months). Serum KL-6 was elevated in six of the eight patients with a range of 525-2915 U/mL. Chest computed tomography (CT) findings showed non-segmental consolidation and/or ground glass opacity. Foamy macrophages were found in bronchoalveolar lavage (BAL) fluids of all examined patients and in transbronchial lung biopsy (TBLB) specimens in half of the examined patients. We concluded that serum KL-6, chest CT findings, and foamy macrophages in BAL fluids and TBLB specimens will be helpful for the diagnosis of amiodarone-induced pulmonary toxicity.


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