scholarly journals X-ray study as an alternative method for visualizing changes in lungs, with infection caused by COVID-19

2021 ◽  
Vol 25 (2) ◽  
pp. 12-18
Author(s):  
E. A. Litvinenko ◽  
M. M. Erovenko ◽  
I. V. Burova
Keyword(s):  
Computed Tomography ◽  
Lung Tissue ◽  
Morphological Changes ◽  
Pathological Process ◽  
Lung Damage ◽  
Radiographic Examination ◽  
Pathological Changes ◽  
X Ray ◽  
Chest X Ray ◽  
Coronavirus Infection

Introduction. Despite the existence of generally accepted diagnostic protocols, when a new coronavirus infection is suspected, in some cases, it is increasingly difficult to detect changes in the lung tissue in a timely manner due to the heavy workload of the main method of radiation diagnostics – computed tomography. Purpose of the study. To determine the effectiveness of the appointment of an X-ray examination as first-line metgod, as well as to carry out a comparative analysis of the use of radiation diagnostics methods – computed tomography and radiography in relation to the diagnostic sensitivity to changes in lung tissue when a person is infected with the SARS-COV-2 virus.Materials and methods. 150 patients (63.0 ± 8.4 years) with confirmed coronavirus infection were examined. Each of the participants underwent X-ray examination and computed tomography of the chest organs. The percentage of subjects studied for each of the degrees of severity of lung damage was determined to identify the proportion of involvement of lung tissue in the pathological process in the bulk of the examined individuals.Results. Of the 150 patients, changes in the lung tissue during chest X-ray were detected in 97 (65%), respectively, in 53 (35%), pathological changes in the lungs were not visualized. When examining patients by computed tomography, changes in the lungs were detected in 143 patients (95%), X-ray morphological changes were not detected in 7 subjects (5%). When detecting the volume of lung damage, it turned out that the majority of the subjects – 86 people (57%) – had the degree of damage CT-2. The degree of CT-1 and CT-3 was determined in 26 (17%) and 25 (17%) patients, respectively. CT-4 was observed in 6 patients (4%), and in 5% of cases, CT was not able to detect pathological changes in the lung tissue, the degree of CT-0 was established.Conclusion. In the assessment of viral lung damage, radiography takes a significant place, but in 35% of cases, radiographic examination failed to identify the existing pathological changes. CT of the chest organs confirms its value as the “gold standard” in the study of pulmonary pathology in coronavirus infection, but if it is impossible to perform it, radiography is recommended.

scholarly journals Early detection of radiation-induced lung damage with X-ray dark-field radiography in mice

2020 ◽  
Author(s):  
Rico Burkhardt ◽  
Thomas Gora ◽  
Alexander A. Fingerle ◽  
Andreas P. Sauter ◽  
Felix Meurer ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Lung Tissue ◽  
Morphological Changes ◽  
Left Lung ◽  
Dark Field ◽  
Lung Damage ◽  
Control Group ◽  
X Ray ◽  
Radiation Induced ◽  
Healthy Lung

Abstract Objective Assessing the advantage of x-ray dark-field contrast over x-ray transmission contrast in radiography for the detection of developing radiation-induced lung damage in mice. Methods Two groups of female C57BL/6 mice (irradiated and control) were imaged obtaining both contrasts monthly for 28 weeks post irradiation. Six mice received 20 Gy of irradiation to the entire right lung sparing the left lung. The control group of six mice was not irradiated. A total of 88 radiographs of both contrasts were evaluated for both groups based on average values for two regions of interest, covering (irradiated) right lung and healthy left lung. The ratio of these average values, R, was distinguished between healthy and damaged lungs for both contrasts. The time-point when deviations of R from healthy lung exceeded 3σ was determined and compared among contrasts. The Wilcoxon-Mann-Whitney test was used to test against the null hypothesis that there is no difference between both groups. A selection of 32 radiographs was assessed by radiologists. Sensitivity and specificity were determined in order to compare the diagnostic potential of both contrasts. Inter-reader and intra-reader accuracy were rated with Cohen’s kappa. Results Radiation-induced morphological changes of lung tissue caused deviations from the control group that were measured on average 10 weeks earlier with x-ray dark-field contrast than with x-ray transmission contrast. Sensitivity, specificity, and accuracy doubled using dark-field radiography. Conclusion X-ray dark-field radiography detects morphological changes of lung tissue associated with radiation-induced damage earlier than transmission radiography in a pre-clinical mouse model. Key Points • Significant deviations from healthy lung due to irradiation were measured after 16 weeks with x-ray dark-field radiography (p = 0.004). • Significant deviations occur on average 10 weeks earlier for x-ray dark-field radiography in comparison to x-ray transmission radiography. • Sensitivity and specificity doubled when using x-ray dark-field radiography instead of x-ray transmission radiography.

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

Przewlekły kaszel jako główna manifestacja chłoniaka Hodgkina – opis przypadku

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Katarzyna Wójcicka ◽  
Andrzej Pogorzelski
Keyword(s):  
Chronic Cough ◽  
Correct Diagnosis ◽  
Diagnostic Methods ◽  
Radiographic Examination ◽  
Older Children ◽  
X Ray ◽  
Volume Curve ◽  
Flow Volume Curve ◽  
Mediastinal Widening ◽  
Chest X Ray

A cough lasting longer than 4-8 weeks, defined as chronic cough, always requires thorough diagnostic evaluation. In addition to detailed history-taking and physical examination, simple and available diagnostic methods, such as chest x-ray and spirometry, should be performed. They may be helpful tool to establish the underlying cause of cough. Many younger children may have difficulties in performing the forced expiratory maneuvers and fulfilling repeatability criteria for spirometry. The disturbances resulting from insufficient cooperation should be considered in interpratation of the obtained results. The shape of the flow-volume curve, which suggests upper or central airways obstruction, can not be ignored and always requires further investigation for diagnosis of respiratory pathology. The chest x-ray is the most frequently performed radiographic examination in children. Accurate interpretation is essential in reaching a correct diagnosis. Mediastinal widening on the chest x-ray in children can occur due to a large variety of causes. The normal thymus can take on a variety of sizes and shapes and still be considered normal in the first few years of life. In older children mediastinal widening should be differentiated from mediastinal masses. Lymph node enlargement represents a frequent cause, usually as a result of infection or malignancy. The article reports a case of a 12-year-old boy with chronic cough, mediastinal widening on the chest X-ray and abnormal spirometry results, who was finally diagnosed with stage III Hodgkin’s lymphoma.

scholarly journals LUNG ULTRASOUND DURING COVID-19 PANDEMICS: WHY, HOW AND WHEN?

2021 ◽  
Vol 74 (8) ◽  
pp. 1783-1788
Author(s):  
Khrystyna O. Pronyuk ◽  
Liudmyla O. Kondratiuk ◽  
Andrii D. Vysotskyi ◽  
Olga A. Golubovska ◽  
Iryna M. Nikitina
Keyword(s):  
Hospital Stay ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Limited Resource ◽  
Clinical Decision ◽  
Lung Damage ◽  
Dynamic Monitoring ◽  
Initial Assessment ◽  
X Ray ◽  
Chest X Ray

The aim: To optimize diagnostic of pathological processes in lungs affected by COVID-19, dynamic monitoring and clinical decision making using lung ultrasound in limited resources settings. Materials and methods: Between the onset of pandemics and January 2021, approximately 9000 patients have been treated for confirmed COVID-19 in the Olexandrivska Clinical Hospital. Assessment of all hospitalized patients included hematology, chemistries and proinflammatory cytokines – IL-6, CRP, procalcitonin, ferritin. Diagnosis was confirmed by PCR for SARS-CoV-2 RNA. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. Lung ultrasound was proactively utilized to assess the type and extent of lung damage and to monitor the progress of disease in patients hospitalized into the ICU and Infection Unit (n=135). Ultrasound findings were recorded numerically based on scales. Results: In the setting of СOVID-19, bedside lung ultrasound has been promptly recognized as a tool to diagnose and monitor the nature and extent of lung injury. Lung ultrasound is a real time assessment, which helps determine the nature of a pathologic process affecting lungs. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. Described in article data is collected in one of the biggest facility that deals with COVID-19. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. The cases presented in the paper indicate potential advantages to the use of ultrasound in limited resource healthcare settings, especially when the risk of transportation to CT outweighs the value of information obtained. Conclusions: Grading of ultrasonographic findings in the lungs was sufficient for both initial assessment with identification of high risk patients, and routine daily monitoring. Hence, lung ultrsound may be used to predict deterioration, stratify risks and make clinical decisions.

Differential diagnosis of hemoptysis

2021 ◽  
pp. 47-55
Author(s):  
Petr Arkadievich Ilyin
Keyword(s):  
Infectious Disease ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Differential Diagnosis ◽  
Correct Interpretation ◽  
Diagnostic Investigation ◽  
Detailed History ◽  
X Ray ◽  
Chest X Ray ◽  
Upper Gastrointestinal

Blood expectoration or hemoptysis is the coughing up of sputum with blood from the larynx, bronchi or lungs. Hemoptysis is most often caused by diseases of the respiratory tract and lungs — bronchitis or pneumonia, as well as lung cancer, aspergilloma, tuberculosis, bronchiectasis, pulmonary embolism, etc. In the diagnostic investigation of the cause of hemoptysis, it is important to take a detailed history (in the case of an epidemiological history, a laboratory analysis of the secreted sputum for the detection of the causative agent of an infectious disease is necessary), to make the correct interpretation of the patient’s complaints and an assessment of the nature of the sputum (differential diagnosis with bleeding from the upper gastrointestinal tract). A chest X-ray is performed and, then, if indicated, computed tomography, bronchoscopy, and other studies are made. The article presents an algorithm for differential diagnostic investigation of hemoptysis in a patient

Pericardial masses and congenital abnormalities

ESC CardioMed ◽  
2018 ◽  
pp. 1582-1584
Author(s):  
Angelos G. Rigopoulos ◽  
Hubert Seggewiss
Keyword(s):  
Computed Tomography ◽  
Surgical Management ◽  
Congenital Abnormalities ◽  
Benign Lesions ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Wall Calcification ◽  
Chest X Ray ◽  
Pericardial Cysts ◽  
The Right

Pericardial masses include cysts, pericardial tumours, and pericardial haematomas. Pericardial cysts are benign lesions commonly located in the right cardiophrenic angle that remain typically asymptomatic and are incidentally found in chest X-ray or chest computed tomography but might cause pressure symptoms or become infected, thus requiring surgical management. Hydatid cysts due to echinococcosis are the most common acquired pericardial cysts, characterized by wall calcification, and indicate surgery.

Focal abnormalities

ESC CardioMed ◽  
2018 ◽  
pp. 411-412
Author(s):  
Nicola Sverzellati ◽  
Gianluca Milanese ◽  
Mario Silva
Keyword(s):  
Computed Tomography ◽  
Clinical Assessment ◽  
Lung Nodules ◽  
Technological Equipment ◽  
X Ray ◽  
Progressive Development ◽  
Software Applications ◽  
Lung Abnormalities ◽  
Challenging Tasks ◽  
Chest X Ray

Both the detection and interpretation of focal abnormalities on chest X-ray (CXR) are challenging tasks. CXR accuracy depends on the view (e.g. the supine view has limited sensitivity) and technological equipment. The detection of small focal abnormalities (e.g. lung nodules) varies between anatomical regions according to the presence of dense anatomic structures, such as the bones and the hila. The interpretation of focal abnormalities on CXR is paramount within the whole clinical assessment, because CXR findings can guide the patient’s management, or warrant further investigations, such as computed tomography. Focal lung abnormalities on CXR are still a cornerstone of diagnostic algorithms; however, the radiological approach has progressively changed in the last decade because of the progressive development of both hardware and software applications that enable sensitive detection and accurate characterization.

scholarly journals (F)utility of computed tomography of the chest in the presence of pleural effusion

2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Clinical Management ◽  
Chest Ct ◽  
X Ray ◽  
Contrast Enhanced ◽  
Plain Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

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