scholarly journals Evolution of CT Findings and Lung Residue in Patients with COVID-19 Pneumonia: Quantitative Analysis of the Disease with a Computer Automatic Tool

2021 ◽  
Vol 11 (7) ◽  
pp. 641
Author(s):  
Roberto Grassi ◽  
Salvatore Cappabianca ◽  
Fabrizio Urraro ◽  
Vincenza Granata ◽  
Giuliana Giacobbe ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Lung Disease ◽  
Lung Volume ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
P Value ◽  
Total Lung Volume ◽  
Computer Aided ◽  
Discharged Patients

Purpose: the purpose of this study was to assess the evolution of computed tomography (CT) findings and lung residue in patients with COVID-19 pneumonia, via quantified evaluation of the disease, using a computer aided tool. Materials and methods: we retrospectively evaluated 341 CT examinations of 140 patients (68 years of median age) infected with COVID-19 (confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR)), who were hospitalized, and who received clinical and CT examinations. All CTs were evaluated by two expert radiologists, in consensus, at the same reading session, using a computer-aided tool for quantification of the pulmonary disease. The parameters obtained using the computer tool included the healthy residual parenchyma, ground glass opacity, consolidation, and total lung volume. Results: statistically significant differences (p value ≤ 0.05) were found among quantified volumes of healthy residual parenchyma, ground glass opacity (GGO), consolidation, and total lung volume, considering different clinical conditions (stable, improved, and worsened). Statistically significant differences were found among quantified volumes for healthy residual parenchyma, GGO, and consolidation (p value ≤ 0.05) between dead patients and discharged patients. CT was not performed on cadavers; the death was an outcome, which was retrospectively included to differentiate findings of patients who survived vs. patients who died during hospitalization. Among discharged patients, complete disease resolutions on CT scans were observed in 62/129 patients with lung disease involvement ≤5%; lung disease involvement from 5% to 15% was found in 40/129 patients, while 27/129 patients had lung disease involvement between 16 and 30%. Moreover, 8–21 days (after hospital admission) was an “advanced period” with the most severe lung disease involvement. After the extent of involvement started to decrease—particularly after 21 days—the absorption was more obvious. Conclusions: a complete disease resolution on chest CT scans was observed in 48.1% of discharged patients using a computer-aided tool to quantify the GGO and consolidation volumes; after 16 days of hospital admission, the abnormalities identified by chest CT began to improve; in particular, the absorption was more obvious after 21 days.

scholarly journals Follow-up Chest CT findings from discharged patients with severe COVID-19: an 83-day observational study

2020 ◽  
Author(s):  
Tianhe Ye ◽  
Yanqing Fan ◽  
Jiacheng Liu ◽  
Chongtu Yang ◽  
Songjiang Huang ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Virus Disease ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Ct Findings ◽  
Lung Abnormalities ◽  
Discharged Patients

Abstract Background: Chest computed tomography (CT) has been used to be a monitoring measure to assess the severity of lung abnormalities in corona virus disease 19 (COVID-19). Up to date, there has been no reports about follow-up chest CT findings from discharge patients with severe COVID-19. This study aims to describe the change pattern of radiological abnormalities from admission, to discharge, and to the last chest CT follow-up through an 83-day retrospective observation, and focuses on follow-up chest CT findings in discharged patients with severe COVID-19.Methods: Twenty-nine discharged patients (17 males, 12 females; median age, 56 years, IQR, 47-67) confirmed with severe COVID-19 from 13 January to 15 February were enrolled in this study. A total of 80 chest CT scans was performed from admission to the last follow-up. Images were mainly evaluated for ground-glass opacity, consolidation, parenchymal bands, and crazy-paving pattern. A semi-quantitative CT scoring system was used for estimating lung abnormalities of each lobe.Results: All patients received nasal cannula or/and high-flow mask oxygen therapy. Admission occurred 9 days (IQR, 5-13) after symptom onset. The median in-hospital period was 18 days (IQR, 11-26). The last follow-up chest CT was performed 66 days (IQR, 61-77) after symptom onset. Total CT scores in follow-up decreased significantly compared to that of performed in-hospital ([3, IQR, 0-5] to [13, IQR, 10-16], P < 0.001). Predominant patterns on follow-up chest CT performed 64 days after symptom onset were subpleural parenchymal bands (47%, 9/19) and complete radiological resolution (37%, 7/19). Consolidation absorbed earlier than ground-glass opacity did, and subpleural parenchymal bands were the longest-lasting feature during radiological resolution.Conclusions: Radiological abnormalities in patients of severe COVID-19 could be completely absorbed with no residual lung injury in more than two months’ follow-up. Serial chest CT scans could be used as a monitoring modality to help clinician better understand the disease course.

scholarly journals Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia

2020 ◽  
Author(s):  
Davide Ippolito ◽  
Maria Ragusi ◽  
Davide Gandola ◽  
Cesare Maino ◽  
Anna Pecorelli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Volume ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
Invasive Ventilation ◽  
Lung Volumes ◽  
Total Lung Volume ◽  
Reactive Protein ◽  
Absolute Volume ◽  
Patient’S Outcome

Abstract Objectives To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. Methods All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. Results A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO2 (r = 0.176), HCO3− (r = 0.284), and PaO2/FiO2 (P/F) values (r = − 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = −0.225), CRP (r = 0.306), PaCO2 (r = 0.227), pH (r = 0.162), HCO3− (r = 0.394), and P/F (r = − 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). Conclusion The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. Key Points • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient’s outcome, in particular concerning invasive ventilation.

scholarly journals The halo sign: HRCT findings in 85 patients

2016 ◽  
Vol 42 (6) ◽  
pp. 435-439 ◽  
Author(s):  
Giordano Rafael Tronco Alves ◽  
◽  
Edson Marchiori ◽  
Klaus Irion ◽  
Carlos Schuler Nin ◽  
...  
Keyword(s):  
Immune Status ◽  
Ground Glass Opacity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Ct Scans ◽  
Pulmonary Lesions ◽  
Halo Sign ◽  
Immunosuppressed Patients ◽  
Primary Neoplasm ◽  
Immunocompetent Patients

ABSTRACT Objective: The halo sign consists of an area of ground-glass opacity surrounding pulmonary lesions on chest CT scans. We compared immunocompetent and immunosuppressed patients in terms of halo sign features and sought to identify those of greatest diagnostic value. Methods: This was a retrospective study of CT scans performed at any of seven centers between January of 2011 and May of 2015. Patients were classified according to their immune status. Two thoracic radiologists reviewed the scans in order to determine the number of lesions, as well as their distribution, size, and contour, together with halo thickness and any other associated findings. Results: Of the 85 patients evaluated, 53 were immunocompetent and 32 were immunosuppressed. Of the 53 immunocompetent patients, 34 (64%) were diagnosed with primary neoplasm. Of the 32 immunosuppressed patients, 25 (78%) were diagnosed with aspergillosis. Multiple and randomly distributed lesions were more common in the immunosuppressed patients than in the immunocompetent patients (p < 0.001 for both). Halo thickness was found to be greater in the immunosuppressed patients (p < 0.05). Conclusions: Etiologies of the halo sign differ markedly between immunocompetent and immunosuppressed patients. Although thicker halos are more likely to occur in patients with infectious diseases, the number and distribution of lesions should also be taken into account when evaluating patients presenting with the halo sign.

scholarly journals Diagnostic value of lung ultrasound versus chest CT in COVID-19

2020 ◽  
Vol 11 (2) ◽  
pp. 5-18
Author(s):  
S. S. Petrikov ◽  
I. E. Popova ◽  
V. M. Abuchina ◽  
R. Sh. Muslimov ◽  
L. T. Khamidova ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Lung Diseases ◽  
Structural Changes ◽  
Lung Ultrasound ◽  
Ground Glass Opacity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Ct Scans ◽  
Chest Computed Tomography ◽  
Ct Data

Lung ultrasound demonstrates a high diagnostic value in the assessment of lung diseases.Aim. To determine the diagnostic accuracy of lung ultrasound compared to chest computed tomography (CT) in the diagnosis of lung changes in COVID-19. Materials and methods. The retrospective study included 45 patients (28 men) aged 37 to 90 years who underwent polypositional lung ultrasound with an assessment of 14 zones. The study compared lung echograms with chest CT data in assessing the prevalence of the process and the nature of structural changes. The diagnostic accuracy, sensitivity, and specificity of lung ultrasound in comparison with CT scans were determined, 95% confidence intervals (CI) were calculated.Results. In 44 patients (98%), CT revealed pathological changes with subpleural localization in both lungs. Of these, in 30 cases, the inflammation was limited only to the subpleural parts, and in 14 cases, the changes spread to the basal parts of the lungs, while ultrasound revealed changes at the depth of the lesion no more than 4 cm. The lesion of 10–11 zones according to lung ultrasound corresponds to CT 1–2 degrees, the lesion of 13–14 zones — CT 3–4 degrees. The sensitivity of ultrasound to detect lung changes of various types was ≥ 92%. The highest sensitivity of 97.9% (95% CI: 92.8–99.8%) was determined for small consolidations on the background of interstitial changes (degree 1A+, 1B+), which corresponded to “crazy-paving” pattern on CT. The specificity depended on the nature of the changes and varied from 46.7 to 70.0%. Diagnostic accuracy was ≥ 81%, the maximum values of 90.6% (95% CI: 85.6–94.2%) were obtained for moderate interstitial changes (grade 1A) corresponding to ground-glass opacity (type one) according to CT data.Conclusion. The sensitivity of ultrasound to detect lung changes in COVID-19 is more than 90%. Lung ultrasound has some limitations: inability to determine the prevalence of the process clearly and identify centrally located areas of changes in the lung tissue.

scholarly journals Agreement between low-dose and ultra-low-dose chest CT for the diagnosis of viral pneumonia imaging patterns during the COVID-19 pandemic

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Hooman Bahrami-Motlagh ◽  
Yashar Moharamzad ◽  
Golnaz Izadi Amoli ◽  
Sahar Abbasi ◽  
Alireza Abrishami ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ct Scan ◽  
Predictive Value ◽  
Low Dose ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Viral Pneumonia ◽  
Ct Scans ◽  
Low Dose Ct ◽  
Chest Ct Scan

Abstract Background Chest CT scan has an important role in the diagnosis and management of COVID-19 infection. A major concern in radiologic assessment of the patients is the radiation dose. Research has been done to evaluate low-dose chest CT in the diagnosis of pulmonary lesions with promising findings. We decided to determine diagnostic performance of ultra-low-dose chest CT in comparison to low-dose CT for viral pneumonia during the COVID-19 pandemic. Results 167 patients underwent both low-dose and ultra-low-dose chest CT scans. Two radiologists blinded to the diagnosis independently examined ultra-low-dose chest CT scans for findings consistent with COVID-19 pneumonia. In case of any disagreement, a third senior radiologist made the final diagnosis. Agreement between two CT protocols regarding ground-glass opacity, consolidation, reticulation, and nodular infiltration were recorded. On low-dose chest CT, 44 patients had findings consistent with COVID-19 infection. Ultra-low-dose chest CT had sensitivity and specificity values of 100% and 98.4%, respectively for diagnosis of viral pneumonia. Two patients were falsely categorized to have pneumonia on ultra-low-dose CT scan. Positive predictive value and negative predictive value of ultra-low-dose CT scan were respectively 95.7% and 100%. There was good agreement between low-dose and ultra-low-dose methods (kappa = 0.97; P < 0.001). Perfect agreement between low-dose and ultra-low-dose scans was found regarding diagnosis of ground-glass opacity (kappa = 0.83, P < 0.001), consolidation (kappa = 0.88, P < 0.001), reticulation (kappa = 0.82, P < 0.001), and nodular infiltration (kappa = 0.87, P < 0.001). Conclusion Ultra-low-dose chest CT scan is comparable to low-dose chest CT for detection of lung infiltration during the COVID-19 outbreak while maintaining less radiation dose. It can also be used instead of low-dose chest CT scan for patient triage in circumstances where rapid-abundant PCR tests are not available.

COMPUTER-AIDED CHARACTERIZATION OF CT SCANS IN TELOMERE-RELATED INTERSTITIAL LUNG DISEASE

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A1158
Author(s):  
Ashley Egan ◽  
Brian Bartholmai ◽  
Chi Wan Koo ◽  
Tobias Peikert ◽  
Eva Carmona
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Ct Scans ◽  
Computer Aided

scholarly journals POS0863 DIFFERENTIATING THE DOMINANCE OF PULMONARY VASCULAR DISEASE OR INTERSTITIAL LUNG DISEASE ON HEMODYNAMIC ABNORMALITIES IN SYSTEMIC SCLEROSIS AND CLARIFYING EACH CHARACTERISTIC BY USING QUANTITATIVE EVALUATION OF CHEST CT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 687.1-687
Author(s):  
K. Ninagawa ◽  
M. Kato ◽  
M. Kono ◽  
Y. Fujieda ◽  
K. Oku ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Quantitative Evaluation ◽  
Lung Volume ◽  
Chest Ct ◽  
Normal Lung ◽  
Pulmonary Vascular Disease ◽  
Group 1

Background:Group 1 and 3 pulmonary hypertension (PH) develop through different pathological mechanisms but have similar hemodynamic abnormalities. Systemic sclerosis (SSc) is associated with both pulmonary vascular disease (PVD) and interstitial lung disease (ILD), making it challenging to differentiate group 1 and 3 PH in those patients. A previous study using quantitative evaluation of chest computed tomography (CT) demonstrated that normal lung volume was inversely correlated with mean pulmonary arterial pressure (mPAP) in patients with group 3 PH (1).Objectives:In this study, we aimed to assess the dominance of PVD or ILD in SSc patients by quantitative evaluation of chest CT and to evaluate each characteristic.Methods:A total of 76 SSc patients who underwent right heart catheterization (RHC) were included. Chest CT was evaluated by using a software (Synapse Vincent Ver.3.0, Fujifilm) which quantified normal and total area of the lung. Then, we calculated abnormal area by drawing normal area from total area in the lung (%). Pulmonary function test (PFT) and serum biomarkers, such as KL-6 and LDH, were also evaluated. The dominance of PVD or ILD was defined as divergent or parallel change between the first and last assessments, respectively, in mPAP and abnormal area in the lung calculated using the software. Increase or decrease by over 10% in the last assessment compared to the first assessment was considered as a significant change in mPAP or abnormal area in the lung. P values were calculated by Mann-Whitney U test, and correlation coefficients were calculated by direct regression variance.Results:The median [range] values of mPAP and abnormal area in the lung at baseline were 23 [9-65] mmHg and 30.2 [0-100] %, respectively. Of 37 SSc and PH patients, 18 were defined as having PVD dominance while 19 as ILD dominance. Abnormal area in the lung at baseline was greater in patients with ILD dominance compared to those with PVD dominance (39.1 [16.3-98.3] v.s. 14.0 [0-99] %, p=0.002), whereas mPAP was higher in patients with PVD dominance than those with ILD dominance (42.5 [23.0-65.0] v.s. 26.0 [16.0-42.0] mmHg, p=0.002). PFT parameters including forced vital capacity were not different between the two groups. The ratio of mPAP/KL-6 showed a great difference between the two groups with its significant elevation in patients with PVD dominance (p=0.007).Conclusion:Quantitative evaluation of chest CT showed great efficiency in differentiating the dominance of PVD or ILD in patients with SSc and PH. In addition, the ratio of mPAP/KL-6 may easily be used as a parameter for dominance evaluation.References:[1]Iwasawa T, Kato S, Ogura T, Kusakawa Y, Iso S, Baba T, et al. Low-normal lung volume correlates with pulmonary hypertension in fibrotic idiopathic interstitial pneumonia: computer-aided 3D quantitative analysis of chest CT. AJR Am J Roentgenol. 2014;203(2):W166-73.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document