Neumonía por COVID19: Valoración por imagen, lo básico
[COVID19 pneumonia: Imaging evaluation, the basics]
[Neumonía por COVID19: Valoración por imagen, lo básico [COVID19 pneumonia: Imaging evaluation, the basics]]
Rolando Reyna1, Fernando Gutiérrez2, Carlos Previgliano3
1. Departamento de diagnóstico, servicio imagenología Hospital Santo Tomas, Panamá; 2. Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA.; 3. Louisiana State University Health Sciences Center, Shreveport, LA, USA..
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Resumen
ResumenLa pandemia de COVID-19 ha resultado en una emergencia de salud global. Los estudios de imagen utilizados en esta enfermedad son la radiografía de tórax (RX) y la tomografía computarizada (TC). Ambas modalidades tienen sus hallazgos descritos, pero no son específicos dado que muchas enfermedades pueden producir patrones similares, particularmente las neumonías virales. Los RX de tórax muestra hallazgos consistentes en opacidades alveolares las cuales son múltiples, periféricas, bilaterales y basales, mientras que la tomografía de tórax sus hallazgos más frecuentes son presencia de patrón en vidrio deslustrado, consolidaciones, engrosamiento septal, patrón en empedrado, dilatación bronquial y engrosamiento peri bronquial, broncograma, patrón de halo invertido y patrón de neumonía organizada. Los hallazgos por imagen dependen del tiempo de evolución de la enfermedad ya que en etapas tempranas puede ser normal tanto en la RX como la TC. El riesgo de trombo embolismo pulmonar es alto y más frecuente que en pacientes con COVID-19 negativo.
Abstract
The COVID-19 pandemic has resulted in a global health emergency. The imaging studies used in this disease are chest radiography (CXR) and computed tomography (CT). Both imaging modalities findings have had their findings. These findings described are not specific since many diseases can produce similar patterns. CXR shows somewhat consistent findings consisting of alveolar opacities which are multiple, peripheral, bilateral and basal, while CT the most frequent findings are the presence of grounded glass pattern, consolidations, septal thickening, crazy paving pattern, bronchial dilation and peribronchial thickening, air bronchograms, inverted halo sign and organized pneumonia. Imaging findings depends on the evolution time of the disease since in the early stages both chest radiography and tomography may be normal. The risk for pulmonary embolism is high and more frequent than in patients with negative COVID-19.
Abstract
Resumen
La pandemia de COVID-19 ha resultado en una emergencia de salud global. Los estudios de imagen utilizados en esta enfermedad son la radiografía de tórax (RX) y la tomografía computarizada (TC). Ambas modalidades tienen sus hallazgos descritos, pero no son específicos dado que muchas enfermedades pueden producir patrones similares, particularmente las neumonías virales. Los RX de tórax muestra hallazgos consistentes en opacidades alveolares las cuales son múltiples, periféricas, bilaterales y basales, mientras que la tomografía de tórax sus hallazgos más frecuentes son presencia de patrón en vidrio deslustrado, consolidaciones, engrosamiento septal, patrón en empedrado, dilatación bronquial y engrosamiento peri bronquial, broncograma, patrón de halo invertido y patrón de neumonía organizada. Los hallazgos por imagen dependen del tiempo de evolución de la enfermedad ya que en etapas tempranas puede ser normal tanto en la RX como la TC. El riesgo de trombo embolismo pulmonar es alto y más frecuente que en pacientes con COVID-19 negativo.
Abstract
The COVID-19 pandemic has resulted in a global health emergency. The imaging studies used in this disease are chest radiography (CXR) and computed tomography (CT). Both imaging modalities findings have had their findings. These findings described are not specific since many diseases can produce similar patterns. CXR shows somewhat consistent findings consisting of alveolar opacities which are multiple, peripheral, bilateral and basal, while CT the most frequent findings are the presence of grounded glass pattern, consolidations, septal thickening, crazy paving pattern, bronchial dilation and peribronchial thickening, air bronchograms, inverted halo sign and organized pneumonia. Imaging findings depends on the evolution time of the disease since in the early stages both chest radiography and tomography may be normal. The risk for pulmonary embolism is high and more frequent than in patients with negative COVID-19.
Citas
[1] Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-1207. Doi: 10.1056/NEJMoa2001316
[2] Gorbalenya, A.E., Baker, S.C., Baric, R.S. et al. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 5, 536–544 (2020). https://doi.org/10.1038/s41564-020-0695-z
[3] Rubin Geoffrey D., Linda B. Haramati and Jeffrey P. Kanne et al. "The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society". Radiology (2020): 201365. . doi:10.1148/radiol.2020201365.
[4] ACR recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection/American College of Radiology. https://www.acr.org/Advocacy-and-Economics/ACR-Position-statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-infection.
[5] Rodrigues, J.C.L. et al. An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement. (2020) Clinical Radiology. https://doi.org/10.1016/j.crad.2020.03.003
[6] Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, Lui MM, Lee JCY, Chiu KW, Chung T, Lee EYP, Wan EYF, Hung FNI, Lam TPW, Kuo M, Ng MY. Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients. (2019) Radiology. doi:10.1148/radiol.2020201160 - PubMed
[7] Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review [published online ahead of print, 2020 Apr 8]. Clin Imaging. 2020;64:35‐42. doi:10.1016/j.clinimag.2020.04.001
[8] Sánchez-Oro R, et al. La radiología en el diagnóstico de la neumonía por SARS-CoV-2 (COVID-19). Med Clin (Barc). 2020. https://doi.org/10.1016/j.medcli.2020.03.004
[9] Radiopaedia website. COVID-19. https://radiopaedia.org/articles/covid-19-3 Acceso 22 junio 2020
[10] Radiology assistant website. COVID-19. Imaging Findings. https://radiologyassistant.nl/chest/lk-jg-1 Acceso 22 de junio 2020.
[11] Zhou S, Wang Y, Zhu T, Xia L. CT Features of Coronavirus Disease 2019 (COVID-19) Pneumonia in 62 Patients in Wuhan, China. Am J Roentgenol. March 2020:1–8. doi:10.2214/AJR.20.22975.
[12] Adams HJA, Knee TC, Kwee RM. COVID-19 and chest CT: do not put the sensitivity value in the isolation room and look beyond the numbers [published online ahead of print, 2020 Apr 27]. Radiology. 2020; 201709. doi:10.1148/radiol.2020201709
[13] Adam Bernheim, Xueyan Mei, Mingqian Huang, Yang Yang, Zahi A. Fayad, Ning Zhang, Kaiyue Diao, Bin Lin, Xiqi Zhu, Kunwei Li, Shaolin Li, Hong Shan, Adam Jacobi, and Michael Chung. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology 2020 295:3
[14] Sana Salehi, Aidin Abedi, Sudheer Balakrishnan, and Ali Gholamrezanezhad. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients.American Journal of Roentgenology 2020; 215:1-7
[15] Wei Zhao, Zheng Zhong, Xingzhi Xie, Qizhi Yu, and Jun Liu. Relation between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. American Journal of Roentgenology 2020 214:5, 1072-1077
[16] Gralinski LE, Baric RS. Molecular pathology of emerging coronavirus infections. The Journal of Pathology. 2015 Jan; 235(2):185-195. DOI: 10.1002/path.4454.
[17] Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, Park CM, Kim YH. Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea. Korean J Radiol. 2020 Apr; 21(4):494-500. Doi: 10.3348/kjr.2020.0132. Epub 2019 Feb 26.
[18] Zare Mehrjardi M, Kahkouee S, Pourabdollah M. Radio-pathological correlation of organizing pneumonia (OP): a pictorial review. Br J Radiol. 2017; 90(1071):20160723. doi:10.1259/bjr.20160723
[19] Pan F, Ye T, Sun P, Gui S, Liang B, Li L, Zheng D, Wang J, Hesketh RL, Yang L, Zheng C. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. (2020) Radiology. doi:10.1148/radiol.2020200370
[20] Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected by Pulmonary CT Angiography [published online ahead of print, 2020 Apr 23]. Radiology. 2020;201544. doi:10.1148/radiol.2020201544
[21] Poyiadji N, Cormier P, Patel PY, et al. Acute Pulmonary Embolism and COVID-19 [published online ahead of print, 2020 May 14]. Radiology. 2020; 201955. doi:10.1148/radiol.2020201955
[22] Leonard-Lorant I, Delabranche X, Severac F, et al. Acute Pulmonary Embolism in COVID-19 Patients on CT Angiography and Relationship to D-Dimer Levels [published online ahead of print, 2020 Apr 23]. Radiology. 2020;201561. doi:10.1148/radiol.2020201561
[23] Rotzinger DC, Beigelman-Aubry C, von Garnier C, Qanadli SD. Pulmonary embolism in patients with COVID-19: Time to change the paradigm of computed tomography. Thromb Res. 2020; 190:58-59. doi:10.1016/j.thromres.2020.04.011
[24] Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV).Radiology February 2020; 200230. https://doi.org/10.1148/radiol.2020200230.
[25] J. Azadi; C. Menias; J. Ko; J. Klein; C. Meltzer; M. Mossa-Basha; COVID-19 Task Force. Example Reports of Typical, Indeterminate, Atypical, and Negative Category CTs, with some selected correlative image examples. RSNA web site. https://www.rsna.org/-/media/Files/RSNA/Covid-19/RSNA-COVID19ChestCT-ReportExample
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