COVİD-19 Pnömonisi Şüphesiyle Yapılan Bilgisayarlı Tomografi Görüntülemede Saptanan COVİD-19 Dışı Bulguların Değerlendirilmesi: 6669 Vakanın Restrospektif Analizi
Öz
Amaç: Birkaç yıldır, vaka sayılarının artmasıyla birlikte ciddi bir tehdit ve endişe kaynağı olarak COVİD-19 enfeksiyonu hayatımızda önemli bir rol oynamaya devam etmektedir. Bu pandemi aşamasında toraks bilgisayarlı tomografisinin (BT) hızlı ve doğru tanı açısından büyük öneme sahip olduğu ve belirsiz klinik senaryolara sahip hastaların klinik yönetimine yardımcı olmada önemli bir role sahip olduğu kanıtlanmıştır. Bu retrospektif çalışmada, COVİD-19 pnömonisi şüphesiyle toraks BT incelemesi yapılan hastalarda, toraks BT’ye yönlendiren klinisyenlere ve bu BT’leri raporlayan radyologlara, COVİD-19 dışı bulguların sıklığı ve çeşitliliği hakkında bilgi verilmesi amaçlandı.
Gereç ve Yöntem: Bu retrospektif çalışma kurumsal etik kurulumuz tarafından onaylandı. Yazılı bilgilendirilmiş onam alma zorunluluğundan feragat edildi. Çalışmamıza 20 Mart- 20 Nisan 2020 tarihleri arasında acil servise COVİD-19 enfeksiyonu şüphesiyle başvuran 6669 hasta dahil edildi. Dahil edilme kriterleri, COVİD-19 enfeksiyonuna dair şüpheli semptomları olan ve/ya yakın temasta COVİD-19 enfeksiyonlu bir hastaya yakın teması olan hastalar ve toraks BT çekilen hastalardı. Toraks BT tetkikleri değerlendirildi ve COVİD-19 dışı tüm bulgular manuel olarak kaydedildi.
Bulgular: Çalışma popülasyonu ardışık 6669 hastadan oluşmuştur (%55.5 erkek ve %44.5 kadın). Genel ortalama yaş 41,7 yıl idi. 3159 (%47.4) hastada rastlantısal olarak COVİD-19 dışı bulgular görüldü, 3510 (%52.6) hastada ise COVİD-19 dışı bulgu yoktu.
Sonuç: COVİD-19 pnömonisi şüphesi olan hastalarda yapılan toraks BT incelemeleri klinik açıdan anlamlı bulgular açısından ayrıntılı olarak incelenmelidir. Klinik açıdan anlamlı olabilecek patolojilerde gerekli önlemlerin önceden alınması, uygun zamanda tedavi ve takip planlaması yapılması hayati önem taşımaktadır. Klinisyenin bu patolojilere yönelik doğru yönetimi yapabilmesi için ipuçlarının radyoloji raporunda belirtilmesi önemlidir.
Kaynakça
- Zhu N, Zhang D, Wang W, Li X, Yang B,Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382(8):727–33.
- World Health Organization. Coronavirus disease 2019 (COVID-19): situation reports. Who.com Web site. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. Published January 18th, 2021. Accessed January 26th, 2021.
- Coronavirus disease 2019 (COVID-19): situation report in Turkey. Saglık.gov. tr Web site. https://covid19.saglik.gov.tr/. Published January 26th, 2021. Accessed January 26th, 2021.
- ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection. Acr.org Web site. https://www.acr.org/Advocacy-andEconomics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and CT-for-Suspected-COVID19-Infection. Published March 22, 2020. Accessed January 26th, 2021.
- Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, Raoof S, 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;296(1):172–80.
- Pan F, Ye T, Sun P, Gui S, Liang B, Li L,et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology 2020;295(3):715–21.
- Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H, et al. Emerging coronavirus 2019-nCoV pneumonia. Radiology 2020;295(1):210–17
- Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020;296(2):E46–E54
- Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. European Radiology 2020;30(6):3306–9.
- Taylor SA. CT colonography reporting and data system version 2023: Updated, robust, and relevant. Radiology. 2024;310(1):e233169.
- Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 2020;296(2):E32–E40.
- Bao C, Liu X, Zhang H, Li Y, Liu J. COVID-19 computed tomography findings: A systematic review and meta-analysis. J Am Coll Radiol 2020;17(6):701-9
- Dündar İ, Özkaçmaz S, Durmaz F, Çoban LT, Aygün G, Yıldız R, et al. Detection of incidental findings on chest CT scans in patients with suspectedcovid-19 pneumonia. East J Med 2021;26(4):566-74. [DOI: 10.5505/ejm.2021.26428]
- Romeih M, Mahrous MR, El Kassas M. Incidental radiological findings suggestive of COVID-19 in asymptomatic patients. World J Radiol. 2022 Jan 28;14(1):1-12.
- Turkay R, Bakir B, Asoglu O, Kartal MG, Ucar A, Simsek B, et al. Extracolonic findings in CT colonography: Our experience in 227 cases. Medical Journal of Bakırköy, 2017;13(4):159-63
- Zalis ME, Barish MA, Choi JR, Dachman AH, Fenlon HM, Ferrucci JT, et al. CT colonography reporting and data system: a consensus proposal. Radiology 2005;236(1): 3-9.
- Hara AK, Johnson CD, MacCarty RL, Welch TJ. Incidental extracolonic findings at CT colonography. Radiology 2000;215(2): 353-7.
- Khan M, Kahn H, Khan S, Nawaz M. Epidemiological and clinical characteristics of coronavirus disease (COVİD-19) cases at a screening clinic during the early outbreak period: a single- centre study. J Med Microbiol. 2020;69(8):1114-23.
- Yang J, Zheng Y, Gou X, Pu K, Chen Z,Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Inf Dis. 2020;94:91-95.
- Van Vugt S, Broekhuizen L, Zuithoff N, de Jong P, Butler C, Hood K, et al. Incidental chest radiographic findings in adult patients with acute cough. Ann Fam Med. 2012;10(6):510-5.
- Shankayi Z, Bahrami F, Mohammadzadeh T, Anvar AG, Amini H, Asadi MM, et al.. Cardiomegaly found in hospitalized patinets with novel coronavirus disease (COVID-19). New Microbes New Infect. 2022;46:100974.
- Gupta YS, Finkelstein M, Manna S, Toussie D, Bernheim A, Little BP, et al. Coronary artery calcification in COVID-19 patients: an imaging biomarker for adverse clinical outcomes. Clin Imaging. 2021;77: 1–8.
- Nguyen XV, Choudhury KR, Eastwood JD, Lyman GH, Esclamado RM, Werner JD, et al. Incidental thyroid nodules on CT: evaluation of 2 riskcategorization methods for work-up of nodules. Am J Neuroradiol. 2013;34(9): 1812–7.
- Park JJ, Park BK, Kim CK. Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses. Br J Radiol. 2016 Jun;89(1062):20151018.
- Androulakis II, Kaltsas G, Piaditis G, Grossman AB. The clinical significance of adrenal incidentalomas. Eur J Clin Invest 2011;41(5):552-60.
- Kanczkowski W, Gaba WH, Krone N, Varga Z, Beuschlein F, Hantel C, et al. Adrenal gland function and dysfunction during COVID-19. Horm Metab Res. 2022 Aug;54(8):532-9.
- Özdemir S, Turkay R, Atasoy B. Diagnostic performance and reproducibility of the Radiological Society of North America expert consensus statement on COVID-19 pneumonia. JAMER. 2024;9(1):14-8.
Evaluation of Non-COVID-19 CT Scan Findings Detected on CT Images Performed due to Suspected COVID-19 Pneumonia: A Retrospective Analysis of 6669 Cases
Öz
Objective: For the past years, COVID-19 infection has continued to play a significant role in our lives as a serious threat and concern due to increase in the number of cases. During this pandemic stage, chest computed tomography (CT) has been proven to have great importance for rapid and accurate diagnosis and a pivotal role in assisting the clinical management of patients with uncertain clinical scenarios.
The present retrospective study aimed to inform the clinicians who referred chest CT and the radiologists reporting these CTs about the frequency and variety of non-COVID-19 findings in patients who underwent chest CT examination with the suspicion of COVID-19 pneumonia.
Material and Method: This retrospective study was approved by our Institutional Ethics Committee. The requirement for written informed consent was waived. Our study included 6669 patients who applied to the emergency room with the suspicion of COVID-19 infection between March 20th and April 20th, 2020. The inclusion criteria were patients who had suspicious symptoms of having COVID-19 infection and/or had close contact with a patient with COVID-19 infection and (ii) patients who underwent chest CT. They evaluated CT scans individually, and all non-COVID-19 findings (NCF) were recorded manually
Results: The study population consisted of 6669 consecutive patients (males 55.5% and females 44.5%). The overall mean age was 41.7 years [SD±15.1]. There were incidental non-COVID-19 findings in 3159 (47.4%) patients and none in 3510 (52.6%) patients
Conclusion: CT examinations performed in patients with suspected COVID-19 pneumonia should be examined in detail regarding clinically significant findings. It is vital to take necessary precautions in advance regarding pathologies that may be clinically significant regarding appropriate treatment and follow-up planning at the appropriate time. The clues must be stated in the radiology report so that the clinician can make appropriate management regarding these pathologies.
Anahtar Kelimeler
Kaynakça
- Zhu N, Zhang D, Wang W, Li X, Yang B,Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382(8):727–33.
- World Health Organization. Coronavirus disease 2019 (COVID-19): situation reports. Who.com Web site. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. Published January 18th, 2021. Accessed January 26th, 2021.
- Coronavirus disease 2019 (COVID-19): situation report in Turkey. Saglık.gov. tr Web site. https://covid19.saglik.gov.tr/. Published January 26th, 2021. Accessed January 26th, 2021.
- ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection. Acr.org Web site. https://www.acr.org/Advocacy-andEconomics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and CT-for-Suspected-COVID19-Infection. Published March 22, 2020. Accessed January 26th, 2021.
- Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, Raoof S, 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;296(1):172–80.
- Pan F, Ye T, Sun P, Gui S, Liang B, Li L,et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology 2020;295(3):715–21.
- Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H, et al. Emerging coronavirus 2019-nCoV pneumonia. Radiology 2020;295(1):210–17
- Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020;296(2):E46–E54
- Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. European Radiology 2020;30(6):3306–9.
- Taylor SA. CT colonography reporting and data system version 2023: Updated, robust, and relevant. Radiology. 2024;310(1):e233169.
- Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 2020;296(2):E32–E40.
- Bao C, Liu X, Zhang H, Li Y, Liu J. COVID-19 computed tomography findings: A systematic review and meta-analysis. J Am Coll Radiol 2020;17(6):701-9
- Dündar İ, Özkaçmaz S, Durmaz F, Çoban LT, Aygün G, Yıldız R, et al. Detection of incidental findings on chest CT scans in patients with suspectedcovid-19 pneumonia. East J Med 2021;26(4):566-74. [DOI: 10.5505/ejm.2021.26428]
- Romeih M, Mahrous MR, El Kassas M. Incidental radiological findings suggestive of COVID-19 in asymptomatic patients. World J Radiol. 2022 Jan 28;14(1):1-12.
- Turkay R, Bakir B, Asoglu O, Kartal MG, Ucar A, Simsek B, et al. Extracolonic findings in CT colonography: Our experience in 227 cases. Medical Journal of Bakırköy, 2017;13(4):159-63
- Zalis ME, Barish MA, Choi JR, Dachman AH, Fenlon HM, Ferrucci JT, et al. CT colonography reporting and data system: a consensus proposal. Radiology 2005;236(1): 3-9.
- Hara AK, Johnson CD, MacCarty RL, Welch TJ. Incidental extracolonic findings at CT colonography. Radiology 2000;215(2): 353-7.
- Khan M, Kahn H, Khan S, Nawaz M. Epidemiological and clinical characteristics of coronavirus disease (COVİD-19) cases at a screening clinic during the early outbreak period: a single- centre study. J Med Microbiol. 2020;69(8):1114-23.
- Yang J, Zheng Y, Gou X, Pu K, Chen Z,Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Inf Dis. 2020;94:91-95.
- Van Vugt S, Broekhuizen L, Zuithoff N, de Jong P, Butler C, Hood K, et al. Incidental chest radiographic findings in adult patients with acute cough. Ann Fam Med. 2012;10(6):510-5.
- Shankayi Z, Bahrami F, Mohammadzadeh T, Anvar AG, Amini H, Asadi MM, et al.. Cardiomegaly found in hospitalized patinets with novel coronavirus disease (COVID-19). New Microbes New Infect. 2022;46:100974.
- Gupta YS, Finkelstein M, Manna S, Toussie D, Bernheim A, Little BP, et al. Coronary artery calcification in COVID-19 patients: an imaging biomarker for adverse clinical outcomes. Clin Imaging. 2021;77: 1–8.
- Nguyen XV, Choudhury KR, Eastwood JD, Lyman GH, Esclamado RM, Werner JD, et al. Incidental thyroid nodules on CT: evaluation of 2 riskcategorization methods for work-up of nodules. Am J Neuroradiol. 2013;34(9): 1812–7.
- Park JJ, Park BK, Kim CK. Adrenal imaging for adenoma characterization: imaging features, diagnostic accuracies and differential diagnoses. Br J Radiol. 2016 Jun;89(1062):20151018.
- Androulakis II, Kaltsas G, Piaditis G, Grossman AB. The clinical significance of adrenal incidentalomas. Eur J Clin Invest 2011;41(5):552-60.
- Kanczkowski W, Gaba WH, Krone N, Varga Z, Beuschlein F, Hantel C, et al. Adrenal gland function and dysfunction during COVID-19. Horm Metab Res. 2022 Aug;54(8):532-9.
- Özdemir S, Turkay R, Atasoy B. Diagnostic performance and reproducibility of the Radiological Society of North America expert consensus statement on COVID-19 pneumonia. JAMER. 2024;9(1):14-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 6 Mayıs 2024 |
| Yayımlanma Tarihi | |
| Gönderilme Tarihi | 17 Ekim 2023 |
| Kabul Tarihi | 8 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 6 Sayı: 2 |
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