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      Interpretation of chest radiography in patients with known or suspected SARS-CoV-2 infection: what we learnt from comparison with computed tomography

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          Abstract

          Differently from computed tomography (CT), well-defined terminology for chest radiography (CXR) findings and standardized reporting in the setting of known or suspected COVID-19 are still lacking. We propose a revision of CXR major imaging findings in SARS-CoV-2 pneumonia derived from the comparison of CXR and CT, suggesting a precise and standardized terminology for CXR reporting. This description will consider asymptomatic patients, symptomatic patients, and patients with SARS-CoV-2-related pulmonary complications. We suggest using terms such as ground-glass opacities, consolidation, and reticular pattern for the most common findings, and characteristic chest radiographic pattern in presence of one or more of the above-mentioned findings with peripheral and mid-to-lower lung zone distribution.

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          CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV)

          Michael Chung, Adam Bernheim, Xueyan Mei … (2020)
          In this retrospective case series, chest CT scans of 21 symptomatic patients from China infected with the 2019 novel coronavirus (2019-nCoV) were reviewed, with emphasis on identifying and characterizing the most common findings. Typical CT findings included bilateral pulmonary parenchymal ground-glass and consolidative pulmonary opacities, sometimes with a rounded morphology and a peripheral lung distribution. Notably, lung cavitation, discrete pulmonary nodules, pleural effusions, and lymphadenopathy were absent. Follow-up imaging in a subset of patients during the study time window often demonstrated mild or moderate progression of disease, as manifested by increasing extent and density of lung opacities. © RSNA, 2020
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            Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy

            Corrado Lodigiani, Giacomo Iapichino, Luca Carenzo … (2020)
            Background Few data are available on the rate and characteristics of thromboembolic complications in hospitalized patients with COVID-19. Methods We studied consecutive symptomatic patients with laboratory-proven COVID-19 admitted to a university hospital in Milan, Italy (13.02.2020–10.04.2020). The primary outcome was any thromboembolic complication, including venous thromboembolism (VTE), ischemic stroke, and acute coronary syndrome (ACS)/myocardial infarction (MI). Secondary outcome was overt disseminated intravascular coagulation (DIC). Results We included 388 patients (median age 66 years, 68% men, 16% requiring intensive care [ICU]). Thromboprophylaxis was used in 100% of ICU patients and 75% of those on the general ward. Thromboembolic events occurred in 28 (7.7% of closed cases; 95%CI 5.4%–11.0%), corresponding to a cumulative rate of 21% (27.6% ICU, 6.6% general ward). Half of the thromboembolic events were diagnosed within 24 h of hospital admission. Forty-four patients underwent VTE imaging tests and VTE was confirmed in 16 (36%). Computed tomography pulmonary angiography (CTPA) was performed in 30 patients, corresponding to 7.7% of total, and pulmonary embolism was confirmed in 10 (33% of CTPA). The rate of ischemic stroke and ACS/MI was 2.5% and 1.1%, respectively. Overt DIC was present in 8 (2.2%) patients. Conclusions The high number of arterial and, in particular, venous thromboembolic events diagnosed within 24 h of admission and the high rate of positive VTE imaging tests among the few COVID-19 patients tested suggest that there is an urgent need to improve specific VTE diagnostic strategies and investigate the efficacy and safety of thromboprophylaxis in ambulatory COVID-19 patients.
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              Fleischner Society: glossary of terms for thoracic imaging.

              David Hansell, Alexander Bankier, Heber MacMahon … (2008)
              Members of the Fleischner Society compiled a glossary of terms for thoracic imaging that replaces previous glossaries published in 1984 and 1996 for thoracic radiography and computed tomography (CT), respectively. The need to update the previous versions came from the recognition that new words have emerged, others have become obsolete, and the meaning of some terms has changed. Brief descriptions of some diseases are included, and pictorial examples (chest radiographs and CT scans) are provided for the majority of terms. (c) RSNA, 2008.
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                Author and article information

                Contributors
                Nicola Flor:
                ORCID: http://orcid.org/0000-0002-5314-8944
                nicola.flor@unimi.it
                Journal
                Journal ID (nlm-ta): Emerg Radiol
                Journal ID (iso-abbrev): Emerg Radiol
                Title: Emergency Radiology
                Publisher: Springer International Publishing (Cham )
                ISSN (Print): 1070-3004
                ISSN (Electronic): 1438-1435
                Publication date (Electronic): 26 November 2022
                Pages: 1-14
                Affiliations
                [1 ]GRID grid.144767.7, ISNI 0000 0004 4682 2907, Department of Radiology, ASST Fatebenefratelli Sacco, , Luigi Sacco University Hospital, ; Via GB Grassi 74, 20157 Milan, Italy
                [2 ]GRID grid.4708.b, ISNI 0000 0004 1757 2822, Postgraduation School in Radiodiagnostics, Facoltà Di Medicina E Chirurgia, , Università Degli Studi Di Milano, ; Via Festa del Perdono 7, 20122 Milan, Italy
                [3 ]GRID grid.477093.e, Radiology Department, , Clinical Hospital Center Zemun, ; Belgrade, Serbia
                [4 ]GRID grid.5841.8, ISNI 0000 0004 1937 0247, Department of Radiology, CDI, Hospital Clínic, , University of Barcelona, ; Barcelona, Spain
                [5 ]GRID grid.214458.e, ISNI 0000000086837370, Departments of Radiology and Internal Medicine, , University of Michigan/Michigan Medicine, ; Ann Arbor, MI USA
                Author information
                http://orcid.org/0000-0002-5314-8944
                Article
                Publisher ID: 2105
                DOI: 10.1007/s10140-022-02105-6
                PMC ID: 9702901
                PubMed ID: 36435951
                SO-VID: 82adf2d2-32e6-42d2-8904-514ca56a31b7
                Copyright © © The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER) 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 12 August 2022
                Date accepted : 16 November 2022
                Categories
                Subject: Pictorial Essay

                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: chest x-ray,computed tomography,coronavirus disease-2019 (covid-19)
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: chest x-ray, computed tomography, coronavirus disease-2019 (covid-19)

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