COVID-19: CT Findings

Описание: Audience: Radiology Residents, Radiologists, and other Medical Professionals
Recommended playback speed: 1.25 to 1.5

Learning Objectives:
-Identify and describe the spectrum of findings in viral pneumonia
-Explain a basic algorithm for managing patients with suspected viral pneumonia in a radiology department

Note: CT is not recommended for screening or diagnosis of COVID-19 pneumonia by The American College of Radiology or the Society of Thoracic Radiology. CT should only be used when indicated by the severity of the patients symptoms.

Summary:
The Findings are non-specific with CT showing a pattern of acute lung injury (organizing pneumonia)
There is a broad differential diagnosis:
-Viral pneumonia (Influenza A, influenza B, RSV, coronavirus, rhinovirus, parainfluenza, and adenovirus)
-Bacteria pneumonia (Legionella, mycoplasma)
-Drug induced (chemotherapy, immunotherapy)
-Cryptogenic organizing pneumonia

New consensus statement, directly quoted:
" Essentials

■ Imaging is not indicated in patients with suspected COVID-19 and mild clinical features unless they are at risk for disease progression.

■ Imaging is indicated in a patient with COVID-19 and worsening respiratory status.

■ In a resource-constrained environment, imaging is indicated for medical triage of patients with suspected COVID-19 who present with moderate-severe clinical features and a high pre-test probability of disease"
https://pubs.rsna.org/doi/10.1148/rad...



Clinical context is key with specificity dependent on a high pretest probability:
Symptoms of COVID-19: Fever, shortness of breath, cough, fatigue, no rhinorrhea (runny nose)

Please Wash Your Hands (for 20 seconds and more frequently than in the past)
Do Not Touch Your Face (Touching a contaminated surface and then you face is a primary route of spread).

If you are over 60 y/o (or under 60 with high blood pressure, diabetes, or cardiovascular disease), consider staying at home, and avoiding groups, crowds, and travel.

Comprehensive collection of COVID-19 related radiology articles: https://pubs.rsna.org/2019-ncov
Kentucky webpage for up to date information on Local COVID-19: https://kycovid19.ky.gov

References:
Ai, Tao, 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): 200642.
Bernheim, Adam, et al. "Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection." Radiology (2020): 200463.