Importance of the imaging techniques in the management of COVID-19-infected patients

Abstract:

:Critical-care physicians are facing a challenging process in healthcare due to the overwhelming case number of hypoxic respiratory failure patients. Pneumonia has an utmost importance in the primary pathomechanism of the development of critical illness in the COVID-19 patients. Thus, imaging techniques are situated in the frontline to aim the diagnostic decision-making, to follow up the progress and to evaluate the possible complications. Reviewing the available literature, so far the common chest CT, chest X-ray and chest wall ultrasound features are presented, and recommendations are pronounced for the indications of the different modalities. At the initial phase, the atypical presentations of the virus infection are multiplex, peripheral ground glass opacities situated in the right lower lobe of the lung evolving rapidly into a bilateral involvement of the middle and basal zones. Along with the progression, the ratio of the consolidation is increasing subsequently deteriorating into fibrosis with reticular pattern. Chest ultrasound performed at the bedside has a paramount importance to reduce the possible number of health-care worker contacts in consequence of the strict and special infection control orders established on account of the SARS-CoV-2 pandemia. Orv Hetil. 2020; 161(17): 672–677. :A legújabb koronavírus-járvány a nagy esetszámban előforduló hypoxiás légzési elégtelen beteg miatt komoly kihívás elé állítja a gyakorló intenzív terápiás orvosokat. Mivel a COVID–19-megbetegedés kritikus állapotot okozó patomechanizmusában kiemelkedő helyen áll a tüdőgyulladás, a képalkotó vizsgálatok első helyen szerepelnek mind a diagnosztikában, mind a betegség lefolyásának utánkövetésében, illetve a lehetséges szövődmények felderítésében. Az eddigi irodalmi adatokat áttekintve bemutatjuk a mellkas-CT, a mellkasröntgen és a mellkasfali ultrahang jellemző eltéréseit, illetve ajánlásokat fogalmazunk meg a különböző vizsgálati modalitások használatának indikációira. A vírusfertőzés kezdeti, atípusos megjelenési képe a CT-vel észlelt, jobb alsó lebenyi, perifériás, többgócú tejüveghomály, amely hamar kétoldali, a középső és az alsó tüdőmezőket érintő elváltozássá fajul. A betegség progressziójával nő a konszolidált területek aránya, majd fibroticus rajzolatfokozódás jelenik meg. A SARS-CoV-2 vírus miatti speciális infekciókontroll-szabályok miatt a betegágy melletti ultrahangvizsgálatnak komoly szerepe van abban, hogy a fertőzött betegek minél kisebb számú egészségügyi személyzettel kerüljenek kontaktusba. Orv Hetil. 2020; 161(17): 672–677.

journal_name

Orv Hetil

journal_title

Orvosi hetilap

authors

Lovas A,Hankovszky P,Korsós A,Kupcsulik S,Molnár T,Szabó Z,Babik B

doi

10.1556/650.2020.31814

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

672-677

issue

17

eissn

0030-6002

issn

1788-6120

journal_volume

161

pub_type

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