Rendgenološki aspekti upale pluća COVID-19 

Rade R. Babić, Gordana Stanković-Babić, Strahinja Babić, Aleksandra Marjanović,

Nenad Govedarović, Nevena Babić

Med Reč 2020; 1(3): 127–135

https://doi.org/10.5937/medrec2003127B

Apstrakt

Korona virusna bolest 2019 (COVID-19) predstavlja tešku infektivnu bolest respiratornog sistema sa kliničkim znacima teškog akutnog respiratornog sindroma. Uzročnik je koronavirus 2 (SARS-CoV-2). Uobičajeni simptomi upale pluća COVID-19 su povišena telesna temperatura, kašalj, otežano disanje, mialgija, iskašljavanje ispljuvka i grlobolja. Rendgenološka slika upale pluća COVID-19 ima svoje karakteristike i menja se sa evoluiranjem bolesti. Na početku bolesti radiološki nalaz na plućima može da bude uredan ili da se na plućima vizualizuju promene u vidu multiplih magličastih nejasno delineiranih senki, koje nastaju postepeno, diskretno i skromno, da bi u kasnijem stadijumu bolesti promene uzele maha, napredovale galopirajuće i brzo, sa tendencijom konfluiranja u veće najpre nepravilne krpičaste formacije, zatim prerasle u masivnu nepravilnu senku inteziteta mlečnog stakla da bi na kraju difuzno zahvatile cela pluća – bela pluća. Zapaljenske promene su obično bilateralne, ređe jednostrane lokalizacije, pretežno u srednjem ili donjem plućnom polju, na periferiji uz zid grudnog koša i/ili suprafrenično. Cilj rada je da prikaže rendgensku sliku upale pluća COVID-19 i naša iskustva u rendgenološkoj dijagnostici ove bolesti. Materijal rada čine iz filmoteke autora odabrani digitalni rendgenogrami pluća i srca i CT pluća sa upalom pluća COVID-19 kod 220 bolesnika, koji su u toku pandemije COVID-19 od aprila do jula 2020. godine bili pregledani u covid rendgenu KC Niš. Rezultati rada prikazani su ilustrativno.

Zaključak: Rendgenološke metode pregleda u dijagnostici upale pluća COVID-19 su suverene, dominantne i bez premca, a od presudnog značaja su znanje autora i saradnika i iskustvo stečeno višegodišnjim radom u struci i  covidrendgenu.

Ključne reči: upala pluća COVID-19, radiološki nalaz, MSCT, digitalni rendgenogram pluća i srca

Ceo tekst

Literatura

  • COVID-19 pandemija. [Internet]. 2020. [cited 2020 May 6] Available from: https://en.wikipedia.org/wiki/COVID-19_pandemic
  • COVID-19. [Internet]. 2020. [cited 2020 May 6] Available from: https://commons.wikimedia.org/wiki/File: Novel_Coronavirus_SARS-CoV-2.jpg#/media/Датотека:Novel_Coronavirus_SARS-CoV-2.jpg
  • Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020; 7: 4. doi: 10.1186/s40779-020-0233-6
  • Liang T. Priručnik o prevenciji i lečenju COVID-19 infekcije. [Internet]. 2020. [cited 2020 May 6] Available from: https://medf.kg.ac.rs/oglasna_tabla/Handbook_of_COVID19_Prevention_and_Treatment_Srpski.pdf
  • Mostafa El-Feky, Daniel J Bell. COVID-19. [Internet]. 2020. [cited 2020 May 6] Available from: https://radiopaedia.org/articles/covid-19-3
  • Babić RR. Filmoteka COVID-19. 2020.
  • Radiological Society of North America. CT provides best diagnosis for COVID-19. ScienceDaily [Internet]. 2020. [cited 2020 May 6] Available from: www.sciencedaily.com/releases/2020/02/200226151951.htm
  • Ministarstvo zdravlja Republike Srbije: Covid-19 protokol. 2020. www.covid19.rs
  • Bell DJ, Knipe H. Middle East respiratory syndrome coronavirus (MERS-CoV) infection. [Internet]. 2020. [cited 2020 May 6] Available from: https://radiopaedia.org/articles/middle-east-respiratory-syndrome-coronavirus-mers-cov-infection?
  • Weerakkdy Y et al. Severe acute respiratory syndrome. [Internet]. 2020. [cited 2020 May 6] Available from: https://radiopaedia.org/articles/severe-acute-respiratory-syndrome-1?
  • Cellina M, Orsi M, Toluian T, Valenti Pittino C, Oliva G. False negative chest X-Rays in patients affected by COVID-19 pneumonia and corresponding chest CT findings. Radiography. [Internet]. 2020. [cited 2020 May 25] Available from: https://www.radiographyonline.com/article/S1078-8174(20)30069-9/pdf
  • Tianyi X, Jiawei L, Jiao G, Xunhua X. Small Solitary Ground-Glass Nodule on CT as an Initial Manifestation of Coronavirus Disease 2019 (COVID-19) Pneumonia. Korean J Radiol 2020; 21(5): 545-9.
  • Pereira RP, Bertolini D, Teixeira LO, Silla CS Jr, Costa YMG. COVID-19 Identification in Chest X-ray Images on Flat and Hierarchical Classification Scenarios. Comput Methods Programs Biomed 2020: 8; 194: 105532. https://doi.org/10.1016/j.cmpb.2020.105532
  • Guan CS, Wei LG, Xie RM, Ly ZB, Yan S, Zhang ZX, Xhen BD. CT findings of COVID-19 in follow-up: comparison between progression and recovery. Diagn Interv Radiol 2020: 26(4): 301-7.
  • Flowe L, Carter JPL, Lopez JR, Henry AM. Tension pneumothorax in a patient with COVID-19. BMJ Case Rep 2020; 13(5): e235861.
  • Sun R, Liu H, Wang X. Mediastinal Emphysema, Giant Bulla, and Pneumothorax Developed during the Course of COVID-19 Pneumonia. Korean J Radiol 2020; 21(5): 541-4.
  • Plesner LL, Dyrberg E, Hansen IV, Abild A, Andersen MB. Diagnostic Imaging Findings in COVID-19. Ugeskr Laeger 2020; 182(15): V03200191.
  • Li B, Li X, Wang Y, Han Y, Wang Y, Wang C, et al. Diagnostic value and key features of computed tomography in Coronavirus Disease 2019. Emerg Microbes Infect 2020; 9(1): 787-93.
  • Hu L, Wang C. Radiological Role in the Detection, Diagnosis and Monitoring for the Coronavirus Disease 2019 (COVID-19) Eur Rev Med Pharmacol Sci 2020; 24(8): 4523-8.
  • Şule Akçay, Tevfik Özlü, Aydın Yılmaz: Radiological Approaches to COVID-19 Pneumonia. Turk J Med Sci 2020; 50(SI-1): 604-10. doi:10.3906/sag-2004-160.
  • Feng H, Liu Y, Lv M, Zhong J. A Case Report of COVID-19 With False Negative RT-PCR Test: Necessity of Chest CT Jpn J Radiol 2020; 38(5): 409-10.
  • Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology 2020; 295(3): 715-21.
  • Kooraki S, Hosseiny M, Myers L, Gholamrezanezhad A. Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know. Am Coll Radiol 2020; 17(4): 447-51.
  • Babić RR, Stanković-Babić G, Babić S, Marjanović A, Pavlović D, Babić N. Rendgenska slika upale pluća COVID-19. Apollinem medicum et Aesculapium 2020; 18(1): 11-3.
  • Korona virus COVID-19. [Internet]. 2020. [cited 2020 Jul 9] Available from: https://covid19.rs
  • Najmlađa zrtva – beba stara 30 sati. [Internet]. 2020. [cited 2020 Jul 9] Available from: https://www.bbc.com/serbian/
    lat/svet-51398215
  • Babić RR, Stanković-Babić G, Babić S, Marjanović A, Pavlović D, Babić N, Diferencijalna dijagnoza rendgenološke slike virusnih upala pluća. Apollinem medicum et Aesculapium 2020; 18(2): 11-3.