Radiological findings of covid 19 pptx 2023

Covid19 pptx 36 slides

1. Radiological findings of covid 19 Prepared By : Masooda Ahmadzai (2023)

2. Definition COVID-19 is an infectious disease caused by severe acute respiratory syndrome. The first cases were seen in Wuhan, China, in December 2019 before spreading globally.  A definitive diagnosis of COVID-19 requires a positive RT-PCR test. The official virus name is similar to SARS-CoV-1. 

3. Epidemiology The number of cases of confirmed COVID-19 globally is over 670 million. As of may 2023, the official number of deaths from COVID-19 exceeds six million globally. In the Chinese population, 55-60% of COVID-19 patients were male; the median age has been reported between 47 and 59 years. As of May 2023, more than 13 billion vaccine doses had been administered globally.

4. Clinical presentation Common Fever (85-90%) Cough (65-70%) Anosmia or taste disorder (40-50%) fatigue (35-40%) sputum production (30-35%) shortness of breath (15-20%) Less Common Myalgia/arthralgia (10-15%) Headaches (10-36%)  Cutaneous lesions (20%), most Freq. Erythematous rash Sore throat (10-15%) Chills (10-12%) Pleuritic Pain Diarrhea (3-34%)  Splenomegaly

5. Diagnosis RT-PCR test The gold standard diagnostic test for SARS-CoV-2 is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test.  CT as a diagnostic test Multiple radiological organizations and learned societies stated early in the pandemic that CT should not be relied upon as a diagnostic/screening tool for COVID-19. On 16 March 2020, an American-Singaporean panel published that CT findings were not part of the diagnostic criteria for COVID-19. However, CT findings have been used controversially as a surrogate diagnostic test by some.

6. Laboratory Tests Lymphopenia Thrombocytosis Increased (PT) CRP ESR Elevated D-dimer Mildly elevated serum amylase Elevated ALT/AST

7. Radiographic features The primary findings of COVID-19 on chest radiograph and CT are those of atypical pneumonia or organizing pneumonia. However imaging has limited sensitivity for COVID-19, as up to 18% demonstrate normal chest radiographs or CT when mild or early in the disease course, but this decreases to 3% in severe disease. Bilateral and/or multilobar involvement is common. The current recommendation of the vast majority of learned societies and professional radiological associations is that imaging should not be employed as a screening/diagnostic tool for COVID-19, but reserved for the evaluation of complications

8. Plain radiography Although less sensitive than chest CT, chest radiography is typically the first-line imaging modality used for patients with suspected COVID-19. Chest radiographs may be normal in early/mild disease. In those COVID-19 cases requiring hospitalization, 69% had an abnormal chest radiograph at the initial time of admission, and 80% had radiographic abnormalities sometime during hospitalization. Findings are most extensive about 10-12 days after symptom onset The most frequent findings are airspace opacities, whether described as consolidation or less commonly, GGO. The distribution is most often bilateral, peripheral , and lower zone predominant . In contrast to parenchymal abnormalities, pleural effusion is rare (3%)

9. Plain radiograph Plain radiograph The British Society of Thoracic Imaging (BSTI) has published a reporting proforma for the plain chest radiographic appearances of potential COVID-19 cases. classic/probable COVID-19 • lower lobe and peripheral predominant multiple opacities that are bilateral (unilateral) Indeterminate for COVID-19 Does not fit classic or non-COVID-19 descriptors. non-COVID-19 pneumothorax / lobar pneumonia / pleural effusion(s) / pulmonary oedema other. Normal COVID-19 not excluded

10. C hest radiography

11. Chest Radiograph

12. CT Typical findings Ground-glass opacities (GGO): bilateral,subpleural , peripheral Crazy paving appearance (GGOs and inter/intra-lobular septal thickening) Air space consolidation bronchovascular thickening in the lesion Traction bronchiectasis The ground-glass and/or consolidative opacities are usually bilateral, peripheral, and basal in distribution. The following chest CT findings have been reported to have the highest discriminatory value : peripheral distribution ground-glass opacity bronchovascular thickening (in lesions)

13. Atypical CT findings These findings only seen in a small minority of patients should raise concern for superadded bacterial pneumonia or other diagnoses. Mediastinal lymphadenopathy Pleural effusions: may occur as a complicationof COVID-19 Multiple tiny pulmonary nodules (unlike many other types of viral pneumonia) Tree-in-bud Pneumothorax Cavitation hallo sign pneumomediastinum

14. GGO(Ground glass opacity)

15. GGO to Consolidation

16. Halo Sign

17. Reversed Halo Sign

18. Tree-in-Bud Sign

19. Crazy paving pattern

20. CT Signs of COVID 19 Vascular dilatation

21. CT Signs of COVID 19 Traction Bronchiectasis Another common finding in the areas of ground glass is traction

22. CT Signs of COVID 19 Subpleural bands and Architectural distortion

23. Temporal CT changes Four stages on CT have been described: 1- Early/initial stage (0-4 days): normal CT or GGO. only up to half of patients have normal CT scans within two days of symptom onset 2- Progressive stage (5-8 days): increased GGO and crazy paving appearance 3- Peak stage (9-13 days): consolidation 4- Absorption stage (>14 days): with an improvement in the disease course, "fibrous stripes" appear and the abnormalities resolve at one month and beyond.

24. Ultrasound Multiple B-lines ranging from focal to diffuse with spared areas. representing thickened subpleural interlobular septa may also manifest as a light beam sign, an evanescent, broad-based vertical reverberation artifact arising from a regular pleural line. Irregular, thickened pleural line with scattered discontinuities. subpleural consolidations can be associated with a discrete, localized pleural effusion relatively vascular with colour flow Doppler interrogation pneumonic consolidation is typically associated with preservation of flow or hyperaemia .

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