The current reference standard to make a definitive diagnosis of SARS-CoV-2 infection is the reverse transcription- polymerase chain reaction assay (rt-PCR). However, radiological imaging plays a crucial role in evaluating the course of COVID-19 and in choosing proper management of infected patients. Chest X-ray (CXR) is generally considered not to be sensitive for the detection of pulmonary abnormalities in the early stage of the disease. However, in the emergency setting CXR can be a useful diagnostic tool for monitoring the rapid progression of lung involvement in COVID-19, especially in patients admitted to intensive care units. The rapid course of SARS-CoV-2 infection and the severity and progression of lung aberrations require a method of radiological evaluation to implement and manage the appropriate treatment for infected patients. Computed tomography (CT) imaging is considered to be the most effective method for the detection of lung abnormalities, especially in the early stage of the disease. Moreover, serial chest CT imaging with different time intervals is also effective in estimating the evolution of the disease from initial diagnosis to discharge from hospital. Despite having low specificity in distinguishing abnormalities in viral infections, the high sensitivity of CT makes this method ideal for assessing the severity of the disease in patients with confirmed COVID-19. In this review, we present and discuss currently available scales that can be used to assess the severity of lung involvement in COVID-19 patients in everyday work, both for CXR and CT imaging.
Despite development of radiologic imaging, detection and follow-up of neuroendocrine neoplasms (NENs) still pose a diagnostic challenge, due to the heterogeneity of NEN, their relatively long-term growth, and small size of primary tumor. A set of information obtained by using different radiological imaging tools simplifies a choice of the most appropriate treatment method. Moreover, radiological imaging plays an important role in the assessment of metastatic lesions, especially in the liver, as well as, tumor response to treatment. This article reviews the current, broadly in use imaging modalities which are applied to the diagnosis of GEP-NETs, (the most common type of NENs) and put emphasis on the strengths and limitations of each modality.
Background Imaging-based quantitative assessment of lung lesions plays a key role in patient triage and therapeutic decision-making processes. The aim of our study was to validate the Total Severity Score (TSS), Chest Computed Tomography Score (CT-S), and Chest CT Severity Score (CT-SS) scales, which were used to assess the extent of lung inflammation in patients with SARS-CoV-2 infection in terms of interobserver agreement and the correlation of scores with patient clinical condition on the day of the study. Material/Methods A total of 77 chest CT scans collected from 77 consecutive patients hospitalized because of SARS-CoV-2 were included. The scans were assessed independently by 2 radiologists aware of the patients’ positive results of RT-PCR tests. Each chest CT was assessed according to the 3 scales. To assess the interobserver agreement of CT scan assessments, Cohen’s κ and intraclass correlation coefficient (ICC) were calculated. Results For the overall assessment, the κ was 0.944 and the ICC was 0.948 for the TSS; the κ was 0.909 and the ICC was 0.919 for the CT-S; and the κ was 0.888 and the ICC was 0.899 for the CT-SS. The CT-SS ( r =0.627 for Radiologist 1 and r =0.653 for Radiologist 2) revealed the strongest positive correlation with the patient clinical condition as expressed using the Modified Early Warning Score. Conclusions The interobserver agreement for the 3 evaluated scales was very good. The CT-SS was found to have the strongest positive relationship with the Modified Early Warning Score.
Primary sclerosing cholangitis (PSC) is a chronic liver disease in which there are inflammation and scarring of the bile ducts leading to fibrosis, destruction and narrowing of the bile ducts, resulting in cholestasis. In the long run, PSC can cause liver cirrhosis and failure. In clinical practice, the diagnosis of PSC is generally based on blood tests and imaging studies (currently preferably magnetic resonance cholangiopancreatography). To make a diagnosis of PSC it is necessary to exclude secondary causes of sclerosing cholangitis. The most common MRI features of PSC concerning bile ducts are: bile duct dilatation, beading, extrahepatic bile duct stenosis, wall enhancement and thickening. The most common MRI features of PSC concerning hepatic parenchyma are: rounded shape of the liver caused by hypertrophy of caudate lobe and left liver lobe, atrophy of the right lobe, enlargement of portal and/or portacaval lymph nodes, peripheral parenchymal inflammation, wedge-shaped confluent fibrosis, heterogeneity of the liver parenchyma, periportal oedema, cirrhosis with indirect signs of portal hypertension such as splenomegaly, ascites and collateral vasculature.
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