Background Chest CT is remarkably considered as an imminent diagnostic tool and follow-up study in pulmonary changes in COVID-19 patients; being familiar to other coronavirus family CT findings, this improve our diagnostic experience and hence enhance our ability to early diagnose and combat the outbreak of COVID-19. The purpose is to investigate the wide spectrum of radiological pulmonary changes in COVID-19 patients and compare them to the variable CT findings reported in MERS and SARS. Results From March 15 to May 12, 2020, 50 patients in Cairo, Egypt, who have positive RT-PCR tests, were included in our study. MSCT of the chest was performed to all patients and processed in a separate work station. Two experienced radiologists assessed each study for the type and location of different pulmonary affection. The most imminent radiological finding was patchy peripheral subpleural ground glass opacity found in 42 patients (84% of cases), followed by consolidation found in 30 patients (60% of cases) and ground glass and consolidation together found in 22 patients (44% of cases). Unlike SARS, where initial chest imaging abnormalities are more frequently unilateral, COVID-19 is more likely to involve both lungs on initial imaging presented as bilateral peripheral subpleural scattered ground-glass opacities. Pleural effusion is absent in COVID-19 patients while it is not rare in MERS and might be observed in 20–33% of affected individuals. Conclusion The imaging features of COVID-19 pneumonia are highly sensitive mainly in the outbreak pandemic. The imaging features of SARS, MERS, and COVID-19 overlap, but differences still exist especially early in disease course.
Background In the scenario of lung lesions, the differential diagnosis is important, since the treatment is determined by the characteristics of the lesion. The goal in the evaluation of pulmonary lesions is to distinguish malignant lesions from benign lesions in a non-invasive manner as possible. Since, CT is not sufficient to accurately distinguish malignant nodules from benign nodules and patients with benign nodules might undergo invasive diagnostic methods, such as lung biopsy or video-assisted thoracoscopic surgery, to rule out a malignancy. Now, MRI performed by using diffusion-weighted (DW) can offer both qualitative and quantitative information that can be helpful for tumour assessment. Moreover, lesion‐to‐spinal cord signal intensity ratio (LSR) has also been shown to be useful for the differentiation of lung lesions. Quantitative tumour assessment is possible by the calculation of ADC. Results A total of 30 patients were eligible for inclusion in our final analysis; with male/female case number about 10/20 (33.3%/ 66.7%) and age range from 20 to 74 (46.8 ± 14.9) were subjected to MRI study and MRI diffusion. Sensitivity analysis showed that ADC mean, and ADC min value can significantly predict malignant lung lesions using cutoff point < 1.53 and < 1.34 respectively, with sensitivity 75%, 56.3%, and specificity 92.9%, 100% with p values 0.001, and 0.005 respectively. SI lesion can significantly predict malignant lung lesions using cutoff point > 502.8, with sensitivity 92.9% and specificity 68.7%, AUC 89.3% and p value 0.0001. Lesion-to-spinal cord signal intensity ratio (LSR) can significantly predict malignant lung lesions using cutoff point > 1.3, with sensitivity 85.7% and specificity 75%, AUC 79.7% and p value 0.006. Conclusions This study confirmed that the DWI combined with ADC value and LSR is effective and valuable tool in differentiation of pulmonary lesions whether benign or malignant which is considered to be noninvasive alternative tool for the characterization of pulmonary lesions. We recommend before invasive intervention to perform diffusion MRI and LSR as and important aid for proper diagnosis.
Background: Asbestos refers to a group of naturally occurring silicate minerals which have been traditionally used in building materials and household products. Inhalation of asbestos fibers, however, has been associated with adverse health outcomes, with the disease manifestations principally affecting the thorax. The aim of our study is to detect and evaluate the different radiological patterns of asbestos-related lung and pleural disease and its complications Results: MDCT examination was able to assess and distinguish asbestosis as well as asbestos-related lung and pleural disease besides detection of any associated complications. Conclusion: This study demonstrates that while reporting of malignant asbestos-related pleural disease is adequate, there is room for improvement in the reporting of more benign disease.
Background Tumors that arise from the chest wall (including bone structures such as the sternum, clavicle, scapula, and ribs) or from adjacent soft tissues are less common than other parts of the body, and so the resulting unfamiliarity can make it difficult to limit the number of possible diagnoses. These tumors have a wide range of possibilities, including primary chest wall tumors arising from the bone or soft tissue, which are subdivided into malignant and benign tumors, and the secondary metastatic deposits. The aim of the study is to investigate the ability of MRI with diffusion sequence in differentiation between benign and malignant chest wall masses, which is subsequently reflected in the management of chest wall masses patients. Main body MRI has superior soft-tissue resolution and value for local assessment of primary tumors and accurate tissue characterization and plays a key role in preoperative staging to assess for multi-spatial and multi-compartment involvement. ADC values were obtained in 31 patients, and the mean ADC values of benign (13 patients) chest wall masses were 1.31 ± 0.50 × 10−3 mm2/s while the mean ADC values of the malignant (18 patients) chest wall masses were 0.98 ± 0.36 × 10−3 mm2/s. There was a statistically significant difference between the ADC values obtained from the malignant and benign chest wall masses (P < 0.001). Conclusion This study demonstrates that diffusion-weighted MR imaging is a growing imaging modality to predict the histopathological differentiation of malignant from benign chest wall masses.
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