Purpose
Some patients with novel coronavirus disease 2019 (COVID-2019) present with abdominal symptoms. Abdominal manifestations of COVID on imaging are not yet established. The goal of this study was to quantify the frequency of positive findings on abdominopelvic CT in COVID-positive patients, and to identify clinical factors associated with positive findings to assist with imaging triage.
Materials and methods
This retrospective study included adult COVID-positive patients with abdominopelvic CT performed within 14 days of their COVID PCR nasal swab assay from 3/1/2020 to 5/1/2020. Clinical CT reports were reviewed for the provided indication and any positive abdominopelvic findings. Demographic and laboratory data closest to the CT date were recorded. Multivariate logistic regression model with binary outcome of having no reported positive abdominopelvic findings was constructed.
Results
Of 141 COVID-positive patients having abdominopelvic CT (average age 64 years [± 16], 91 [64%] women), 80 (57%) had positive abdominopelvic findings. Abdominal pain was the most common indication, provided in 54% (43/80) and 74% (45/61) of patients with and without reported positive abdominopelvic findings, respectively (
p
= 0.015). 70% (98/141) of patients overall had reported findings in the lung bases. Findings either typical or intermediate for COVID were reported in 50% (40/80) and 64% (39/61) of patients with and without positive abdominopelvic findings, respectively (
p
= 0.099). Of 80 patients with positive abdominopelvic findings, 25 (31%) had an abnormality of gastrointestinal tract, and 14 (18%) had solid organ infarctions or vascular thromboses. In multivariate analysis, age (OR 0.85,
p
= 0.023), hemoglobin (OR 0.83,
p
= 0.029) and male gender (OR 2.58,
p
= 0.032) were independent predictors of positive abdominopelvic findings, adjusted for race and Charlson comorbidity index.
Conclusion
Abdominopelvic CT performed on COVID-positive patients yielded a positive finding in 57% of patients. Younger age, male gender, and lower hemoglobin were associated with higher odds of having reportable positive abdominopelvic CT findings.
The purpose of this study was to assess the concordance in categorization and radiologic T staging using Liver Imaging Reporting and Data System (LI‐RADS, LR) version 2017 (v2017), version 2018 (v2018), and the Organ Procurement and Transplantation Network (OPTN) criteria. All magnetic resonance imaging and computed tomography reports using a standardized LI‐RADS macro between April 2015 and March 2018 were identified retrospectively. The major features (size, arterial phase hyperenhancement, washout, enhancing capsule, or threshold growth) were extracted from the report for each LR‐3, LR‐4, and LR‐5 observation. Each observation was assigned a new category based on LI‐RADS v2017, v2018, and OPTN criteria. Radiologic T stage was calculated based on the size and number of LR‐5 or OPTN class 5 observations. Categories and T stages assigned by each system were compared descriptively. There were 398 patients (66.6% male; mean age, 63.4 years) with 641 observations (median size, 14 mm) who were included. A total of 73/182 (40.1%) observations categorized LR‐4 by LI‐RADS v2017 were up‐categorized to LR‐5 by LI‐RADS v2018 due to changes in the LR‐5 criteria, and 4/196 (2.0%) observations categorized as LR‐5 by LI‐RADS v2017 were down‐categorized to LR‐4 by LI‐RADS v2018 due to changes in the threshold growth definition. The T stage was higher by LI‐RADS v2018 than LI‐RADS v2017 in 49/398 (12.3%) patients. Compared with the OPTN stage, 12/398 (3.0%) patients were upstaged by LI‐RADS v2017 and 60/398 (15.1%) by LI‐RADS v2018. Of 101 patients, 5 (5.0%) patients with T2 stage based on LI‐RADS v2017 and 10/102 (9.8%) patients with T2 stage based on LI‐RADS v2018 did not meet the T2 criteria based on the OPTN criteria. Of the 98 patients with a T2 stage based on OPTN criteria, 2 (2.0%) had a T stage ≥3 based on LI‐RADS v2017 and 6 (6.1%) had a T stage ≥3 based on LI‐RADS v2018.
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