Background: COVID-19 has become a national and an international preoccupation to all doctors. Dealing with patients with clinical suspicion of COVID-19 is a daily markedly growing professional issue for radiologists. The number of COVID-19 cases we deal with is peaking since last March and so is our experience in recognizing the disease patterns and in assessing its severity. The purpose of this study is to assess the role of CT chest in the diagnosis of COVID-19 based on our experience with 220 Egyptian cases. Results: A cross-sectional multicenter study involving 220 patients; 68 (30.9%) females and 152 (69.1%) males, their age range was 10-92 years (average 49.198 years). Non-contrast MSCT chest was done to patients with clinically suspected COVID-19. Data assessment and analysis for lesions probability, pattern, localization, and severity were done. Bilateral affection was seen in 168/220 cases (76.36%). Multilobar affection was noted in 186/220 cases (84.54%). Lower lobes affection was noted in 179/220 cases (81.36%). Peripheral/subpleural affection was noted in 203/220 cases (92.27%). The common CT patterns (ground-glass opacities, consolidation, crazy paving, vascular thickening, traction bronchiectasis, vacuolar sign, architectural distortion signs, and reversed halo sign) and the uncommon CT patterns (halo sign, masses, nodules, lobar affection, tree in-bud-pattern and cysts) were discussed. Associated extrapulmonary lesions described. Temporal changes, severity scoring, reporting, and possible pitfalls were all assessed. Conclusion: In our experience, CT plays a basic essential role in diagnosing COVID-19 in the current declared pandemic.
Background Malignant lymphoma accounts for nearly 20% of all mediastinal neoplasms in adults and 50% in children. Hodgkin’s disease is the most common primary mediastinal lymphoma. In non-Hodgkin’s lymphoma, the two most common forms of primary mediastinal lymphoma are lymphoblastic lymphoma and diffuse large B-cell lymphoma. The aim of this study is to implement diffusion MRI in the algorithm of diagnosis of mediastinal lymphoma, differentiating Hodgkin's from non-Hodgkin's lymphoma and assessment of post therapeutic response. Results Using Diffusion weighted magnetic resonance imaging DWI-MRI, there were statistic significant difference between ADC values in lymph nodes and mediastinal masses in Hodgkin and non-Hodgkin lymphomas. ADC range in non-treated Hodgkin lymphoma cases was 0.774 to 1.4, while ADC range in in non-treated non-Hodgkin lymphoma was 0.476 to 0.668. In this study, there was statistically significant difference of ADC values in lymphoma cases presented by mediastinal masses with and without chemotherapy. Conclusions Diffusion weighted magnetic resonance imaging DWI-MRI is a promising functional technique in diagnosis of Hodgkin's and non-Hodgkin's lymphoma and assessment of response to treatment with no need for special preparation, contrast injection or radiation exposure.
Background Systemic sclerosis is a connective tissue disease that affects multiple systems and causes fibrosis of the skin and internal organs. There are two ways in which the lungs can be involved in patients with systemic sclerosis, either isolated pulmonary hypertension or interstitial lung fibrosis. The purpose of this study is to correlate the high resolution CT findings with pulmonary function tests in patients with systemic sclerosis to evaluate the severity of lung changes. Results Significant inverse correlations were found between the maximal extent radiological score, maximal severity radiological score as well as total (global) radiological score on one hand and the pulmonary function tests on the other hand Conclusion The combination of high resolution CT and pulmonary function tests are recommended for better assessment of the extent and severity of systemic sclerosis associated interstitial lung disease.
Background Sarcoidosis is a multisystem disease defined by non-caseous epithelioid cell granulomas that can affect virtually all organs. Lung, mediastinal and hilar lymph node involvement is prevalent, occurring in around 90% of the patients, and is responsible for the majority of the morbidity and mortality related to the disorder. Sarcoidosis is one of the differential diagnoses of the benign mediastinal lymphadenopathy. This research aimed to detect the diagnostic value of magnetic resonance imaging (MRI) diffusion in evaluation of mediastinal lymphadenopathy in sarcoid patients. Results This cross study involved a total of 30 patients known to have sarcoidosis: 6 males and 24 females aged between 18 and 50 years (with a mean age 38.97 ± 8.67); all of them presented with mediastinal lymphadenopathy. For all patients, each lymph node group was evaluated for the average size and average ADC value. The mean ADC measured was (1.76 ± 0.28) × 10−3 mm2/s. Eight patients showed concurrent activity with poor response to the treatment, and they showed different ADC values with one of them showing low ADC with pattern of diffusion restriction displaying mean ADC value of 1.28 × 10−3 mm2/s. Conclusions Diffusion-weighted MRI is an established imaging technique that could be utilized to evaluate mediastinal lymphadenopathy in sarcoidosis as the benign counterpart of mediastinal lymphadenopathy.
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