Purpose. The research goal comprises primary analysis of CT examinations results and their interpretation by comparing with the data already available in the literature.Material and methods. During the period from April 17, 2020 to May 18, 2020, 830 chest CT scans were performed and results of 123 CDs with CT scans made by other institutions were interpreted. Follow-up examinations were carried out every 3–4 days or when clinical presentation changed. At the primary stage, we have analysed in a more detail way a group of 69 patients, who were diagnosed with CT-3 or CT-4 volume of lung damage at least once during hospitalization. The patients underwent PCR analysis three times during hospitalization. Among 69 patients, 34 patients had a positive PCR test at least once, the remaining 35 patients had a clinic, corresponding with this disease.Results. At the initial examination, ground-glass opacity prevailed, as it was observed in 44 cases (64%), and lung tissue consolidation was observed in 25 cases (36%) in a group of 69 patients. When comparing the two groups, the average age of the patients with consolidation changes was statistically significantly lower than one of the group where ground-glass opacity prevailed – 51.7 and 59.4 years, respectively (p = 0.01) In the group of patients with pulmonary tissue consolidation, there were fewer concomitant diseases, fatal outcomes, positive PCR test results, a shorter hospitalization period, and fewer cases of tocilizumab administration were noted. At the initial examination the average percentage of pulmonary parenchyma involvement in the group of patients with lung tissue consolidation was higher (63.3%; p = 0.04), follow-up examinations showed c statistically significantly lower average values of the increase in the percentage of involvement of the parenchyma, which acquired negative values after the third CT scan (8.3 after the 2nd CT and −5.2 after the 3rd CT versus 18.5 and 3 in the GGO glass group; p = 0.02 and 0.03, respectively). No visible differences in CT between the period from the onset of the disease and the predominant symptom in CT were revealed. Meanwhile, on the 5th day (the day of the check-up CT examination) the largest number of patients was determined in both groups.Conclusion. An analysis of our experience during the first month of operation of Covid-19 Hospital is presented. According to our data, the appearance of consolidation at the initial CT examination is probably not related to the period, when the disease has been in progress, and may be associated with a more favorable course of the process.
We present the very rare clinical case of a 54-year-old man who was diagnosed on CT and MRI with a mixed cystic-soft tissue pancreatic lesion with septa and calcification, looking like a malignant tumor of pancreas. The preoperative diagnosis was uncertain because of unclear features of the mass. This tumor from the body and tail of pancreas was excised by means of laparotomy. The final diagnosis of a complicated hydatid cyst was confirmed on morphological examination.
Purpose. Review and analysis of the available foreign literature about CT findings in patients with COVID-19 pneumonia after treatment with tocilizumab.Material and methods. 6 publications were analyzed that were available for the keywords “COVID-19”, “radiology”, “CT”, “tocilizumab”, “cytokine release syndrome”, “interleukin 6”, “IL-6”. Search was limited only to English language manuscripts with no time limit. The literature search was last done on 3rd June 2020.Results. There is a small number of studies on CT findings of COVID-19 pneumonia during the treatment of actemra (tocilizumab). At the request of “COVID-19”, “radiology”, “CT”, “tocilizumab”, “cytokine release syndrome”, “interleukin 6”, “IL-6” in the database of medical and biological publications “PubMed” on 03.06.2020 can be found only 8 publications that would satisfy the search query. At the time of writing this article we were able to locate only 1 full text articles in English which was the study of CT findings in patients with COVID-19 pneumonia after treatment with tocilizumab. It is important to note that new data is being shared regularly and so far, it consists mostly of pre-prints, case reports, small case series.Conclusion. After analyzing the available literature, it can be concluded that the majority of authors confirm the positive effect associated with taking tocilizumab, as evidenced by a very rapid improvement in the condition of patients, however, the CT-findings often does not correlate with the clinical course of the disease and does not always show improvement in lung tissue, which should not be regarded as negative dynamics, but as a natural regression of pathological changes in lung tissue.
To demonstrate the possible difficulties in the diagnosis of hepatic echinococcosis, that a specialist in ultrasound diagnostics and a radiologist may encounter in everyday practice, russian and foreign literature as well as our own experience have been reviewed. With high accuracy and specificity of ultrasonography in the differential diagnosis of echinococcal cysts, incorrect interpretation is possible in the presence of mural hemorrhages and (or) hemorrhagic clots in a nonparasitic cyst, which aren’t also visible in ultrasonography and can imitate elements of the chitinous membrane. The degree of prevalence of the process, the exclusion of damage to the lungs and other organs of the abdominal cavity are important. In such cases CT scan is the most convenient and accurate diagnostic method due to its high spatial and temporal resolution, standardization and availability. In the most difficult cases the capabilities of MRI are used in the comparison of diffusion-weighted images and apparent diffusion coefficient, which also makes it possible to diagnose cystic neoplasms. Ultrasonography is a diagnostic technology that is still the most commonly used to differentiate cavity structures; however, all dubious clinical observations should be further examined by using CT or MRI.
Metastases in the pancreas are rather rare tumor lesion of this organ. According to different data, the incidence of metastatic pancreatic lesions varies from 1.8 to 4% of all pancreatictumors.The article presents three clinical observations of metastases of melanoma, renal clearcell cancer, lung cancer in the pancreas. All patients were treatedusing cryosurgical methods with positive dynamics in the postoperative period.A brief review of the literature discussing metastatic lesions of the pancreas is also done, and the management treatment tactics of these patients is described.
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