Additional Chest Imaging Signs That Have the Potential of Being COVID-19 Imaging Markers

Merchant, S; Ansari, Shehbaz M S; Merchant, Neesha

doi:10.2214/ajr.20.24170

Cited by 2 publications

(8 citation statements)

References 2 publications

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“…Five cases showed a QDAR > 50, and three out five cases had a low semiquantitative score (0–1) in each scoring system. These three cases showed mild diffuse mosaic-like increased attenuation in the lung parenchyma, possibly due to air trapping or presumed pulmonary embolus (Westermark sign) [ 12 ] or inadequate inspiration.…”

Section: Resultsmentioning

confidence: 99%

“…The lesions in the left lower lobe demonstrate bulging opacity presumably indicative of Hampton’s hump sign ( a , 4: black arrow), and triangular wedge-shaped opacities ( a , 2, 3: black arrowheads). These imaging findings are presumably indicative of infarct [ 12 ]. Solid nodules in the right middle lobe and left upper lobe ( a , 2 and 3: white arrowheads) were considered unrelated to COVID-19.…”

Section: Methodsmentioning

confidence: 99%

“…Computed tomography (CT) plays a crucial role in assessing the severity and extent of lung involvement by COVID-19 [ 5 ], whereas the standard confirmatory test for SARS-CoV-2 infection is reverse-transcription polymerase chain reaction (RT-PCR) assay [ 6 ]. Characteristic imaging findings of acute lung involvement by COVID-19 include parenchymal or ground-glass opacities with peripherally and lower-lung predominant distribution, crazy-paving appearance, reversed-halo appearance, and subpleural sparing [ 7 – 12 ]. Subpleural sparing along with Hampton’s hump and triangular wedge-shaped opacities could suggest the presence of underlying coagulopathies that are commonly seen in COVID-19 patients, and scrutiny on these findings could result in better diagnostic accuracy for COVID-19 infection (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…Subpleural sparing along with Hampton’s hump and triangular wedge-shaped opacities could suggest the presence of underlying coagulopathies that are commonly seen in COVID-19 patients, and scrutiny on these findings could result in better diagnostic accuracy for COVID-19 infection (Fig. 1 ) [ 12 ]. Interstitial fibrosis is observed as a late sequela of COVID-19 infection [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Subpleural ground-glass opacity is surrounded by dense linear opacity, corresponding with “reversed CT halo sign” ( a white arrows). The subpleural sparing of ground-glass opacities is noted (subpleural sign: black arrows) [ 12 ]. One reader rated a score of 9 in total severity score (TSS), 17 in chest CT score (CCTS), and 22 in CT severity score (CTSS), and the other reader rated a score of 12 in TSS, 16 in CCTS, and 21 in CTSS.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of semiquantitative chest CT scoring systems to estimate severity in coronavirus disease 2019 (COVID-19) pneumonia

et al. 2022

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Objectives To compare the clinical usefulness among three different semiquantitative computed tomography (CT) severity scoring systems for coronavirus disease 2019 (COVID-19) pneumonia. Methods Two radiologists independently reviewed chest CT images in 108 patients to rate three CT scoring systems (total CT score [TSS], chest CT score [CCTS], and CT severity score [CTSS]). We made a minor modification to CTSS. Quantitative dense area ratio (QDAR: the ratio of lung involvement to lung parenchyma) was calculated using the U-net model. Clinical severity at admission was classified as severe ( n = 14) or mild ( n = 94). Interobserver agreement, interpretation time, and degree of correlation with clinical severity as well as QDAR were evaluated. Results Interobserver agreement was excellent (intraclass correlation coefficient: 0.952–0.970, p < 0.001). Mean interpretation time was significantly longer in CTSS (48.9–80.0 s) than in TSS (25.7–41.7 s, p < 0.001) and CCTS (27.7–39.5 s, p < 0.001). Area under the curve for differentiating clinical severity at admission was 0.855–0.842 in TSS, 0.853–0.850 in CCTS, and 0.853–0.836 in CTSS. All scoring systems correlated with QDAR in the order of CCTS ( ρ = 0.443–0.448), TSS ( ρ = 0.435–0.437), and CTSS ( ρ = 0.415–0.426). Conclusions All semiquantitative scoring systems demonstrated substantial diagnostic performance for clinical severity at admission with excellent interobserver agreement. Interpretation time was significantly shorter in TSS and CCTS than in CTSS. The correlation between the scoring system and QDAR was highest in CCTS, followed by TSS and CTSS. CCTS appeared to be the most appropriate CT scoring system for clinical practice. Key Points • Three semiquantitative scoring systems demonstrate substantial accuracy (area under the curve: 0.836–0.855) for diagnosing clinical severity at admission and (area under the curve: 0.786–0.802) for risk of developing critical illness. • Total CT score (TSS) and chest CT score (CCTS) were considered to be more appropriate in terms of clinical usefulness as compared with CT severity score (CTSS), given the shorter interpretation time in TSS and CCTS, and the lowest correlation with quantitative dense area ratio in CTSS. • CCTS is assumed to distinguish subtle from mild lung involvement better than TSS by adopting a 5% threshold in scoring the degree of severity.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of semiquantitative chest CT scoring systems to estimate severity in coronavirus disease 2019 (COVID-19) pneumonia

et al. 2022

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Augmentation of literature review of COVID-19 radiology

Merchant¹,

Nadkarni²,

Shaikh³

2022

World J Radiol

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We suggest an augmentation of the excellent comprehensive review article titled “Comprehensive literature review on the radiographic findings, imaging modalities, and the role of radiology in the coronavirus disease 2019 (COVID-19) pandemic” under the following categories: (1) “Inclusion of additional radiological features, related to pulmonary infarcts and to COVID-19 pneumonia”; (2) “Amplified discussion of cardiovascular COVID-19 manifestations and the role of cardiac magnetic resonance imaging in monitoring and prognosis”; (3) “Imaging findings related to fluorodeoxyglucose positron emission tomography, optical, thermal and other imaging modalities/devices, including ‘intelligent edge’ and other remote monitoring devices”; (4) “Artificial intelligence in COVID-19 imaging”; (5) “Additional annotations to the radiological images in the manuscript to illustrate the additional signs discussed”; and (6) “A minor correction to a passage on pulmonary destruction”.

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Additional Chest Imaging Signs That Have the Potential of Being COVID-19 Imaging Markers

Cited by 2 publications

References 2 publications

Comparison of semiquantitative chest CT scoring systems to estimate severity in coronavirus disease 2019 (COVID-19) pneumonia

Comparison of semiquantitative chest CT scoring systems to estimate severity in coronavirus disease 2019 (COVID-19) pneumonia

Augmentation of literature review of COVID-19 radiology

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