Pulmonary Contusion Similar to COVID-19 Pneumonia

Lee, Seung Hwan; Hyun, Sung Youl; Jeon, Yang Bin; Lee, Jung Nam; Lee, Gil Jae

doi:10.20408/jti.2020.0014

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…Six of these surveys were case reports that exclusively showed some similarities, although they did not conduct proper criteria to differentiate these two entities. 19 , 20 , 21 , 22 , 23 , 24 Five out of six case reports had pulmonary contusions, and their CT images showed bilateral multifocal lesions. Based on our results, we concluded that the prevalence of bilateral lung involvement is higher in pure pulmonary contusion, although it was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Comparison of chest CT scan findings between COVID-19 and pulmonary contusion in trauma patients based on RSNA criteria: Established novel criteria for trauma victims

Fard

Mahmudi‐Azer

Yaqoob

et al. 2022

Chinese Journal of Traumatology

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Propose In this study, we re-assessed the criteria defined by the radiological society of north America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 and pulmonary contusion. Methods All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between group P and PP; statistically significant ones were re-evaluated between Pa and Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between two groups. Results In the group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected ( p < 0.001 and p = 0.25, respectively). Single bilateral GGOs were only seen among the group PP. The Chi-square tests showed that the prevalence of diffused GGOs, multiple unilateral GGOs, multiple consolidations, and multiple bilateral consolidations were significantly higher in the group P ( p = 0.001, 0.01, 0.003, and 0.003, respectively). However, GGOs with irregular borders and single consolidations were more significant among the group PP ( p = 0.01 and 0.003, respectively). Of note, reticular distortions and subpleural spares were exclusively detected in the group PP. Conclusion We concluded that the criteria set by RSNA for the diagnosis of COVID-19 are not appropriate in trauma patients. The clinical signs and symptoms are not always useful either. The presence of multiple unilateral GGOs, diffused GGOs, and multiple bilateral consolidations favor COVID-19 with 88%, 97.62%, and 77.7% diagnostic accuracy.

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