Atypical chest CT findings of COVID-19 pneumonia: a pictorial review

Coronavirus disease 2019 (COVID-19) first emerged in China and rapidly spread in the world causing a pandemic. Chest computed tomography (CT) continues to play an important role in the diagnosis and follow-up of the disease due to shortcomings of the real-time reverse transcription-polymerase chain reaction test, which is the gold standard in the diagnosis of this disease. Typical chest CT findings of COVID-19 pneumonia have been widely reported in the literature. However, atypical findings such as central involvement, peribronchovascular involvement, isolated upper lobe involvement, nodular involvement, lobar consolidation, solitary involvement, pleural and pericardial fluid, and subpleural sparing can also be seen. Knowing these atypical findings is important to avoid misdiagnosis. This review summarizes the atypical findings that can be seen in the course of the disease and may be confused with other diseases

The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

Sekonder Kardiyomyopatiler

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Tuberculosis Cutis Orificialis in Adalimumab Related Immunosupressive Patient

WOS: 000397356200024PubMed ID: 2822376

Anoftalmik sokette gelişen konjonktiva kisti tedavisinde trikloroasetik asit enjeksiyonu

Pur po se: To report the efficacy of trichloroacetic acid injection in the management of a conjunctival cyst in an anophthalmic socket that recurred after previous aspiration. Ma te ri al and Met hod: A 34-year-old male, who underwent left enucleation and polymethyl methacrylate sphere implantation due to trauma 5 years earlier, presented with the complaint of prosthesis instability. Examination revealed a lobulated appearing cystic mass filling the socket. Magnetic resonance imaging showed a cystic lesion occupying the entire anterior orbit in front of the implant. The conjunctival cyst that reportedly recurred after an attempt of aspiration in another clinic was injected with 20% trichloroacetic acid (IL-33, 10 ml solution, Istanbul Ila;ccedil; Sanayi ve Tic. A.S.). Re sults: The conjunctival cyst, which was pushing the prosthesis forward before treatment, disappeared after the injection. The exophthalmic appearance resolved. Prosthesis could be used properly. No recurrence was detected at 12-month follow-up visit. Dis cus si on: Conjunctival cysts, which are occasionally monitored in anophthalmic sockets, can be refractory to various treatment modalities. Though less desirable, these cases may even require explantation of the implant, since relapse is inevitable after basic aspiration. In the treatment of anophthalmic conjunctival cysts, the injection of 20% trichloroacetic acid into the cyst is a cosmetically successful and recurrence-abolishing procedure. (Turk J Ophthalmol 2011; 41: 389-91)Amaç: Anoftalmik sokette gelişmiş olan ve daha önce aspirasyon yapılmasına rağmen nüks eden konjonktiva kistinin tedavisinde trikloroasetik asit enjeksiyonunun etkinliğini göstermek. Ge­reç ve Yön­tem: Beş yıl önce travma nedeniyle sol gözüne enükleasyon ve polimetil metakrilat küre implantasyonu yapılan anoftalmik soketli 34 yaşındaki erkek olgu, kliniğimize sol göze taktığı protezin yerinde durmamasışikayeti ile başvurdu. Yapılan muayenede soket konjonktivasını dolduran, lobüle görünümlü kistik oluşum izlendi. Çekilen orbita manyetik rezonans görüntülemede ön orbitayı tamama yakın dolduran kistik oluşum izlendi. Daha önce başka merkezde aspirasyon uygulanan, fakat nüks ettiği belirtilen konjonktiva kisti içine %20’lik trikloroasetik asit (IL-33, 10 ml solüsyon, İstanbul İlaç Sanayi ve Tic. A.Ş.) enjekte edildi. So­nuç­lar: Enjeksiyon öncesi protezi öne ittiren konjonktiva kisti, enjeksiyondan sonra kayboldu. Ekzoftalmik görünüm düzeldi. Protez enjeksiyondan 3 hafta sonra sağlıklı bir şekilde kullanılabilir hale geldi. Enjeksiyon sonrası on iki aylık izlemde nüks saptanmadı. Tartışma: Anoftalmik soketlerde çok nadir olarak gözlenebilen konjonktiva kistleri çeşitli tedavi yöntemlerine oldukça dirençli olabilmektedir. Basit aspirasyon ile nüks kaçınılmaz olduğundan, kozmetik olarak kabul edilebilir olmasa da, konulmuş olan kürenin eksizyonu dahi gerekebilmektedir. Kist içine yapılacak %20’lik trikloroasetik asit enjeksiyonu anoftalmik konjonktiva kistlerinin tedavisinde kozmetik açıdan başarılı ve nüksü ortadan kaldırabilecek bir uygulamadır. (Turk J Ophthalmol 2011; 41: 389-91

Salvage of Suboptimal Enhancement of Pulmonary Artery in Pulmonary CT Angiography Studies: Rapid kVp Switch Dual Energy CT Experience

WOS: 000533549200015Background: Multidetector computed tomography (MDCT) angiography is considered as the gold standard imaging modality in the evaluation of acute pulmonary embolism. Optimum vascular enhancement is critical forMDCTstudies. the suboptimal opacification in pulmonary artery could be salvaged using low-energy virtual monoenergetic images (VMI) at rapid kVP switch dual energy CT. Objectives: To explore the potential improvement in pulmonary artery opacification and to assess the change in image quality parameters in VMI using fast switch kVp dual energy CT. Patients and Methods: the CT images of 877 patients who were referred with a preliminary diagnosis of pulmonary embolism were reviewed. Sixty patients with suboptimal enhancement (= 3. Fifty six studies that met these criteria were considered as salvaged. At this best energy level, quantitative parameters were compared with standard images. Results: the mean attenuation of pulmonary arteries was 169.80HUin standard images in patients with suboptimal enhancement. the attenuations of VMIs at 40, 45, 50, 55, 60, 65, and 70 keV were significantly higher than standard images (P < 0.001). Similar findings were observed with SNR and CNR. in the salvaged patients, the average increase in mean pulmonary artery attenuation was 62% (from 172.61 +/- 23.4 to 280.55 +/- 40.7), the average increase in SNR was 38% (from 12.1 +/- 5.3 to 16.7 +/- 7.1) and the average increase in CNR was 48% (9.2 +/- 4.3 to 13.7 +/- 6) (P < 0.001). Conclusions: Low keV VMI reconstructions significantly increase pulmonary artery attenuation, CNR and SNR compared to standard image reconstructions. Suboptimal CT studies could be salvaged using low keV VMIs

The novel coronavirus pneumonia (COVID-19): a pictorial review of chest CT features

WOS:000629039700005PubMed: 32815523Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China. The infection rapidly spread to more than 200 countries around the world. The clinical presentation of the disease may vary from mild illness to severe pneumonia such as acute respiratory distress syndrome (ARDS). The chest computed tomography (CT) has an important complementary role in diagnosis of the disease. The predominant CT findings of the disease are ground glass opacities and consolidations located in subpleural areas of lower lobes. Widespread ground-glass opacities, consolidation, air bronchograms, central involvement of lung parenchyma, mediastinal lymphadenopathy are more common in patients with the severe form of the disease. CT imaging also guides in differentiation of alternative diagnosis or in assessment of associated pulmonary embolism during the course of the disease. in this pictorial review we aim to review the CT features of COVID-19 pneumonia and mention the changes throughout the disease process