OBJECTIVE: The aim of this study was to investigate the clinical and computed tomography (CT) features associated with severe and critical coronavirus disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS: Eighty-three patients with COVID-19 pneumonia including 25 severe/critical cases and 58 ordinary cases were enrolled. The chest CT images and clinical data of them were reviewed and compared. The risk factors associated with disease severity were analyzed. RESULTS: Compared with the ordinary patients, the severe/critical patients had older ages, higher incidence of comorbidities, cough, expectoration, chest pain, and dyspnea. The incidences of consolidation, linear opacities, crazy-paving pattern, and bronchial wall thickening in severe/critical patients were significantly higher than those of the ordinary patients. Besides, severe/critical patients showed higher incidences of lymph node enlargement, pericardial effusion, and pleural effusion than the ordinary patients. The CT scores of severe/critical patients were significantly higher than those of the ordinary patients (P < 0.001). Receiver operating characteristic curve showed that the sensitivity and specificity of CT score were 80.0% and 82.8%, respectively, for the discrimination of the 2 types. The clinical factors of age older than 50 years, comorbidities, dyspnea, chest pain, cough, expectoration, decreased lymphocytes, and increased inflammation indicators were risk factors for severe/critical COVID-19 pneumonia. Computed tomography findings of consolidation, linear opacities, crazy-paving pattern, bronchial wall thickening, high CT scores, and extrapulmonary lesions were features of severe/critical COVID-19 pneumonia. CONCLUSIONS: There are significant differences in clinical symptoms, laboratory examinations, and CT manifestations between the ordinary patients and the severe/critical patients. Many factors are related to the severity of the disease, which can help clinicians to judge the severity of the patient and evaluate the prognosis.

The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia.

COVID-19 in people with diabetes: understanding the reasons for worse outcomes.

COVID-19 and diabetes: Knowledge in progress.

OBJECTIVES: The aim of this study was to investigate the chest computed tomography (CT) findings in patients with confirmed coronavirus disease 2019 (COVID-19) and to evaluate its relationship with clinical features. MATERIALS AND METHODS: Study sample consisted of 80 patients diagnosed as COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, and the relationship between them was analyzed. RESULTS: Totally, 80 patients diagnosed with COVID-19 were included. With regards to the clinical manifestations, 58 (73%) of the 80 patients had cough, and 61 (76%) of the 80 patients had high temperature levels. The most frequent CT abnormalities observed were ground glass opacity (73/80 cases, 91%), consolidation (50/80 cases, 63%), and interlobular septal thickening (47/80, 59%). Most of the lesions were multiple, with an average of 12 � 6 lung segments involved. The most common involved lung segments were the dorsal segment of the right lower lobe (69/80, 86%), the posterior basal segment of the right lower lobe (68/80, 85%), the lateral basal segment of the right lower lobe (64/80, 80%), the dorsal segment of the left lower lobe (61/80, 76%), and the posterior basal segment of the left lower lobe (65/80, 81%). The average pulmonary inflammation index value was (34% � 20%) for all the patients. Correlation analysis showed that the pulmonary inflammation index value was significantly correlated with the values of lymphocyte count, monocyte count, C-reactive protein, procalcitonin, days from illness onset, and body temperature (P < 0.05). CONCLUSIONS: The common chest CT findings of COVID-19 are multiple ground glass opacity, consolidation, and interlobular septal thickening in both lungs, which are mostly distributed under the pleura. There are significant correlations between the degree of pulmonary inflammation and the main clinical symptoms and laboratory results. Computed tomography plays an important role in the diagnosis and evaluation of this emerging global health emergency.

Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features.

In December 2019, the world started to face a new pandemic situation, the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Although coronavirus disease (COVID-19) clinical manifestations are mainly respiratory, major cardiac complications are being reported. Cardiac manifestations etiology seems to be multifactorial, comprising direct viral myocardial damage, hypoxia, hypotension, enhanced inflammatory status, ACE2-receptors downregulation, drug toxicity, endogenous catecholamine adrenergic status, among others. Studies evaluating patients with COVID-19 presenting cardiac injury markers show that it is associated with poorer outcomes, and arrhythmic events are not uncommon. Besides, drugs currently used to treat the COVID-19 are known to prolong the QT interval and can have a proarrhythmic propensity. This review focus on COVID-19 cardiac and arrhythmic manifestations and, in parallel, makes an appraisal of other virus epidemics as SARS-CoV, Middle East respiratory syndrome coronavirus, and H1N1 influenza.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.14479

Cardiac and arrhythmic complications in patients with COVID-19.

The aim of this study was to evaluate the correlation between clinical and imaging findings with a worse clinical outcome in patients with a confirmed diagnosis of H1N1 influenza A virus. Patients with a positive viral test for influenza A H1N1 in 2016 and chest radiography (CR) and/or computed tomography (CT) results had clinical and imaging data reviewed. Hospitalization, admission to the intensive care unit or death were defined as worse clinical outcomes. The association between clinical and imaging features and the worse outcome was calculated in a logistical regression model. Eighty of 160 (50%) patients were men, with a mean age of 43 ± 19 years. The most common symptoms were as follows: flu-like symptoms 141/160 (88%), dyspnea (25/160, 17%), and thoracic pain (7/160, 5%). Abnormalities on CR were detected in 8/110 (7%) patients, and 43/59 (73%) patients had an abnormal CT. The following variables were associated with worse clinical outcomes: the presence of diabetes mellitus (DM), hypertension, dyspnea, thoracic pain, abnormal CR or CT regardless of the type of finding, CT with consolidation or ground glass opacity. The presence of DM, hypertension, dyspnea, thoracic pain, or an abnormal CR or CT on admission were associated with worse clinical outcomes in patients with H1N1 influenza A virus infection. Thus, the use of readily accessible clinical and imaging features on admission may have a role in the evaluation of patients with H1N1 infection.

/pdf/spectrum-of-clinical-and-radiographic-findings-in-patients-3w4sdk4c8b.pdf

Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity.

Hepatocellular carcinoma in an adult with Alagille syndrome: case report and literature review.

HomeRadioGraphicsVol. 42, No. 4 PreviousNext Genitourinary ImagingFree AccessRadioGraphics FundamentalsProstate Cancer Imaging: What We Already Know and What Is on the HorizonDiego N. dos Santos , Natally Horvat, Adriano Basso Dias, Marcelo Mota, George Veloso Filho, Karla Schoen, Sangeet Ghai, Marcelo Queiroz, Publio VianaDiego N. dos Santos , Natally Horvat, Adriano Basso Dias, Marcelo Mota, George Veloso Filho, Karla Schoen, Sangeet Ghai, Marcelo Queiroz, Publio VianaAuthor AffiliationsFrom the Department of Radiology, Hospital Sírio-Libanês, Rua Dona Adma Jafet 91, Bela Vista, São Paulo, SP 01308-050, Brazil (D.N.D.S., N.H., M.M., G.V.F., K.S., M.Q., P.V.); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (N.H.); and Joint Department of Medical Imaging, University Health Network–Mount Sinai Hospital–Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada (A.B.D., S.G.).Address correspondence to D.N.D.S. (e-mail: [email protected]).Diego N. dos Santos Natally HorvatAdriano Basso DiasMarcelo MotaGeorge Veloso FilhoKarla SchoenSangeet GhaiMarcelo QueirozPublio VianaPublished Online:May 27 2022https://doi.org/10.1148/rg.210134MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractThe full digital presentation is available online.TEACHING POINTS■ CT is not as useful as MRI for evaluating the prostate. However, CT can be used to assess bone metastases and some nodal and distant metastases.■ PSMA PET is well established for evaluating biochemical recurrence, even in patients with low prostate-specific antigen levels. PET/MRI has improved sensitivity for detection of prostate cancer compared with mpMRI and has also shown interesting applications for cancer detection, primary staging, assessment of therapeutic response, and treatment planning.■ Radiomics studies continue to improve prognosis and therapeutic response prediction, paving the way for imaging-based precision medicine.In this online presentation, the clinical features and anatomic landmarks of prostate cancer are shown to review the roles of different imaging modalities in several clinical contexts, including screening, detection, staging, active surveillance, and biochemical recurrence, from conventional imaging methods that are currently the most used, to new modalities that lie ahead.The evolution of diagnostic imaging methods has contributed to a more accurate depiction of prostate cancer. Transrectal US (TRUS) has an important role in guiding systematic biopsies, but some tumors may be missed. CT is not as useful as MRI for evaluation of the prostate, but it can be used to assess some nodal, bone, and distant metastases. Multiparametric MRI (mpMRI) has been used for tumor depiction, local-regional staging, follow-up, active surveillance, and therapeutic response assessment (Fig 1). TRUS/MRI fusion guidance improves the accuracy of transrectal biopsies. Prostate-specific membrane antigen (PSMA) PET imaging is well established for evaluating biochemical recurrence. PSMA PET/CT is superior to conventional imaging methods for N and M staging (Fig 2). PET/MRI improves sensitivity in the detection of prostate cancer compared with mpMRI and has also shown interesting applications for cancer depiction, primary staging, assessment of therapeutic responses, and treatment planning. Microultrasound has sensitivity and specificity for clinically significant prostate cancer that are comparable to those of mpMRI. It is a promising low-cost option for prostate cancer depiction and targeted biopsy. Radiomics studies continue to improve prognosis and therapeutic response prediction, paving the way for imaging-based precision medicine.Figure 1. MpMRI evaluation. Axial MR images show a nodular lesion in the peripheral zone that demonstrates typical imaging features that are highly suspicious for a significant cancer, with hypointensity (blue arrow) on the T2-weighted (T2WI) image, restriction to water diffusion (yellow arrows), and marked early contrast enhancement (red arrow) with washout in the late phase (white arrow). ADC = apparent diffusion coefficient, DCE = dynamic contrast-enhanced, T1WI = T1-weighted.Figure 1.Download as PowerPointOpen in Image Viewer Figure 2. Upstaged cancer in a patient who had normal results at baseline conventional MRI (not shown) performed for high-risk staging of a recently diagnosed Gleason grade 9 prostate adenocarcinoma (T3N0; prostate-specific antigen level of 7.0 ng/dL). Coronal (A) and axial (B) gallium 68–PSMA PET/CT images show foci of uptake in lymph nodes of the right internal iliac (yellow arrow) and left para-aortic (red arrows) chains. The cancer was upstaged to T3N1M1. Physiologic uptake is seen in the liver, kidneys, bladder, and bowel (white arrows).Figure 2.Download as PowerPointOpen in Image Viewer Disclosures of conflicts of interest.—S.G. Grant from the University Health Network, Toronto.AcknowledgmentThe authors would like to express their deepest gratitude to Joanne Chin, MFA, ELS, for her editorial support for this article.Supported in part by a Cancer Center Support Grant from the National Cancer Institute (P30 CA008748).Presented as an education exhibit at the 2020 RSNA Annual MeetingS.G. has provided disclosures (see end of article); all other authors have disclosed no relevant relationships.Suggested Readings Ahdoot M, Lebastchi AH, Long L, et al . Using Prostate Imaging-Reporting and Data System (PI-RADS) Scores to Select an Optimal Prostate Biopsy Method: A Secondary Analysis of the Trio Study . Eur Urol Oncol 2021 . https://doi.org/10.1016/j.euo.2021.03.004. Published online April 10, 2021. Google Scholar Ahmed HU, El-Shater Bosaily A, Brown LC, et al . Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study . Lancet 2017 ; 389 ( 10071 ): 815 – 822 . Crossref, Medline, Google Scholar Hofman MS, Lawrentschuk N, Francis RJ, et al . Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study . Lancet 2020 ; 395 ( 10231 ): 1208 – 1216 . Crossref, Medline, Google Scholar Stonier T, Simson N, Shah T, et al . The “Is mpMRI Enough” or IMRIE Study: A Multicentre Evaluation of Prebiopsy Multiparametric Magnetic Resonance Imaging Compared with Biopsy . Eur Urol Focus 2021 ; 7 ( 5 ): 1027 – 1034 . Crossref, Medline, Google ScholarArticle HistoryReceived: Apr 18 2021Revision requested: May 29 2021Revision received: July 11 2021Accepted: July 15 2021Published online: May 27 2022Published in print: July 2022 FiguresReferencesRelatedDetailsAccompanying This ArticleProstate Cancer Imaging: What We Already Know and What Is on the Horizon27 May 2022Default Digital Object SeriesRecommended Articles Current Imaging Techniques for and Imaging Spectrum of Prostate Cancer Recurrence and Metastasis: A Pictorial ReviewRadioGraphics2020Volume: 40Issue: 3pp. 709-726Review of 18F-Fluciclovine PET for Detection of Recurrent Prostate CancerRadioGraphics2019Volume: 39Issue: 3pp. 822-841Revisiting Prostate Cancer Recurrence with PSMA PET: Atlas of Typical and Atypical Patterns of SpreadRadioGraphics2019Volume: 39Issue: 1pp. 186-212Prostate-specific Membrane Antigen PET: Therapy Response Assessment in Metastatic Prostate CancerRadioGraphics2020Volume: 40Issue: 5pp. 1412-1430Prostate MRI in Stereotactic Body Radiation Treatment Planning and Delivery for Localized Prostate CancerRadioGraphics2022Volume: 42Issue: 4pp. 1251-1264See More RSNA Education Exhibits Prostate Cancer: What We Already Know About What Is on the HorizonDigital Posters2020Current Status and Future Perspective of Molecular Imaging Studies in Prostate CancerDigital Posters2018PET Imaging in Oncology: An Updated Review of Evidence-based IndicationsDigital Posters2020 RSNA Case Collection Locally advanced, metastatic prostate adenocarcinomaRSNA Case Collection2020Hydrogel infiltration into rectal wallRSNA Case Collection2020Radioembolization of Liver Metastasis RSNA Case Collection2020 Vol. 42, No. 4 Slide PresentationAbbreviations Abbreviations: mpMRI multiparametric MRI PSMA prostate-specific membrane antigen Metrics Downloaded 3,230 times Altmetric Score PDF download 

Prostate Cancer Imaging: What We Already Know and What Is on the Horizon.

Poster: "ECR 2019 / C-1732 / Spectrum of clinical and imaging findings in patients with serological diagnosis of H1N1 and its correlation with clinical severity " by: "K. Schoen1, N. Horvat2, N. F. C. Guerreiro 2, I. de Castro2, K. Giassi2; 1Sao Paulo, Parana/BR, 2Sao Paulo/BR"

Karla Schoen

Papers

Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity.

Hepatocellular carcinoma in an adult with Alagille syndrome: case report and literature review.

Prostate Cancer Imaging: What We Already Know and What Is on the Horizon.

Spectrum of clinical and imaging findings in patients with serological diagnosis of H1N1 and its correlation with clinical severity