Visualizing techniques for new coronavirus infection: Focus on computed tomography. experience of the city clinical hospital no. 15 named after O.M. Filatov

ABSTRACT

The first case of Coronavirus pneumonia (COVID-19) was detected in Wuhan, China, but the disease became a pandemic and health-care institutions in the Russian Federation faced confirmed cases of COVID-19. Objective. To describe the possibilities of imaging techniques with a focus on multispiral computed tomography (MSCT), as well as a dynamic analysis of pathology manifestations in patients hospitalized in Clinical Hospital No. 15 named after O.M. Filatov with a confirmed coronavirus infection. Material and methods. The retrospective study collected data from 300 patients with confirmed coronavirus infection from one of the largest multidisciplinary hospitals in the Russian Federation. General clinical manifestations were analyzed, as well as characteristics and features of the development of changes, revealed mainly by MSCT of the chest. Results. Examined 300 patients with PCR-confirmed COVID-19. Among the clinical manifestations, coughing, fever, shortness of breath prevailed. Most of the changes identified in pulmonary MSCT were polysegmental and bilateral in nature of the lesion, were more likely to be localized in the peripheral departments, 235 (78%) patients had more than two lobes involved in the pathological process, 263 (87.7%) patients had focal points of pulmonary tissue compaction by «frosted glass» type, and the combination of the above manifestations with the presence of consolidation foci and reticular changes was noted in 129 (43%) among the complications, there were more frequent thickening of the pleura, hydrothorax, less often pneumothorax, and in rare cases, the empyema of pleura. When monitoring lung MSCT in 300 patients, rapid development of positive dynamics (on average, 5—7 days) was noted in 95 (31.6%) patients, 40 (13.2%) patients showed multidirectional dynamics, progression (CT stage in-creases) was observed in 111 (37%) cases, in 54 (18.2%) cases there were no significant changes in the dynamics of the X-ray pat-tern. Conclusions. Lung MSCT plays a key role in the diagnosis of COVID-19. The appearance of specific zones of pulmonary tissue compaction in the form of a «frosted glass», as a manifestation of a one-sided or two-sided, mono-or polyphocal lung lesion, can with a high probability indicate a manifestation of COVID-19 with a possible rapid progression of the X-ray pattern in a short period of time.