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Chest radiography findings of COVID-19 pneumonia: a specific pattern for a confident differential diagnosis.
Landini, Nicholas; Colzani, Giulia; Ciet, Pierluigi; Tessarin, Giovanni; Dorigo, Alberto; Bertana, Luca; Felice, Carla; Scaldaferri, Luca; Orlandi, Martina; Nardi, Cosimo; Romagnoli, Micaela; Saba, Luca; Rigoli, Roberto; Morana, Giovanni.
  • Landini N; Department of Radiology, Ca' Foncello General Hospital, Treviso, Italy.
  • Colzani G; Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit no. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
  • Ciet P; Department of Radiology, Ca' Foncello General Hospital, Treviso, Italy.
  • Tessarin G; Department of Radiology and Nuclear Medicine, 6993Erasmus MC, Rotterdam, The Netherlands.
  • Dorigo A; Department of Radiology and Nuclear Medicine, 6993Erasmus MC, Rotterdam, The Netherlands.
  • Bertana L; Department of Pediatric Pulmonology and Allergology, 6993Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
  • Felice C; Department of Radiology and Department of Medical Science, 60276University of Cagliari, Cagliari, Italy.
  • Scaldaferri L; Department of Radiology, Ca' Foncello General Hospital, Treviso, Italy.
  • Orlandi M; Department of Medicine-DIMED, Institute of Radiology, 60242University of Padova, Padua, Italy.
  • Nardi C; Department of Radiology, Ca' Foncello General Hospital, Treviso, Italy.
  • Romagnoli M; Department of Radiology, Ca' Foncello General Hospital, Treviso, Italy.
  • Saba L; Department of Medicine (DIMED), University of Padua, Medicine 1, 18703Ca' Foncello General Hospital, Treviso, Italy.
  • Rigoli R; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy.
  • Morana G; Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Acta Radiol ; : 2841851211055163, 2021 Nov 13.
Article in English | MEDLINE | ID: covidwho-1511628
ABSTRACT

BACKGROUND:

Chest radiography (CR) patterns for the diagnosis of COVID-19 have been established. However, they were not ideated comparing CR features with those of other pulmonary diseases.

PURPOSE:

To create the most accurate COVID-19 pneumonia pattern comparing CR findings of COVID-19 and non-COVID-19 pulmonary diseases and to test the model against the British Society of Thoracic Imaging (BSTI) criteria. MATERIAL AND

METHODS:

CR of COVID-19 and non-COVID-19 pulmonary diseases, admitted to the emergency department, were evaluated. Assessed features were interstitial opacities, ground glass opacities, and/or consolidations and the predominant lung alteration. We also assessed uni-/bilaterality, location (upper/middle/lower), and distribution (peripheral/perihilar), as well as pleural effusion and perihilar vessels blurring. A binary logistic regression was adopted to obtain the most accurate CR COVID-19 pattern, and sensitivity and specificity were computed. The newly defined pattern was compared to BSTI criteria.

RESULTS:

CR of 274 patients were evaluated (146 COVID-19, 128 non-COVID-19). The most accurate COVID-19 pneumonia pattern consisted of four features bilateral alterations (Expß=2.8, P=0.002), peripheral distribution of the predominant (Expß=2.3, P=0.013), no pleural effusion (Expß=0.4, P=0.009), and perihilar vessels' contour not blurred (Expß=0.3, P=0.002). The pattern showed 49% sensitivity, 81% specificity, and 64% accuracy, while BSTI criteria showed 51%, 77%, and 63%, respectively.

CONCLUSION:

Bilaterality, peripheral distribution of the predominant lung alteration, no pleural effusion, and perihilar vessels contour not blurred determine the most accurate COVID-19 pneumonia pattern. Lower field involvement, proposed by BSTI criteria, was not a distinctive finding. The BSTI criteria has lower specificity.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Prognostic study Language: English Journal: Acta Radiol Year: 2021 Document Type: Article Affiliation country: 02841851211055163

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Prognostic study Language: English Journal: Acta Radiol Year: 2021 Document Type: Article Affiliation country: 02841851211055163