Chest computed tomography findings in different phases of SARS-CoV-2 infection. / Hallazgos en la tomografía computarizada de tórax en las fases evolutivas de la infección por SARS-CoV-2.

OBJECTIVE: To compare the findings on chest computed tomography (CT) in patients with COVID-19 during different phases of the disease and to evaluate the reproducibility of a visual radiologic score for estimating the extent of lung involvement. METHODS: We retrospectively reviewed chest CT studies from 182 patients with RT-PCR findings positive for SARS-CoV-2. Patients were classified according to the time elapsed from the onset of symptoms, as follows: early (0-4 days), intermediate/progressive (5-9 days), or advanced (≥10 days). We analyzed the frequency of each radiologic finding, as well as the pattern, appearance, and predominant distribution of lung involvement. A visual tomographic score (range, 0-25) was used to estimate the extent of involvement in each lobe and in the total lung volume. RESULTS: The predominant CT finding was the ground-glass pattern (n=110; 60.4%), the most common distribution was peripheral (n = 116; 66.7%), and the most prevalent appearance was typical (n=112; 61.5%). The halo sign was seen most frequently in the early phase (25%), whereas ground-glass opacities were more common in the intermediate/progressive and advanced phases. The median severity score was 10 (IQR: 5-13), and the scores increased as the disease progressed. The interobserver agreement (kappa) was 0.92 for the appearance, 0.84 for the distribution, 0.70 for the predominant pattern, and 0.89 for the visual score. CONCLUSION: The CT findings in patients with COVID-19 vary with the course of the infection. The proposed visual radiologic score is a simple, reproducible, and reliable tool for assessing lung involvement in COVID-19 pneumonia.

[Chest computed tomography findings in different phases of SARS-CoV-2 infection]. / Hallazgos en la tomografía computarizada de tórax en las fases evolutivas de la infección por SARS-CoV-2.

Objective: To compare the findings on chest computed tomography (CT) in patients with COVID-19 during different phases of the disease and to evaluate the reproducibility of a visual radiologic score for estimating the extent of lung involvement. Methods: We retrospectively reviewed chest CT studies from 182 patients with RT-PCR findings positive for SARS-CoV-2. Patients were classified according to the time elapsed from the onset of symptoms, as follows: early (0-4 days), intermediate/progressive (5-9 days), or advanced (≥10 days). We analyzed the frequency of each radiologic finding, as well as the pattern, appearance, and predominant distribution of lung involvement. A visual tomographic score (range, 0-25) was used to estimate the extent of involvement in each lobe and in the total lung volume. Results: The predominant CT finding was the ground-glass pattern (n=110; 60.4%), the most common distribution was peripheral (n = 116; 66.7%), and the most prevalent appearance was typical (n=112; 61.5%). The halo sign was seen most frequently in the early phase (25%), whereas ground-glass opacities were more common in the intermediate/progressive and advanced phases. The median severity score was 10 (IQR: 5-13), and the scores increased as the disease progressed. The interobserver agreement (kappa) was 0.92 for the appearance, 0.84 for the distribution, 0.70 for the predominant pattern, and 0.89 for the visual score. Conclusion: The CT findings in patients with COVID-19 vary with the course of the infection. The proposed visual radiologic score is a simple, reproducible, and reliable tool for assessing lung involvement in COVID-19 pneumonia.

Talleres prácticos de ecografía para estudiantes de Medicina como método de enseñanza de conceptos básicos de semiología ecográfica / Practical ultrasound workshops to teach medical students basic concepts of ultrasound semiology

OBJETIVOS: Evaluar la efectividad de los talleres prácticos de ecografía en la adquisición y afianzamiento de conceptos de física y semiología ecográfica básica, dirigidos a estudiantes del módulo de exploración física en el tercer año del grado de Medicina. MATERIAL Y MÉTODOS: Se impartieron talleres prácticos de ecografía a dos grupos de 177 y 175 alumnos durante dos cursos académicos consecutivos. Todos ellos habían cursado una asignatura de radiología básica durante el curso académico anterior. Los estudiantes realizaron exploraciones ecográficas entre ellos, bajo supervisión, en una sesión práctica de 2 horas de duración. Se realizó un examen antes de empezar el taller y, nuevamente, al concluir este. El examen constaba de siete preguntas de elección múltiple sobre semiología básica y de dos preguntas que evaluaban del 1 al 10 el grado de confianza al interpretar imágenes ecográficas y al manejar un ecógrafo. RESULTADOS: No se encontraron diferencias estadísticamente significativas en las puntaciones obtenidas entre ambos cursos (p >0,05). En conjunto, la puntuación media del cuestionario inicial fue del 59,71%, que mejoró de forma significativa hasta el 88,29% tras el taller (p < 0,01). La confianza inicial en la interpretación de imágenes y en el manejo del ecógrafo fue de 3,39/10 y 3,73/10, respectivamente. Después del taller mejoró significativamente hasta los 6,28/10 y 6,51/10, respectivamente (p <0,01). CONCLUSIÓN: Los talleres prácticos demostraron ser útiles en el aprendizaje de conceptos básicos de ecográfica, logrando una mejoría significativa en la puntuación final del cuestionario. Los estudiantes partieron con un bajo nivel de confianza en la interpretación de imágenes y manejo de un ecógrafo, el cual también mejoró significativamente

OBJECTIVES: To evaluate the effectiveness of practical ultrasound workshops for the acquisition and consolidation of conceptual learning about the basic physics and semiology of ultrasonography aimed at third-year medical school students doing the physical examination module of their studies. MATERIAL AND METHODS: We carried out practical ultrasound workshops with two groups of 177 and 175 students in two consecutive academic years. All students had taken a class in basic radiology in the previous year. Students examined each other with ultrasonography under instructors' supervision in a two-hour session. Before and after the workshop, students did a seven-question multiple-choice test about basic semiology and answered two questions evaluating their degree of confidence in interpreting ultrasonographic images and handling the ultrasound scanner on a scale from 1 to 10. RESULTS: No significant differences were found between the scores obtained in the two groups. Overall, the mean score on the multiple-choice test improved from 59.71% on the initial assessment to 88.29% on the post-workshop assessment (p <0.01). Confidence in interpreting images improved from 3.39/10 to 6.28/10 (p <0.01), and confidence in handling the equipment improved from 3.73/10 to 6.51/10 (p <0.01). CONCLUSION: Practical workshops were useful for learning basic concepts about ultrasound imaging, allowing students to significantly improve their scores on the multiple-choice test. Students had a low level of confidence in their ability to interpret ultrasound images and handle the equipment before starting the workshop, but their confidence improved significantly after completing the workshop

Hallazgos ecográficos transitorios y normales en el postoperatorio inmediato del trasplante hepático / Normal and transitory ultrasonography findings in the immediate postoperative period after liver transplantation

OBJETIVO: El trasplante hepático es uno de los tratamientos de la hepatopatía crónica en estadios avanzados y pacientes seleccionados con tumores hepáticos. La ecografía es la técnica de imagen de elección para su evaluación. En este trabajo se revisan la técnica quirúrgica, la anatomía del trasplante hepático y los hallazgos ecográficos normales en el postoperatorio inmediato, que servirán de referencia para evaluaciones posteriores. CONCLUSIÓN: Las complicaciones vasculares tempranas (arteriales y portales) pueden suponer una amenaza para el injerto o el paciente. Tras el trasplante hepático existe un periodo de adaptación del injerto al nuevo medio y de recuperación posquirúrgica en el que podemos observar alteraciones parenquimatosas o hallazgos en el estudio Doppler que difieren de los habituales y se pueden considerar como normales en esta situación; generalmente son transitorios. Su conocimiento e interpretación es clave para detectar o excluir complicaciones

OBJECTIVE: Liver transplantation is one of the treatments for patients with advanced stage chronic liver disease and for selected patients with hepatic tumors. Ultrasonography is the first-choice imaging technique to evaluate liver transplants. This article reviews the surgical technique, anatomy, and normal findings on ultrasonography in the immediate postoperative period in patients who have undergone liver transplantation, which will be used as a reference in follow-up studies. CONCLUSION: Early vascular (arterial and portal) complications can represent a threat for the graft or the patient. During the period after liver transplantation, the patient is recovering from surgery and the transplanted organ is adapting to its new environment. In this period, ultrasonography can show alterations in the parenchyma or Doppler findings that would be considered abnormal in other situations; these findings are usually transitory. Knowing how to interpret them is key to detecting or ruling out complications

Practical ultrasound workshops to teach medical students basic concepts of ultrasound semiology. / Talleres prácticos de ecografía para estudiantes de Medicina como método de enseñanza de conceptos básicos de semiología ecográfica.

OBJECTIVES: To evaluate the effectiveness of practical ultrasound workshops for the acquisition and consolidation of conceptual learning about the basic physics and semiology of ultrasonography aimed at third-year medical school students doing the physical examination module of their studies. MATERIAL AND METHODS: We carried out practical ultrasound workshops with two groups of 177 and 175 students in two consecutive academic years. All students had taken a class in basic radiology in the previous year. Students examined each other with ultrasonography under instructors' supervision in a two-hour session. Before and after the workshop, students did a seven-question multiple-choice test about basic semiology and answered two questions evaluating their degree of confidence in interpreting ultrasonographic images and handling the ultrasound scanner on a scale from 1 to 10. RESULTS: No significant differences were found between the scores obtained in the two groups. Overall, the mean score on the multiple-choice test improved from 59.71% on the initial assessment to 88.29% on the post-workshop assessment (p <0.01). Confidence in interpreting images improved from 3.39/10 to 6.28/10 (p <0.01), and confidence in handling the equipment improved from 3.73/10 to 6.51/10 (p <0.01). CONCLUSION: Practical workshops were useful for learning basic concepts about ultrasound imaging, allowing students to significantly improve their scores on the multiple-choice test. Students had a low level of confidence in their ability to interpret ultrasound images and handle the equipment before starting the workshop, but their confidence improved significantly after completing the workshop.

Normal and transitory ultrasonography findings in the immediate postoperative period after liver transplantation. / Hallazgos ecográficos transitorios y normales en el postoperatorio inmediato del trasplante hepático.

OBJECTIVE: Liver transplantation is one of the treatments for patients with advanced stage chronic liver disease and for selected patients with hepatic tumors. Ultrasonography is the first-choice imaging technique to evaluate liver transplants. This article reviews the surgical technique, anatomy, and normal findings on ultrasonography in the immediate postoperative period in patients who have undergone liver transplantation, which will be used as a reference in follow-up studies. CONCLUSION: Early vascular (arterial and portal) complications can represent a threat for the graft or the patient. During the period after liver transplantation, the patient is recovering from surgery and the transplanted organ is adapting to its new environment. In this period, ultrasonography can show alterations in the parenchyma or Doppler findings that would be considered abnormal in other situations; these findings are usually transitory. Knowing how to interpret them is key to detecting or ruling out complications.