Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY. 1 Gustave L. Levy Pl, Bix 1234, New York, NY 10029, United States of America.
Clin Imaging. 2020 Aug;64:35-42. doi: 10.1016/j.clinimag.2020.04.001. Epub 2020 Apr 8.
As the global pandemic of coronavirus disease-19 (COVID-19) progresses, many physicians in a wide variety of specialties continue to play pivotal roles in diagnosis and management. In radiology, much of the literature to date has focused on chest CT manifestations of COVID-19 (Zhou et al. [1]; Chung et al. [2]). However, due to infection control issues related to patient transport to CT suites, the inefficiencies introduced in CT room decontamination, and lack of CT availability in parts of the world, portable chest radiography (CXR) will likely be the most commonly utilized modality for identification and follow up of lung abnormalities. In fact, the American College of Radiology (ACR) notes that CT decontamination required after scanning COVID-19 patients may disrupt radiological service availability and suggests that portable chest radiography may be considered to minimize the risk of cross-infection (American College of Radiology [3]). Furthermore, in cases of high clinical suspicion for COVID-19, a positive CXR may obviate the need for CT. Additionally, CXR utilization for early disease detection may also play a vital role in areas around the world with limited access to reliable real-time reverse transcription polymerase chain reaction (RT-PCR) COVID testing. The purpose of this pictorial review article is to describe the most common manifestations and patterns of lung abnormality on CXR in COVID-19 in order to equip the medical community in its efforts to combat this pandemic.
随着全球冠状病毒疾病 19 型(COVID-19)大流行的进展,许多不同专业的医生继续在诊断和管理方面发挥关键作用。在放射学中,迄今为止,大量文献主要集中在 COVID-19 的胸部 CT 表现上(Zhou 等人,[1];Chung 等人,[2])。然而,由于与将患者转运至 CT 套房相关的感染控制问题、CT 室消毒带来的效率低下以及世界部分地区缺乏 CT,便携式胸部 X 线摄影(CXR)可能是识别和随访肺部异常最常用的方式。事实上,美国放射学会(ACR)指出,COVID-19 患者扫描后需要进行 CT 消毒,这可能会破坏放射科服务的可用性,并建议考虑使用便携式胸部 X 线摄影,以最大限度地降低交叉感染的风险(美国放射学会,[3])。此外,对于 COVID-19 的高度临床怀疑,阳性 CXR 可能可以避免 CT 的需要。此外,在世界上某些难以获得可靠实时逆转录聚合酶链反应(RT-PCR)COVID 检测的地区,CXR 的早期疾病检测的应用也可能在对抗这一大流行方面发挥重要作用。本影像学综述文章旨在描述 COVID-19 患者的 CXR 上最常见的肺部异常表现和模式,以便为医学界抗击这一大流行提供帮助。