Department of Biomedical Imaging, University of Malaya Research Imaging Centre, Kuala Lumpur, Malaysia.
Department of Medicine, Faculty of Medicine and Health Science, University Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.
Curr Med Imaging. 2021;17(6):677-685. doi: 10.2174/1573405616666201231103312.
Coronavirus disease 2019 (COVID-19) is highly contagious and has claimed more than one million lives, besides causing hardship and disruptions. The Fleischner Society has recommended chest X-ray (CXR) in detecting cases at high risk of disease progression, for triaging suspected patients with moderate-to-severe illness, and for eliminating false negatives in areas with high pre-test probability or limited resources. Although CXR is less sensitive than real-- time reverse transcription-polymerase chain reaction (RT-PCR) in detecting mild COVID-19, it is nevertheless useful because of equipment portability, low cost and practicality in serial assessments of disease progression among hospitalized patients.
This study aims to review the typical and relatively atypical CXR manifestations of COVID-19 pneumonia in a tertiary care hospital.
The CXRs of 136 COVID-19 patients confirmed through real-time RT-PCR from March to May 2020 were reviewed. A literature search was performed using PubMed.
A total of 54 patients had abnormal CXR whilst the others were normal. Typical CXR findings included pulmonary consolidation or ground-glass opacities in a multifocal, bilateral peripheral, or lower zone distribution, whereas atypical CXR features comprised cavitation and pleural effusion.
Typical findings of COVID-19 infection in chest computed tomography studies can also be seen in CXR. The presence of atypical features associated with worse disease outcome. Recognition of these features on CXR will improve the accuracy and speed of diagnosing COVID-19 patients.
2019 年冠状病毒病（COVID-19）具有高度传染性，已导致超过 100 万人死亡，并造成困难和混乱。弗莱舍纳学会（Fleischner Society）建议使用胸部 X 线（CXR）来检测疾病进展风险高的病例，对疑似中度至重度疾病的患者进行分类，并消除高预测试概率或资源有限地区的假阴性结果。尽管 CXR 在检测轻度 COVID-19 方面的敏感性不如实时逆转录聚合酶链反应（RT-PCR），但由于设备便携性、低成本以及对住院患者疾病进展进行连续评估的实用性，它仍然具有重要意义。
本研究旨在回顾三级护理医院中 COVID-19 肺炎的典型和相对非典型 CXR 表现。
对 2020 年 3 月至 5 月通过实时 RT-PCR 确诊的 136 例 COVID-19 患者的 CXR 进行了回顾。使用 PubMed 进行了文献检索。
共有 54 例患者的 CXR 异常，其余患者正常。典型 CXR 表现包括肺部实变或磨玻璃影呈多灶性、双侧外周性或下叶分布，而非典型 CXR 特征包括空洞和胸腔积液。
胸部计算机断层扫描研究中 COVID-19 感染的典型表现也可见于 CXR。存在与疾病预后不良相关的非典型特征。在 CXR 上识别这些特征将提高 COVID-19 患者诊断的准确性和速度。
