Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama, Kanagawa, 236-8651, Japan.
Department of Diagnostic Radiology, School of Medicine, Yokohama City University, 3 Chome-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Jpn J Radiol. 2021 May;39(5):451-458. doi: 10.1007/s11604-020-01085-2. Epub 2021 Jan 27.
To assess the relationships among pulmonary vascular enlargement, computed tomography (CT) findings quantified with software, and coronavirus disease (COVID-19) severity.
Ultra-high-resolution (UHR) CT images of 87 patients (50 males, 37 females; median age, 63 years) with COVID-19 confirmed using real-time polymerase chain reaction were analyzed. The maximum subsegmental vascular diameter was measured on CT. Total CT lung volume (CTLV total) and lesion extent (ratio of lesion volume to CTLV total) of ground-glass opacities, reticulation, and consolidation were measured using software. Maximum pulmonary vascular diameter and lesion extent were analyzed using Spearman's correlation analysis. Logistic regression analysis was performed on CT results to predict disease severity. We also assessed changes in these measures on follow-up scans in 16 patients.
All 23 patients with severe and critical illness had vascular enlargement (> 4 mm). Pulmonary vascular enlargement (odds ratio 3.05, p = 0.018) and CT lesion extent (odds ratio 1.07, p = 0.002) were independent predictors of disease severity after adjustment for age and comorbidities. On follow-up CT, vascular diameter and CT lesion volume decreased (p = 0.001, p = 0.002; respectively), but CTLV total did not change significantly.
Subsegmental vascular enlargement is a notable finding to predict acute COVID-19 disease severity.
评估肺血管扩张、使用软件定量的计算机断层扫描（CT）结果与冠状病毒病（COVID-19）严重程度之间的关系。
对 87 例经实时聚合酶链反应证实的 COVID-19 患者（50 名男性，37 名女性；中位年龄 63 岁）的超高分辨率（UHR）CT 图像进行分析。在 CT 上测量最大亚段血管直径。使用软件测量磨玻璃影、网状影和实变的总 CT 肺容积（CTLV 总）和病变程度（病变体积与 CTLV 总之比）。采用 Spearman 相关分析对最大肺血管直径和病变程度进行分析。对 CT 结果进行逻辑回归分析以预测疾病严重程度。我们还评估了 16 例患者的随访扫描中这些指标的变化。
23 例重症和危重症患者均存在血管扩张（>4mm）。血管扩张（比值比 3.05，p=0.018）和 CT 病变程度（比值比 1.07，p=0.002）是调整年龄和合并症后疾病严重程度的独立预测因素。在随访 CT 上，血管直径和 CT 病变体积减少（p=0.001，p=0.002；分别），但 CTLV 总无明显变化。
亚段血管扩张是预测急性 COVID-19 疾病严重程度的显著发现。
Zotero 插件
