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新型冠状病毒肺炎感染中的多器官受累:放射科医生从头到脚的作用

Multiorgan Involvement in SARS-CoV-2 Infection: The Role of the Radiologist from Head to Toe.

作者信息

Ippolito Davide, Vernuccio Federica, Maino Cesare, Cannella Roberto, Giandola Teresa, Ragusi Maria, Bigiogera Vittorio, Capodaglio Carlo, Sironi Sandro

机构信息

Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy.

School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB, Italy.

出版信息

Diagnostics (Basel). 2022 May 10;12(5):1188. doi: 10.3390/diagnostics12051188.

Abstract

Radiology plays a crucial role for the diagnosis and management of COVID-19 patients during the different stages of the disease, allowing for early detection of manifestations and complications of COVID-19 in the different organs. Lungs are the most common organs involved by SARS-CoV-2 and chest computed tomography (CT) represents a reliable imaging-based tool in acute, subacute, and chronic settings for diagnosis, prognosis, and management of lung disease and the evaluation of acute and chronic complications. Cardiac involvement can be evaluated by using cardiac computed tomography angiography (CCTA), considered as the best choice to solve the differential diagnosis between the most common cardiac conditions: acute coronary syndrome, myocarditis, and cardiac dysrhythmia. By using compressive ultrasound it's possible to study the peripheral arteries and veins and to exclude the deep vein thrombosis, directly linked to the onset of pulmonary embolism. Moreover, CT and especially MRI can help to evaluate the gastrointestinal involvement and assess hepatic function, pancreas involvement, and exclude causes of lymphocytopenia, thrombocytopenia, and leukopenia, typical of COVID-19 patients. Finally, radiology plays a crucial role in the early identification of renal damage in COVID-19 patients, by using both CT and US. This narrative review aims to provide a comprehensive radiological analysis of commonly involved organs in patients with COVID-19 disease.

摘要

在新冠病毒病(COVID-19)患者疾病的不同阶段,放射学对于其诊断和管理起着至关重要的作用,能够早期发现COVID-19在不同器官中的表现及并发症。肺是严重急性呼吸综合征冠状病毒2(SARS-CoV-2)最常累及的器官,胸部计算机断层扫描(CT)是在急性、亚急性和慢性情况下用于诊断、预后评估及管理肺部疾病以及评估急慢性并发症的可靠的基于影像的工具。心脏受累情况可通过心脏计算机断层扫描血管造影(CCTA)进行评估,CCTA被认为是解决最常见心脏疾病(急性冠状动脉综合征、心肌炎和心律失常)之间鉴别诊断的最佳选择。通过使用超声压迫法可以研究外周动静脉,并排除与肺栓塞发病直接相关的深静脉血栓形成。此外,CT尤其是磁共振成像(MRI)有助于评估胃肠道受累情况,并评估肝功能、胰腺受累情况,排除COVID-19患者典型的淋巴细胞减少、血小板减少和白细胞减少的原因。最后,通过CT和超声检查,放射学在早期识别COVID-19患者的肾损伤方面起着至关重要的作用。本叙述性综述旨在对COVID-19患者常见受累器官进行全面的放射学分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4444/9140872/a3a1e5b83636/diagnostics-12-01188-g001.jpg

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