University of Health Sciences İstanbul Ümraniye Training and Research Hospital, Pediatric Radiology, İstanbul, Turkey.
Br J Radiol. 2022 Aug 1;95(1136):20220101. doi: 10.1259/bjr.20220101. Epub 2022 Jul 7.
To retrospectively evaluate the imaging and clinical findings of patients diagnosed with multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19.
The clinical, laboratory and radiological data of 110 patients (74 male and 36 female) diagnosed with COVID-19-related MIS-C between June 2020 and November 2021 were evaluated retrospectively. Cases with a diagnosis of MIS-C based on a positive real time polymerase chain reaction (RT-PCR) test or serology results according to the WHO criteria were included in the study. All the radiological data were evaluated by a pediatric radiologist with 14 years of radiology experience.
Peribronchial thickening and hyperinflation were the most common findings on chest X-ray, while atelectasis and pleural effusion were often present in thoracic CT. Cardiac involvement was detected in 30% of the patients, mainly with valve insufficiency and systolic dysfunction, and 7.2% of these patients had sequalae findings. The most common abdominal findings were hepatosplenomegaly, mesenteric inflammation, lymphadenomegaly, thickening of the intestinal walls and free fluid. 23 of the patients had comorbidities. Neurological radiological findings observed in a total of six patients were reversible splenial lesion syndrome, posterior reversible encephalopathy syndrome, meningitis, and cerebral edema. 37 patients were followed up in the intensive care unit and 2 of them died.
Radiological findings seen in MIS-C vary according to the affected system. There is no specific radiologic finding for this disease, but radiological findings can assist in the evaluation of affected systems and guide treatment.
Since there are few studies with a limited number of patients in the literature, data on this subject are limited. We aimed to contribute to the literature with our large patient data.
回顾性评估与 COVID-19 相关的儿童多系统炎症综合征 (MIS-C) 患者的影像学和临床发现。
回顾性评估了 2020 年 6 月至 2021 年 11 月期间诊断为 COVID-19 相关 MIS-C 的 110 例患者(74 例男性和 36 例女性)的临床、实验室和影像学数据。本研究纳入了根据世界卫生组织 (WHO) 标准通过实时聚合酶链反应 (RT-PCR) 检测或血清学结果确诊为 MIS-C 的病例。所有影像学数据均由具有 14 年放射学经验的儿科放射科医生进行评估。
胸部 X 线最常见的表现为支气管周围增厚和过度充气,而胸部 CT 常显示肺不张和胸腔积液。30%的患者存在心脏受累,主要表现为瓣膜功能不全和收缩功能障碍,其中 7.2%的患者存在后遗症。最常见的腹部表现为肝脾肿大、肠系膜炎症、淋巴结肿大、肠壁增厚和游离液体。23 例患者存在合并症。共有 6 例患者存在神经系统影像学表现,包括可逆性胼胝体病变综合征、后部可逆性脑病综合征、脑膜炎和脑水肿。37 例患者在重症监护病房接受随访,其中 2 例死亡。
MIS-C 的影像学表现因受累系统而异。这种疾病没有特定的影像学表现,但影像学表现可以帮助评估受累系统并指导治疗。
由于文献中此类疾病的研究较少且患者数量有限,因此该领域的数据有限。我们旨在通过大量患者数据为文献做出贡献。