Marginean Cristina Maria, Popescu Mihaela, Vasile Corina Maria, Cioboata Ramona, Mitrut Paul, Popescu Iulian Alin Silviu, Biciusca Viorel, Docea Anca Oana, Mitrut Radu, Marginean Iulia Cristina, Iacob George Alexandru, Neagoe Daniela
Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Endocrinology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Diagnostics (Basel). 2022 Nov 16;12(11):2823. doi: 10.3390/diagnostics12112823.
COVID-19 pneumonia represents a maximum medical challenge due to the virus's high contagiousness, morbidity, and mortality and the still limited possibilities of the health systems. The literature has primarily focused on the diagnosis, clinical-radiological aspects of COVID-19 pneumonia, and the most common possible differential diagnoses. Still, few studies have investigated the rare differential diagnoses of COVID-19 pneumonia or its overlap with other pre-existing lung pathologies. This article presents the main radiological features of COVID-19 pneumonia and the most common alternative diagnoses to establish the vital radiological criteria for a differential diagnosis between COVID-19 pneumonia and other lung pathologies with similar imaging appearance. The differential diagnosis of COVID-19 pneumonia is challenging because there may be standard radiologic features such as ground-glass opacities, crazy paving patterns, and consolidations. A multidisciplinary approach is crucial to define a correct final diagnosis, as an overlap of COVID-19 pneumonia with pre-existing lung diseases is often possible and suggests possible differential diagnoses. An optimal evaluation of HRTC can help limit the clinical evolution of the disease, promote therapy for patients and ensure an efficient allocation of human and economic resources.
由于新冠病毒具有高传染性、高发病率和高死亡率，且卫生系统应对手段仍有限，新冠肺炎给医学带来了极大挑战。文献主要聚焦于新冠肺炎的诊断、临床放射学特征以及最常见的鉴别诊断。然而，很少有研究探讨新冠肺炎罕见的鉴别诊断或其与其他已存在的肺部病变的重叠情况。本文介绍了新冠肺炎的主要放射学特征以及最常见的其他诊断，以确立新冠肺炎与其他具有相似影像学表现的肺部病变进行鉴别诊断的关键放射学标准。新冠肺炎的鉴别诊断具有挑战性，因为可能存在磨玻璃影、铺路石样改变和实变等典型放射学特征。多学科方法对于明确正确的最终诊断至关重要，因为新冠肺炎与已存在的肺部疾病常常重叠，这提示了可能的鉴别诊断。对高分辨率CT的最佳评估有助于限制疾病的临床进展，促进患者治疗，并确保人力和经济资源的有效分配。
