Westmead Hospital, Sydney, New South Wales, Australia.
Infectious Diseases & Microbiology, Westmead Hospital, Sydney, New South Wales, Australia.
J Med Radiat Sci. 2023 Mar;70(1):40-45. doi: 10.1002/jmrs.642. Epub 2023 Jan 2.
The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 has resulted in a global healthcare crisis. The provision of computed tomography (CT) imaging services by radiology departments for COVID-19 patients poses multiple challenges. Consequently, it is important to explore the clinical need and indications for thoracic CT and whether they subsequently alter patient management.
We report our experience in this single-centre retrospective cohort study of all confirmed COVID-19 cases admitted during the peak of the 'Delta' variant wave in Australia, and who underwent a chest CT. Clinical indication and patient management plan pre- and post-CT were ascertained.
A total of 92 out of 1403 patients who were admitted with COVID-19 underwent a thoracic CT (73 CT pulmonary angiogram (CTPA), 14 CT Chest and five high-resolution CT (HRCT) studies). 72.8% of studies were to evaluate for pulmonary emboli, 16.2% for assessment of COVID-19 pneumonia complications, 5.4% for tuberculosis and 6.5% for other indications. 21 (23%) of these studies resulted in a change in management with two patients having a major change in management (thrombolysis, CT-guided aspiration). Management was altered due to diagnosis of pulmonary embolism (PE), pneumonia, cryptogenic organising pneumonia and other reasons. Of 73 CTPA studies, 11 (15%) patients had evidence of PE.
In our centre, thoracic CT in COVID-19 patients were predominantly for the evaluation of PE with other indications being for COVID-19 complications and other cardiopulmonary pathologies. 23% of studies subsequently altered patient management, suggesting there is good clinical need for CT chests for these indications.
由冠状病毒 SARS-CoV-2 引起的 COVID-19 大流行导致了全球医疗保健危机。放射科为 COVID-19 患者提供计算机断层扫描 (CT) 成像服务带来了多重挑战。因此，探讨胸部 CT 的临床需求和适应症，以及它们是否随后改变患者的管理方案非常重要。
我们报告了在澳大利亚“德尔塔”变异浪潮高峰期住院的所有确诊 COVID-19 病例的单中心回顾性队列研究中的经验，这些患者均接受了胸部 CT 检查。确定了 CT 前后的临床指征和患者管理计划。
在 1403 名因 COVID-19 住院的患者中，共有 92 名患者接受了胸部 CT（73 名 CT 肺动脉造影 (CTPA)、14 名 CT 胸部和 5 名高分辨率 CT (HRCT) 研究）。72.8%的研究是为了评估肺栓塞，16.2%是为了评估 COVID-19 肺炎并发症，5.4%是为了评估肺结核，6.5%是为了其他指征。其中 21 项（23%）研究改变了管理方案，有两名患者的管理方案发生了重大改变（溶栓、CT 引导下抽吸）。管理方案的改变是由于诊断出肺栓塞 (PE)、肺炎、隐源性机化性肺炎和其他原因。在 73 项 CTPA 研究中，有 11 项（15%）患者有 PE 证据。
在我们中心，COVID-19 患者的胸部 CT 主要用于评估 PE，其他指征用于 COVID-19 并发症和其他心肺病理。23%的研究随后改变了患者的管理，这表明这些指征下对 CT 胸部检查有良好的临床需求。
