Fahrni Guillaume, Rocha Ana-Carolina, Gudmundsson Louis, Pozzessere Chiara, Qanadli Salah D, Rotzinger David C
Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Riviera Chablais Hospital and University of Lausanne, Lausanne, Switzerland.
Front Med (Lausanne). 2023 Mar 22;10:1117151. doi: 10.3389/fmed.2023.1117151. eCollection 2023.
Pulmonary manifestations of COVID-19 pneumonia are well known. However, COVID-19 is also associated with a range of vascular manifestations such as embolism, congestion, and perfusion changes. Regarding congestion, research from different groups has suggested arteriovenous anastomosis dysregulation as a contributing factor. In this study, we aim to better describe the changes in vascular volume in affected lung zones and to relate them to pathophysiological hypotheses.
We performed automatic vascular volume extraction in 10 chest CTs of patients, including 2 female and 8 male with a mean age of 63.5 ± 9.3 years, diagnosed with COVID-19 pneumonia. We compared the proportion of vascular volumes between manually segmented regions of lung parenchyma with and without signs of pneumonia.
The proportion of vascular volume was significantly higher in COVID (CVasc) compared to non-COVID (NCVasc) areas. We found a mean difference (DVasc) of 5% and a mean ratio (RVasc) of 3.7 between the two compartments ( < 0.01).
Vascular volume in COVID-19 affected lung parenchyma is augmented relative to normal lung parenchyma, indicating venous congestion and supporting the hypothesis of pre-existing intra-pulmonary arteriovenous shunts.
新型冠状病毒肺炎（COVID-19）的肺部表现已广为人知。然而，COVID-19还与一系列血管表现相关，如栓塞、充血和灌注改变。关于充血，不同研究团队的研究表明动静脉吻合失调是一个促成因素。在本研究中，我们旨在更好地描述受影响肺区的血管容量变化，并将其与病理生理假设相关联。
我们对10例COVID-19肺炎患者的胸部CT进行了自动血管容量提取，其中包括2名女性和8名男性，平均年龄为63.5±9.3岁。我们比较了有肺炎迹象和无肺炎迹象的肺实质手动分割区域之间的血管容量比例。
与非COVID区域（NCVasc）相比，COVID区域（CVasc）的血管容量比例显著更高。我们发现两个区域之间的平均差异（DVasc）为5%，平均比例（RVasc）为3.7（<0.01）。
COVID-19感染的肺实质中的血管容量相对于正常肺实质增加，表明存在静脉充血，并支持肺内动静脉分流预先存在的假设。
