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新型冠状病毒肺炎患者的腹部影像学表现 第2部分:实体器官

Abdominal Imaging Findings in Patients with COVID-19 Part 2: Solid Organs.

作者信息

Shokri Varniab Zahra, Pourabhari Langroudi Ashkan, Amouei Mehrnam, Pak Neda, Khosravi Bardia, Radmard Amir Reza

机构信息

Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Middle East J Dig Dis. 2022 Oct;14(4):373-381. doi: 10.34172/mejdd.2022.298. Epub 2022 Oct 30.

DOI:10.34172/mejdd.2022.298
PMID:37547497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10404099/
Abstract

Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in China in December 2019, the globe has been dealing with an ever-increasing incidence of coronavirus disease 2019 (COVID-19). In addition to respiratory disorders, 40% of patients present with gastrointestinal (GI) involvement. Abdominal pain is the most common indication for computed tomography (CT) and ultrasonography. After GI tract involvement, solid visceral organ infarction is the most prevalent abdominal abnormality in COVID-19. This review aims to gather the available data in the literature about imaging features of solid abdominal organs in patients with COVID-19. Gallbladder wall thickening and distension, cholelithiasis, hyperdense biliary sludge, acalculous cholecystitis, periportal edema, heterogeneous liver enhancement, and liver hypodensity and infarction are among hepatobiliary imaging findings in CT, particularly in patients admitted to ICU. Pancreatic involvement can develop as a result of direct SARS-CoV2 invasion with signs of acute pancreatitis in abdominal CT, such as edema and inflammation of the pancreas. Infarction was the most prevalent renal and splenic involvement in patients with COVID-19 who underwent abdominal CT presenting with areas of parenchymal hypodensity. In conclusion, although solid abdominal organs are rarely affected by COVID-19, clinicians must be familiar with the manifestations since they are associated with the disease severity and poor outcome.

摘要

自2019年12月严重急性呼吸综合征冠状病毒2(SARS-CoV-2)首次在中国出现以来,全球范围内2019冠状病毒病(COVID-19)的发病率一直在不断上升。除呼吸系统疾病外,40%的患者还出现胃肠道受累情况。腹痛是计算机断层扫描(CT)和超声检查最常见的指征。胃肠道受累后,实性内脏器官梗死是COVID-19患者中最常见的腹部异常情况。本综述旨在收集文献中关于COVID-19患者腹部实性器官影像特征的现有数据。胆囊壁增厚和扩张、胆结石、高密度胆汁淤积、无结石性胆囊炎、肝门周围水肿、肝脏强化不均匀以及肝脏低密度和梗死等是CT检查中的肝胆影像表现,尤其是在入住重症监护病房(ICU)的患者中。胰腺受累可能是由于SARS-CoV-2直接侵袭所致,腹部CT显示有急性胰腺炎的迹象,如胰腺水肿和炎症。梗死是接受腹部CT检查的COVID-19患者中最常见的肾脏和脾脏受累情况,表现为实质低密度区。总之,虽然COVID-19很少累及腹部实性器官,但临床医生必须熟悉这些表现,因为它们与疾病严重程度和不良预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/d47d7b16ca3e/mejdd-14-373-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/865a69d767fd/mejdd-14-373-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/e19d49d2607b/mejdd-14-373-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/d47d7b16ca3e/mejdd-14-373-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/865a69d767fd/mejdd-14-373-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/e19d49d2607b/mejdd-14-373-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6c5/10404099/d47d7b16ca3e/mejdd-14-373-g003.jpg

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本文引用的文献

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A Systematic Review of Abdominal Imaging Findings in COVID-19 Patients.新型冠状病毒肺炎患者腹部影像表现的系统评价
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Abdominal and gastrointestinal manifestations in COVID-19 patients: Is imaging useful?新型冠状病毒肺炎患者的腹部和胃肠道表现:影像学检查有用吗?
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Remarkable gastrointestinal and liver manifestations of COVID-19: A clinical and radiologic overview.新型冠状病毒肺炎显著的胃肠道和肝脏表现:临床与影像学概述
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