Geudens Vincent, Van Slambrouck Jan, Aerts Gitte, Willems Lynn, Goos Tinne, Kaes Janne, Zajacova Andrea, Gyselinck Iwein, Aelbrecht Celine, Vermaut Astrid, Beeckmans Hanne, Vermant Marie, De Fays Charlotte, Sacreas Annelore, Aversa Lucia, Orlitova Michaela, Vanstapel Arno, Josipovic Ivan, Boone Matthieu N, McDonough John E, Weynand Birgit, Pilette Charles, Janssens Wim, Dupont Lieven, Wuyts Wim A, Verleden Geert M, Van Raemdonck Dirk E, Vos Robin, Gayan-Ramirez Ghislaine, Ceulemans Laurens J, Vanaudenaerde Bart M
Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of Chrometa, KU Leuven, Leuven, Belgium.
Prague Lung Transplant Program, Department of Pneumology, Motol University Hospital, 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
J Thorac Dis. 2023 Jul 31;15(7):3646-3661. doi: 10.21037/jtd-22-1488. Epub 2023 Jul 3.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19) which can lead to acute respiratory distress syndrome (ARDS) and evolve to pulmonary fibrosis. Computed tomography (CT) is used to study disease progression and describe radiological patterns in COVID-19 patients. This study aimed to assess disease progression regarding lung volume and density over time on follow-up chest CT and give a unique look at parenchymal and morphological airway changes in "end-stage" COVID-19 lungs using microCT.
Volumes and densities of the lung/lobes of three COVID-19 patients were assessed using follow-up CT and whole lung microCT scans. Airways were quantified by airway segmentations on whole lung microCT and small-partition microCT. As controls, three discarded healthy donor lungs were used. Histology was performed in differently affected regions in the COVID-19 lungs.
, COVID-19 lung volumes decreased while density increased over time, mainly in lower lobes as previously shown. COVID-19 lung volumes decreased by 60% and all lobes were smaller compared to controls. Airways were more visible on microCT in COVID-19, probably due to fibrosis and increased airway diameter. In addition, small-partition microCT showed more deformation of (small) airway morphology and fibrotic organization in severely affected regions with heterogeneous distributions within the same lung which was confirmed by histology.
COVID-19-ARDS and subsequent pulmonary fibrosis alters lung architecture and airway morphology which is described using CT, microCT, and histology.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发冠状病毒病19（COVID-19），可导致急性呼吸窘迫综合征（ARDS）并演变为肺纤维化。计算机断层扫描（CT）用于研究COVID-19患者的疾病进展并描述其放射学模式。本研究旨在通过随访胸部CT评估随时间推移肺容积和密度方面的疾病进展，并使用显微CT独特地观察“终末期”COVID-19肺实质和形态学气道变化。
使用随访CT和全肺显微CT扫描评估3例COVID-19患者肺/肺叶的容积和密度。通过全肺显微CT和小分区显微CT上的气道分割对气道进行定量分析。作为对照，使用3个废弃的健康供体肺。对COVID-19肺中不同受累区域进行组织学检查。
如先前所示，COVID-19肺容积随时间减少而密度增加，主要发生在下叶。COVID-19肺容积减少了60%，与对照组相比所有肺叶均较小。在COVID-19中，显微CT上气道更明显，可能是由于纤维化和气道直径增加。此外，小分区显微CT显示严重受累区域（小）气道形态和纤维化组织有更多变形，且在同一肺内分布不均，这一点经组织学证实。
COVID-19-ARDS及随后的肺纤维化改变了肺结构和气道形态，通过CT、显微CT和组织学对其进行了描述。
