The Role of Chest X-Ray in Monitoring Lung Changes among COVID-19 Patients in Gaza Strip

Objective: To investigate the time course and findings severity of COVID-19 infection at chest radiography based on a 6-point radiological severity score, and correlates these with patients’ age and gender. Methods: This is a retrospective study of COVID-19 patients who were admitted at European Gaza Hospital and evaluated between October 6, 2020, and November 30, 2020. Baseline and serial chest radiographs, up to 4 images per patient, were reviewed and assessed for predominant pattern, side, and location of lung opacity. Utilized a 6-point scoring system, which divides the chest X-ray into 6 zones, to assess chest X-ray changes and correlate them with the severity of infection, age, and gender of patients. Results: The study included 136 COVID-19 patients: (51/136, 37%) were males and (85/136, 62.5%) were females, while age ranged from 7 months to 90 years with a mean age of 41.7 ± (19.5) years. Negative Chest x-rays were more observed than positive images. Ground-glass opacity was the most frequent pattern with a decreasing trend from 1st to 4th chest X-ray (from 33.8% to 3.7%), followed by consolidation (from 16.2% to 2.9%). Also, the commonest pattern of opacity was seen in peripheral areas (27/136, 19.9%), lower zone location (23/136, 16.9%), and bilateral opacity involvement (43/136;31.6%). No significant correlation was noticed between the patient’s gender, age, and severity score (P > 0.05). Conclusions: The 6-point chest X-ray severity score as a predictive tool in assessing the severity due to provide an assessment of the progression or regression pathway.

Quantification Threshold Pixel Technique of Magnetic Resonance Imaging in Paraspinal Muscles Atrophy among Discopathy Patients

Purpose: To evaluate the relationship between lumbosacral discopathy status and paraspinal atrophic changes (Cross-sectional area (CSA) and fatty infiltration (FI)) among different age groups. Materials and Methods: We retrospectively evaluated 200 patients with confirmed discopathy who were examined by lumbosacral Magnetic Resonance Imaging (MRI) at the two main governmental hospitals in Gaza Strip. Using ImageJ software and quantification threshold technique, we measured the CSA and FI of paraspinal muscles {multifidus (MF) & erector spinae (ES)}. The interpretation of MRI images was performed by two radiologists with a good inter-observer agreement between the radiological discopathy findings. Results: The highest percentage and severity of discopathy were noticed at the level of L4/5 (89.5%), followed by L5/S1 (14.5%). The FI is increased towards lower levels of L3/4 to L5/S1. No correlation was found between discopathy level, the severity of discopathy, and CSA of MF & ES muscles. In contrast, a correlation was observed between FI of MF & ES muscles, discopathy level, and severity. Also, the results illustrated no significant relation was observed between CSA of MF & ES muscles and age groups (P > 0.05), while a significant correlation was reported between FI and age groups (P Conclusion: The MRI quantification threshold pixel technique for paraspinal muscles reflected the atrophic changes like CSA and FI in discopathy patients.