Diagnostic accuracy of thoracic imaging modalities for the detection of COVID-19

The ongoing coronavirus disease 2019(COVID-19)pandemic continues to present diagnostic challenges.The use of thoracic radiography has been studied as a method to improve the diagnostic accuracy of COVID-19.The‘Living’Cochrane Systematic Review on the diagnostic accuracy of imaging tests for COVID-19 is continuously updated as new information becomes available for study.In the most recent version,published in March 2021,a meta-analysis was done to determine the pooled sensitivity and specificity of chest X-ray(CXR)and lung ultrasound(LUS)for the diagnosis of COVID-19.CXR gave a sensitivity of 80.6%(95%CI:69.1-88.6)and a specificity of 71.5%(95%CI:59.8-80.8).LUS gave a sensitivity rate of 86.4%(95%CI:72.7-93.9)and specificity of 54.6%(95%CI:35.3-72.6).These results differed from the findings reported in the recent article in this journal where they cited the previous versions of the study in which a metaanalysis for CXR and LUS could not be performed.Additionally,the article states that COVID-19 could not be distinguished,using chest computed tomography(CT),from other respiratory diseases.However,the latest review version identifies chest CT as having a specificity of 80.0%(95%CI:74.9-84.3),which is much higher than the previous version which indicated a specificity of 61.1%(95%CI:42.3-77.1).Therefore,CXR,chest CT and LUS have the potential to be used in conjunction with other methods in the diagnosis of COVID-19.

Diagnostic significance of ultrasonography and CT for large upper abdominal mass

OBJECTIVE: To assess the effect of ultrasonography and computerized tomography (CT) in the diagnosis of large upper abdominal mass. METHODS: Data from 43 cases that were clinically and pathologically confirmed were retrospectively analyzed and the effect of their preoperative ultrasonography and CT was compared. RESULTS: Four of 10 (40 percent) cases of liver mass were diagnosed correctly using ultrasonic device, nineteen of 25 (76 percent) cases of adrenal gland mass and 2 of 4 cases of kidney mass. Two of 10 (20 percent) cases of liver mass were correctly diagnosed by CT, and so were 6 of 22 (27.2 percent) cases of adrenal gland mass. In 4 patients with spleen mass, neither ultrasonography nor CT diagnosis was correct. CONCLUSION: Because upper abdomen organs are closely connected with each other, correct imaging localization of a large mass in this region is not easy. In this study, we compared the accuracy of ultrasonography and CT in diagnosing large upper abdominal masses, and found that ultrasonography works better for adrenal rather than liver or kidney. Neither ultrasonography or CT could accurately diagnose a large mass in the spleen.

Chest radiological finding of COVID-19 in patients with and without diabetes mellitus:Differences in imaging finding

The pandemic of novel coronavirus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Diabetes mellitus is a risk factor for developing severe illness and a leading cause of death in patients with COVID-19.Diabetes can precipitate hyperglycaemic emergencies and cause prolonged hospital admissions.Insulin resistance is thought to cause endothelial dysfunction,alveolar capillary micro-angiopathy and interstitial lung fibrosis through pro-inflammatory pathways.Autopsy studies have also demonstrated the presence of microvascular thrombi in affected sections of lung,which may be associated with diabetes.Chest imaging using x-ray(CXR)and computed tomography(CT)of chest is used to diagnose,assess disease progression and severity in COVID-19.This article reviews current literature regarding chest imaging findings in patients with diabetes affected by COVID-19.A literature search was performed on PubMed.Patients with diabetes infected with SARSCoV-2 are likely to have more severe infective changes on CXR and CT chest imaging.Severity of airspace consolidation on CXR is associated with higher mortality,particularly in the presence of co-morbidities such as ischaemic heart disease.Poorly controlled diabetes is associated with more severe acute lung injury on CT.However,no association has been identified between poorlycontrolled diabetes and the incidence of pulmonary thromboembolism in patients with COVID-19.