Covid 19 Chest Imaging
Article Information
Dr. Emre Pakdemirli1*, Dr. Yasser Al Obudi2, Dr. Muhammad Affan Zamir3
1Consultant Radiologist, West Hertfordshire Hospitals NHS Trust, St.Albans and Watford General Hospitals, Cross Sectional and Breast Radiologist, Department of Radiology, St.Albans, UK
2West Hertfordshire Hospitals NHS Trust, Watford General Hospital, department of Accident and Emergency, London, UK
3Consultant Radiologist, West Hertfordshire Hospitals NHS Trust, Watford General Hospital, Cross Sectional and Vascular Interventional Radiologist, Department of Radiology, London, UK
*Corresponding Author: Dr. Emre Pakdemirli, Consultant Radiologist, West Hertfordshire Hospitals NHS Trust, St.Albans and Watford General Hospitals, Cross Sectional and Breast Radiologist, Department of Radiology, Waverley Road, AL3 5PN, St.Albans, UK
Received: 04 May 2020; Accepted: 15 May 2020; Published: 20 May 2020
Citation: Emre Pakdemirli, Yasser Al Obudi, Muhammad Affan Zamir. Covid 19 Chest Imaging. Journal of Radiology and Clinical Imaging 3 (2020): 067-068.
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Covid-19; Chest x-ray; Radiological diagnosis
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Article Details
Abbreviations:
CXR- Chest X-Ray; HRCT- High-resolution Computerized Tomography; RT-PCR- Reverse Transcription Polymerase Chain Reaction
1. Clinical Image
A 61-year-old man admitted to the acute assessment unit presented with a ten-day history of coughing, fever and worsening dyspnea requiring high levels of supplemental oxygen, and failed to respond to antibiotic treatment. The admission chest x-ray (CXR) was unremarkable; however his blood tests were deranged with a low albumin 22 g/L (normal range: 35-50 g/L), a relatively low Basophils 2%, 0.01 (normal range: 0.02 – 0.5) 109/ L and a raised C-Reactive Protein 74 mg/L (Normal range: 0-5 mg/L). Three days later, a repeat CXR demonstrated significant changes coinciding with atypical pneumonic consolidation (Figure 1), presenting as a block like consolidative lesions involving both the lateral and peripheral aspect of the lung. Subsequently, High-resolution CT of the lungs revealed bilateral upper lobe ground-glass opacity in the anterior, posterior and lateral aspect, predominately involving the peripheral lung space and manifesting as thick crescents like opacities (Figure 2) and bi-basal consolidation. A radiological diagnosis of Covid-19 was made, which was subsequently confirmed by COVID-19 RT-PCR testing. After a ten-day admission and high oxygen requirement, the patient made a substantial recovery and completed a full course of IV antibiotics (Co-amoxiclav and Clarithromycin); he was then discharged home without any oxygen requirements.
Figure 1: Chest x-ray of a 61-year-old man three days after admission shows significant changes manifested as atypical pneumonic consolidation (arrows). These bilateral crescent-like consolidative lesions appear mainly in the peripheral aspect of the lung more prominent on the right side (arrows).
Figure 2: A subsequent High-resolution CT of the lung was performed following the CXR. The HRCT demonstrates upper lobe ground-glass opacity in the anterior, posterior and lateral aspect, predominately involving the peripheral lung space and manifesting as thick crescents like opacities and bi-basal consolidation (arrowheads).