avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2020-10-5-357-371avk-1089Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLEКомпьютерная томография при коронавирусной инфекции: дифференциальный диагноз на клинических примерахThe Role of Computed Tomography in Differentiation of Coronavirus Pneumonia, its Complications and Comorbidities. Case ReportsПетровичевВ. С.PetrovichevV. S.

Москва

Moscow

https://orcid.org/0000-0002-1637-2402МелеховА. .В.MelekhovA. V.

Александр Всеволодович Мелехов

Москва

Moscow

avmelekhov@gmail.comСайфуллинМ. А.SayfullinM. A.

Москва

Moscow

НикитинИ. Г.NikitinI. G.

Москва

Moscow

ФГАУ «НМИЦ Лечебно-реабилитационный центр» Минздрава РоссииРоссияNational Medical Research Center of Treatment and Rehabilitation of the Russian Healthcare MinistryRussian FederationФГАУ «НМИЦ Лечебно-реабилитационный центр» Минздрава России; ФГАОУ ВО «РНИМУ имени Н.И. Пирогова» Минздрава РоссииРоссияNational Medical Research Center of Treatment and Rehabilitation of the Russian Healthcare Ministry; Pirogov Russian National Research Medical UniversityRussian FederationФГАУ «НМИЦ Лечебно-реабилитационный центр» Минздрава России; ФГАОУ ВО «РНИМУ имени Н.И. Пирогова» Минздрава России; ФГБУ «Национальный исследовательский центр эпидемиологии и микробиологии имени почетного академика Н.Ф. Гамалеи» Минздрава РоссииРоссияNational Medical Research Center of Treatment and Rehabilitation of the Russian Healthcare Ministry; Pirogov Russian National Research Medical University; Gamaleya National Research Center for Epidemiology and Microbiology of the Russian Healthcare MinistryRussian Federation202008102020105357371Copyright © Петровичев В.С., Мелехов А..., Сайфуллин М.А., Никитин И.Г., 20202020Петровичев В.С., Мелехов А..., Сайфуллин М.А., Никитин И.Г.Petrovichev V.S., Melekhov A.V., Sayfullin M.A., Nikitin I.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1089 

 

Введение

Введение: большое количество литературы посвящено дифференциальному диагнозу рентгенологических симптомов COVID-19, их отличиям от других вариантов легочного поражения (другие вирусные и бактериальные пневмонии), не-легочных заболеваний. В реальной клинической практике коронавирусная пневмония может развиваться у пациентов, имеющих рентгенологические признаки и другого, интеркурентного заболевания.

Цель

Цель: изучение частоты и особенностей рентгенологических проявлений коронавирусной инфекции, ее осложнений и сопутствующих заболеваний органов грудной клетки.

Методы

Методы: ретроспективный анализ рентгенологических и клинических данных 354 пациентов, госпитализированных в ФГАУ «НМИЦ Лечебно-реабилитационный центр» Минздрава России с подозрением на коронавирусную инфекцию в период апрель-май 2020 г.

Результаты

Результаты: Проанализировано 962 исследования (3 (2-3) исследования на пациента). Первое КТ исследование проводилось пациентам на 8 (5-11) день болезни. На основании выявляемых рентгенологических симптомов выделено несколько групп пациентов: с коронавирусной пневмонией (n=295; 83%); с сочетанием коронавирусной пневмонии и другого заболевания (n=36; 10%); с осложнениями COVID-19 (n=12; 3%); с альтернативной патологией (n=2; 1%); без патологии (n=9; 3%). Приведены клинические случаи пациентов, демонстрирующие различные клинико-рентгенологические сценарии.

Заключение

Заключение: В клинической практике, помимо выявления типичных для COVID-19 изменений, метод КТ позволял проводить дифференциальную диагностику легочной и внелегочной патологией у коморбидных больных.

Background

Background: computer tomography (CT) features of COVID-19, their temporal changes and differences from other pulmonary (viral and bacterial pneumonia) and non-pulmonary diseases are well described in recent publications. The prevalence and characteristics of signs of concomitant problems that could be identified at chest CT are less studied.

Aim

Aim: to analyze the prevalence and characteristics of chest CT features of COVID-19, its complications and comorbidities.

Methods

Methods: retrospective analysis of CT and clinical data of 354 patients hospitalized with suspected COVID at April and May of 2020.

Results

Results: 962 CT scans were analyzed (3 (2-3) scans per patient). First CT was performed at 8 (5-11) day of sickness. Several roentgenological scenarios could be highlighted: patients with coronavirus pneumonia (n=295; 83%); with combination of COVID-19 and another pathology (n=36; 10%); with complications of COVID-19 (n=12; 3%); with alternative pathology (n=2; 1%); without any pathological signs (n=9; 3%). Several cases, illustrating CT signs of coronavirus pneumonia, its complications and comorbidities are reported.

Conclusion

Conclusion: CT possibilities are not limited to detect typical COVID-19 signs, it also helps to differentiate pulmonary and other thoracis pathology.

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The authors declare that there are no conflicts of interest present.