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01-12-2021 | Computed Tomography | Original Article

Dual-energy CT angiography reveals high prevalence of perfusion defects unrelated to pulmonary embolism in COVID-19 lesions

Authors: Alice Le Berre, Tom Boeken, Caroline Caramella, Daniel Afonso, Caroline Nhy, Laetitia Saccenti, Anne-Marie Tardivel, Sophie Gerber, Adrien Frison Roche, Joseph Emmerich, Valeria Marini, Marc Zins, Sarah Toledano

Published in: Insights into Imaging | Issue 1/2021

Abstract

Background

Lung perfusion defects (PDs) have been described in COVID-19 using dual-energy computed tomography pulmonary angiography (DE-CTPA). We assessed the prevalence and characteristics of PDs in COVID-19 patients with suspected pulmonary embolism (PE) and negative CTPA.

Methods

This retrospective study included COVID-19 and non-COVID-19 pneumonia groups of patients with DE-CTPA negative for PE. Two radiologists rated the presence of PD within the lung opacities and analyzed the type of lung opacities and PD pattern (i.e. homogeneous or heterogeneous). The clinical, biological, radiological characteristics including time from first symptoms and admission to DE-CTPA, oxygen requirements, CRP, D-dimer levels, duration of hospital admission and death were compared within the COVID-19 group between patients with (PD +) or without PD (PD-).

Results

67 COVID-19 and 79 non-COVID-19 patients were included. PDs were more frequent in the COVID-19 than in the non-COVID-19 group (59.7% and 26.6% respectively, p < 0.001). Patterns of PDs were different, with COVID-19 patients exhibiting heterogenous PDs (38/40, 95%) whereas non-COVID-19 patients showed mostly homogeneous perfusion defects (7/21 heterogeneous PDs, 33%), p < 0.001. In COVID-19 patients, most consolidations (9/10, 90%) exhibited PDs while less than a third of consolidations (19/67, 28%) had PDs in non-COVID-19 patients. D-dimer, oxygen levels and outcome were similar between COVID-19 PD + and PD- patients; however, time between admission and DE-CTPA was longer in PD + patients (median [IQR], 1 [0–7] and 0 [0–2]; p = 0.045).

Conclusion

Unlike in bacterial pneumonia, heterogeneous PDs within lung opacities are a frequent feature of COVID-19 pneumonia in PE-suspected patients.

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Title: Dual-energy CT angiography reveals high prevalence of perfusion defects unrelated to pulmonary embolism in COVID-19 lesions
Authors: Alice Le Berre
Tom Boeken
Caroline Caramella
Daniel Afonso
Caroline Nhy
Laetitia Saccenti
Anne-Marie Tardivel
Sophie Gerber
Adrien Frison Roche
Joseph Emmerich
Valeria Marini
Marc Zins
Sarah Toledano
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keywords: Computed Tomography
Computed Tomography
Pneumonia
CT Angiography
COVID-19
Published in: Insights into Imaging / Issue 1/2021
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-021-00972-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dual-energy CT angiography reveals high prevalence of perfusion defects unrelated to pulmonary embolism in COVID-19 lesions

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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