Comparison of chest CT scan findings between COVID-19 and pulmonary contusion in trauma patients based on RSNA criteria: Established novel criteria for trauma victims.
10.1016/j.cjtee.2022.01.004
- Author:
Hossein ABDOLRAHIMZADEH FARD
1
;
Salahaddin MAHMUDI-AZER
1
;
Qusay ABDULZAHRAA YAQOOB
2
;
Golnar SABETIAN
3
;
Pooya IRANPOUR
4
;
Zahra SHAYAN
5
;
Shahram BOLANDPARVAZ
1
;
Hamid Reza ABBASI
1
;
Shiva AMINNIA
6
;
Maryam SALIMI
6
;
Mohammad Mehdi MAHMOUDI
1
;
Shahram PAYDAR
1
;
Roham BORAZJANI
1
;
Ali TAHERI AKERDI
1
;
Masome ZARE
7
;
Leila SHAYAN
1
;
Mohammadreza SASANI
8
Author Information
1. Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
2. Department of General Surgery, Kufa University of Medical Sciences, Najaf, Iraq.
3. Department of Intensive Care Medicine, Trauma Research Center, Shahid Rajaee (Emtiaz) Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
4. Department of Radiology, Medical Imaging Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
5. Department of Biostatistics, Trauma Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
6. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
7. Trauma Intensive Care Unit, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
8. Department of Radiology, Medical Imaging Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: mohammadrezasasaani@gmail.com.
- Publication Type:Journal Article
- Keywords:
COVID-19;
CT;
Chest wall;
Contusion;
RSNA criteria;
Trauma
- MeSH:
COVID-19;
Contusions/diagnostic imaging*;
Humans;
Lead;
Lung/diagnostic imaging*;
Lung Injury/etiology*;
Retrospective Studies;
SARS-CoV-2;
Tomography, X-Ray Computed/methods*
- From:
Chinese Journal of Traumatology
2022;25(3):170-176
- CountryChina
- Language:English
-
Abstract:
PROPOSE:In this study, we re-assessed the criteria defined by the radiological society of North America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 from pulmonary contusion.
METHODS:All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to Group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between Group P and Group PP; statistically significant ones were re-evaluated between Group Pa and Group Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between Group P and Group PP.
RESULTS:In the Group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected (p < 0.001 and p = 0.25, respectively). Single bilateral GGOs were only seen among the Group PP. The Chi-square tests showed that the prevalence of diffused GGOs, multiple unilateral GGOs, multiple consolidations, and multiple bilateral consolidations were significantly higher in the Group P (p = 0.001, 0.01, 0.003, and 0.003, respectively). However, GGOs with irregular borders and single consolidations were more significant among the Group PP (p = 0.01 and 0.003, respectively). Of note, reticular distortions and subpleural spares were exclusively detected in the Group PP.
CONCLUSION:We concluded that the criteria set by RSNA for the diagnosis of COVID-19 are not appropriate in trauma patients. The clinical signs and symptoms are not always useful either. The presence of multiple unilateral GGOs, diffused GGOs, and multiple bilateral consolidations favor COVID-19 with 88%, 97.62%, and 77.7% diagnostic accuracy.
