Computed Tomography (CT) chest plays a critical role in early identification & stratification of disease burden and prognostication of COVID-19 disease. We compared in-house created CT based scoring system based on ground glass opacities (G-Score), consolidation (C- Score), and atelectasis A-score (i.e. GCA score) with contemporary CT severity scores & validated it against world health organization (WHO) COVID-19 disease severity scale. Patients confirmed with real time polymerase chain reaction confirmed COVID-19 infections that underwent CT chest investigations as a part of standard of care were recruited. A compound GCA score based on the lung involvement was developed and validated. Five-hundred patients of which 249 had mild, 220 with moderate, and 31 with severe COVID-19 disease were recruited.Most involved segments were superior (65%), lateral basal (56%) and posterior basal segments (64%) of right lower lobe and anteromedial (62%) and posterior basal segments (57%) of left lower lobe.Patchy non-confluent peripheral ground-glass opacities with apicobasal gradient is the most common finding (47%) in mild cases. Bilateral lower lobes were most commonly involved (72%).In moderate cases ground-glass opacities with consolidation is the predominant finding (82%).In severe cases ground-glass opacity, consolidation as well as linear platelike atelectasis and reticular opacities may represent with apicobasal gradient (80%).HRCT Chest has certainly come up as a versatile aid for our war against COVID -19. Firstly it helps to diagnose the pulmonary involvement of the disease and when complimented with a good scoring system furthermore it stratifies the disease burden.
Bronchial artery embolization is an established intervention for management of recurrent massive hemoptysis in a majority of patients. The source of bleeding in a majority of cases is systemic arteries – orthotopic bronchial arteries, anomalous bronchial arteries, or nonbronchial systemic collaterals. We report a case of an aberrant left inferior bronchial artery arising from the left gastric artery (LGA) in a patient with massive hemoptysis. Such origin from infradiaphragmatic vessels and specially left gastric arteries is very rare and needs to be considered by interventional radiologists and pulmonologists in case with hemoptysis disproportionate to supply by orthotopic arteries. Technical challenges were present in the present case in the form of an aneurysm in the aberrant artery and nontarget hepatic and gastric branches arising from LGA. Appropriate selection of hardware and embolic agents was done to deal with the clinical situation.
).Presentation of metastasis as a solitary focal lesion at an intravascular location is encountered quite infrequently. Owing to its intravascular location, accessing the lesion for sampling and obtaining an adequate amount of tissue are technically difficult. Among the various methods of obtaining an adequate sample from intravascular lesions, scoop and trucut biopsies appear to be safer and more advantageous. The authors present a case of a 65-year-old woman with symptoms of superior vena cava syndrome secondary to a solitary focal fluorodeoxyglucose (FDG)-avid thrombus within the superior vena cava lumen 14 years after complete remission of breast carcinoma. This lesion was approached via transjugular venous access and biopsied under fluoroscopic guidance with continuous contrast injection and real-time needle visualization in two planes.
AbstractKeywords ► intravascular biopsy ► intracaval metastasis ► superior vena cava syndrome
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