Background We aimed to prospectively assess the lung fibrotic-like changes, as well as to explore their predictive factors, in the patients who survived Coronavirus Disease 2019 (COVID-19) infection. In this prospective cross-sectional study, we recruited patients who had been treated for moderate or severe COVID-19 pneumonia as inpatients and discharged from Rohani hospital in Babol, northern Iran, during March 2020. The clinical severity of COVID-19 pneumonia was classified as per the definition by World Health Organization. We also calculated the CT severity score (CSS) for all patients at admission. Within the 3 months of follow-up, the next chest CT scan was performed. As the secondary outcome, the patients with fibrotic abnormalities in their second CT scan were followed up in the next 3 months. Results Totally, 173 COVID-19 patients were finally included in the study, of whom 57 (32.9%) were male and others were female. The mean age was 53.62 ± 13.67 years old. At 3-month CT follow-up, evidence of pulmonary fibrosis was observed in 90 patients (52.0%). Consolidation (odds ratio [OR] = 2.84), severe disease (OR 2.40), and a higher CSS (OR 1.10) at admission were associated with increased risk of fibrotic abnormalities found at 3-month CT follow-up. Of 62 patients who underwent chest CT scan again at 6 months of follow-up, 41 patients (66.1%) showed no considerable changes in the fibrotic findings, while the rest of 21 patients (33.9%) showed relatively diminished lung fibrosis. Conclusion Post-COVID-19 lung fibrosis was observed in about half of the survivors. Also, patients with severe COVID-19 pneumonia were at a higher risk of pulmonary fibrosis. Moreover, consolidation, as well as a higher CSS, in the initial chest CT scan, was associated with increased risk of post-COVID-19 lung fibrosis. In addition, some patients experienced diminished fibrotic abnormalities in their chest CT on 6-month follow-up, while some others did not.
Background: Computed Tomography (CT) is main contributor of popula on dose from diagnos c X-ray examina ons. Children are more radiosensi ve than adults, thus op miza on of CT examina on in these pa ents is essen al. The purpose of this study was to evaluate dose delivered to pediatric pa ents' undergoing CT examina on of the common examina ons and also establishing local Diagnos c Reference Levels (DRLs). Materials and Methods: Ques onnaires were designed for data collec on at seven public hospitals and informa on about pa ent, protocol and CT system were recorded during 2013 and 2014. Dose measurement was performed in four age groups: 0-1, 1-5, 5-10 and 10-15 years old and two CT dose quan ty including CTDIw and DLP were calculated. Results: Values of 40, 48, 59.5, 59.5 mGy; 16.9, 16.9, 17.14, 17.14 mGy;17,17,17, 17 mGy;17,17, 19.2,19.2 mGy in terms of CTDIw and 448, 538, 758, 758 mGy cm; 129, 129, 154, 167 mGy cm; 184, 225, 306, 315 mGy cm; 289, 408, 595, 670 mGy cm in terms of DLP as regional DRL for brain, sinus, chest, abdomen and pelvic examina ons were obtained respec vely. Conclusion: The varia ons in dose of some examina on were considerable. As the role and usage of CT technology con nues to expand, it is important that all prac oners adapt op mized protocols, especially for pediatrics scanning, following proposed reference levels.
BackgroundThe use of oral implants has been growing, and cone beam computerized tomography (CBCT) has become the method of choice for oral and maxillofacial radiology.ObjectiveTo assess the accuracy of bone densitometry in two different CBCT devices in comparison with MDCT (multi-detector CT).MethodsDifferent concentrations of urografin, including 2.5%, 5%, 7.5%, 10%, 12.5%, were prepared, and the Hounsfield unit of these solution was measured by two CBCT devices (SORDEX CRANEX 3D and NEWTOM 5G) and one spiral CT device (SOMATOM SENSATION). Difference of output Hounsfield units in each concentration was compared in three devices. Correlation of devices with increase of urografin dose also was evaluated. Statistical analyses of the data were performed using SPSS18 and Kruskal–Wallis and Mann–Whitney U tests, along with Spearman’s correlation coefficient.ResultsThe range of gray density for NEWTOM 5G CBCT, SORDEX 3D CBCT, and SOMATOM CT imaging systems was from 781 to 2311, 427 to 1464, and 222 to 994, respectively. There was significant difference between devices in the Hounsfield unit in all urografin concentrations (p<0.001). Also there was a significant correlation between three devices with increasing the urografin dose (p<0.05; r>0.95)ConclusionOur findings indicated a high correlation and linear relationship between different studied imaging systems. Although utilizing CBCT in the assessment of bone density is useful according to its lower emitted dose and less cost, clinicians should be aware of the issue that the voxel value in CBCT is not as perfect as CT.
Background We aimed to investigate the association of initial chest CT scan findings with status and adverse outcomes of COVID-19 (including ICU admission, mortality, and disease severity). This retrospective cohort study was performed in three hospitals in Babol, northern Iran, between February and March 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). Clinical and paraclinical data of the patients were collected from their medical records. CT severity score (CSS) was calculated by a senior radiologist. Disease severity was determined based on the World Health Organization criteria. Results In total, 742 patients were included, of whom 451 (60.8%) were males and 291 (39.2%) were females. The mean age was 56.59 ± 14.88 years old. Also, 523 (70.5%) were RT-PCR-positive. Ground glass opacity was directly associated with RT-PCR positivity (odds ratio [OR] = 2.07). Also, RT-PCR-positive cases had significantly a higher CSS than RT-PCR-negative cases (p = 0.037). In patients confirmed with COVID-19, peribronchovascular distribution of lesions, number of zones involved, and CSS were associated with increased risk of ICU admission (OR = 2.93, OR = 2.10, and OR = 1.14, respectively), mortality (OR = 2.30, OR = 1.35, and OR=1.08, respectively), severe disease (OR = 2.06, OR = 1.68, and OR = 1.10, respectively), and critical disease (OR = 4.62, OR = 3.21, and OR = 1.23, respectively). Also, patients who had consolidation were at a higher risk of severe disease compared with those who did not (OR = 4.94). Conclusion Initial chest CT scan can predict COVID-19 positivity, ICU admission, mortality, and disease severity, specifically through CSS.
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