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Chest X-ray (CXR) is an essential first-line tool in COVID-19 pneumonia diagnosis and management. Our study aimed at assessing 1) CXR manifestations, frequency, and distribution; 2) the feasibility and repeatability of a CXR severity score; and 3) the correlation between the CXR severity score and clinical and laboratory parameters. We reviewed baseline CXRs and clinical data of consecutive patients who presented to our emergency department and resulted positive at SARS-CoV-2 reverse transcriptase-PCR oropharyngeal swab test from March 1, 2020 to April 6, 2020. Lung abnormalities and their distribution were analyzed. A score of CXR severity was assigned by two radiologists, independently, according to the extent of lung involvement, with a maximum score of 8 for CXR. Correlations between the CXR score and the clinical data were assessed. One hundred fifty-five patients were included; 143/155 (92%) were positive at baseline CXR. Ground-glass opacity was the most common finding (141/143, 99%). Involvement was mainly bilateral (96/143, 67%), with peripheral distribution (79/143, 55%). The mean CXR severity score was 3.3 (±2); interobserver agreement was excellent, with a Cohen's K correlation coefficient of 0.901. The CXR score showed a significant positive correlation with C-reactive protein, lactate dehydrogenase, and fever duration, and a negative correlation with oxygen saturation. Chest X-ray findings are in line with those reported by computed tomography studies. The use of a visual CXR score, easy to assess and highly reproducible, can reflect the clinical severity and help the patients' management.

Due to the wide availability, rapid execution, low cost, and possibility of being acquired at the patient's bed, chest X-Ray is a fundamental tool in the diagnosis, follow-up and evaluation of the treatment effectiveness of patients with pneumonia, also in the context of COVID-19 infection. However, false negative cases are possible.We report 4 cases of false negative chest X-Rays, in patients who were diagnosed positive for COVID-19 by real-time transverse-transcript-polymerase chain reaction (RT-PCR), and executed chest unenhanced CTs just after the X-Rays, demonstrating signs of COVID-19 pneumonia.

Available information on chest Computed Tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) is constantly evolving. Ground glass opacities and consolidation with bilateral and peripheral distribution were reported as the most common CT findings, but also less typical features could be identified. All radiologists should be aware of the imaging spectrum of the COVID-19 pneumonia and imaging changes in the course of the disease. Our aim is to display the chest CT findings at first assessment and follow-up through a pictorial essay, to help in the recognition of these features for an accurate diagnosis.

Background The paranasal sinuses are complex anatomical structures, characterised by highly variable shape, morphology and size. With the introduction of multidetector scanners and the development of many post-processing possibilities, computed tomography became the gold standard technique to image the paranasal sinuses. Segmentation allows the extraction of metrical and shape data of these anatomical components that can be applied for diagnostic, education, surgical planning and simulation, and to plan minimally invasive interventions in otorhinolaryngology and neurosurgery. Discussion Our aim was to provide a review of the existing literature on segmentation, its types and application, and the data obtained from this procedure. The literature search was conducted on PubMed (including Medline), ScienceDirect and Google Scholar databases, using the keywords as follows: ‘paranasal sinuses’, ‘frontal sinus’, ‘maxillary sinus’, ‘sphenoid sinus’, ‘ethmoid sinus’, in all possible combinations with the keywords ‘segmentation’ and ‘volumetric analysis’. Inclusion criteria were: articles written in English, on living human subjects, on the adult population and focused on paranasal sinuses analysis. Conclusion This article provides an overview of the types and main application of segmentation procedures on paranasal sinuses, and the results provided by the studies on this topic.

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Aim: To correlate the clinical, laboratory, and radiographic characteristics of patients with a confirmed diagnosis of COVID-19 disease, with fatal outcome. Methods: We reviewed Chest X-Ray (CXR) features, clinical, and laboratory data of patients with RT-PCR confirmed diagnosis of COVID-19 infection. The relationship with mortality was investigated by fitting a logistic regression model. Results: 246 patients were included (170 males; mean age: 63). Most of the patients had one or more comorbidity (62%); fever (95%) and cough (60%) were the most common symptoms; CXR detected abnormalities in 88.6%, mainly showing ground-glass opacities (GGO) (90 %) with bilateral (64%) and peripheral (46%) distribution. Multivariate analysis showed that age (p<.001; mortality of 59% in patients >66 years old; 5% at a younger age) and consolidation at CXR (p=.001; mortality of 11% with positive CXR; 2% in those without) represented the two most significant independent risk factors of mortality. Chronic pathologies such as diabetes and chronic obstructive pulmonary disease and peripheral GGO at CXR also showed a significant correlation with mortality. Conclusions: We identified predictive factors for the fatal outcome of COVID-19 patients. The prognostic value of these findings can be useful for the right patient management and resource allocation.

We present the case of a 74-year-old female who attempted suicide by stabbing repeatedly with a nail scissor in the sub-sternal chest.Chest Computed Tomography (CT) performed at her arrival at our emergency department detected the presence of massive pericardial effusion. A follow-up cardiac CT after the pericardial drainage showed a Pseudo-aneurysm of the anterior wall of the right ventricle. < Learning objective: The evidence of post-traumatic right ventricular pseudo-aneurysm is a rare finding. Due to the challenge of diagnosis and potential fatality of this rare condition, it is important to be aware of its occurrence and to refine its recognition with imaging examinations. >