Purpose Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome. Methods Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease. Results Median age was 52 years (IQR 39-63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 and P = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO 2 ≤ 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO 2 ≤ 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017). Conclusion Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO 2 and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.
Paracoccidioidomycosis is a granulomatous systemic mycosis that is endemic in Latin America; it is an extremely rare infection following solid organ transplantation. In this study, we describe the first report of disseminated paracoccidioidomycosis in a 3-year-old girl who underwent liver transplantation 2 years previously. The radiologic diagnosis and patient follow-up are described. In addition, we review the clinical evolution and treatment regimens for this infection.
Objectives To evaluate the diagnostic performance and interobserver agreement of PI-RADS v2.Materials and Methods In this Institutional Review Board approved single-center retrospective study, 98 patients with clinically suspected PCa who underwent 3-T multiparametric MRI followed by MRI/TRUS fusion-guided prostate biopsy were included from June 2013 to February 2015. Two radiologists (R1 and R2) with 8 and 1 years of experience in abdominal radiology reviewed the MRI scans and assigned PI-RADS v2 scores in all prostate zones. PI-RADS v2 were compared to MRI/TRUS fusion-guided biopsy results, which were classified as negative, PCa, and significant PCa (sPCa).Results Sensitivity, specificity, NPV, PPV and accuracy for PCa was 85.7% (same for all metrics) for R1 and 81.6%, 79.6%, 81.2%, 80.0% and 80.6% for R2. For detecting sPCa, the corresponding values were 95.3%, 85.4%, 95.9%, 83.7% and 89.8% for R1 and 93.0%, 81.8%, 93.7%, 86.7% and 86.7% for R2. There was substantial interobserver agreement in assigning PI-RADS v2 score as negative (1, 2, 3) or positive (4, 5) (Kappa=0.78). On multivariate analysis, PI-RADS v2 (p <0.001) was the only independent predictor of sPCa compared with age, abnormal DRE, prostate volume, PSA and PSA density.Conclusions Our study population demonstrated that PI-RADS v2 had high diagnostic accuracy, substantial interobserver agreement, and it was the only independent predictor of sPCa.
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