Chest CT findings in patients with dysphagia and aspiration: a systematic review

Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a worldwide pandemic. Especially in the centers most affected by the pandemic, symptoms (such as fever, cough, myalgia, or fatigue) and/or radiological signs (such as ground-glass opacity) typically related to COVID-19 often diverted clinicians’ attention from other diseases. Despite the urgency to recognize and cure SARS-CoV-2 infection, a plethora of differential diagnoses must be considered, and other diseases must be equally and promptly treated, as described in this case report.

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“…In this patient, considering the clinical history, [18F]FDG PET/CT findings matched aspiration pneumonia, mimicking COVID-19 infection [16,17].…”

Section: Case Reportmentioning

confidence: 79%

COVID-19 and Aspiration Pneumonia: Similar Pulmonary Findings with Different Diagnoses—a Pitfall in [18F]FDG PET/CT

Liberini

Grimaldi

Huellner

et al. 2021

SN Compr. Clin. Med.

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“…This distribution is probably influenced by aspiration pneumonia in bedridden patients. Infiltrations were distributed across multiple lobes in patients with aspiration pneumonia 27 , 29 , 30 , and these were less frequently seen in the upper lobes of elderly patients with TB 6 . This fact may also support the reason for the absence of a significant difference in the upper lobe distribution of both groups.…”

Section: Discussionmentioning

confidence: 97%

High-resolution computed tomography features associated with differentiation of tuberculosis among elderly patients with community-acquired pneumonia: a multi-institutional propensity-score matched study

Komiya

Yamasue

Goto

et al. 2022

Sci Rep

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While high-resolution computed tomography (HRCT) is increasingly performed, its role in diagnosing pulmonary tuberculosis (TB) among elderly patients with community-acquired pneumonia (CAP) has not been fully elucidated. This study aimed to determine HRCT features that can differentiate pulmonary TB from non-TB CAP in elderly patients. This study included consecutive elderly patients (age > 65 years) admitted to two teaching hospitals for pulmonary TB or non-TB pneumonia who met the CAP criteria of the American Thoracic Society/Infectious Diseases Society of America guidelines. After propensity score matching for clinical background between patients with pulmonary TB and those with non-TB CAP, their HRCT features were compared. This study included 151 patients with pulmonary TB and 238 patients with non-TB CAP. The presence of centrilobular nodules, air bronchograms, and cavities and the absence of ground-glass opacities and bronchial wall thickening were significantly associated with pulmonary TB. The negative predictive values of centrilobular nodules, air bronchograms, and cavities for pulmonary TB were moderate (70.6%, 67.9%, and 63.0%, respectively), whereas the positive predictive value of cavities was high (96.6%). In elderly patients, although some HRCT features could differentiate pulmonary TB from non-TB CAP, no useful findings could rule out pulmonary TB with certainty.

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“…Nevertheless, kappa values were moderate to good. Third, GGO or airspace consolidation observed on chest CT might not denote an acute inflammatory reaction in older adults 27 . The evaluation of a past chest CT or a follow-up chest CT after treatment is required to solve this issue, but we could not confirm due to its retrospective nature.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with gravity-dependent distribution on chest CT in elderly patients with community-acquired pneumonia: a retrospective observational study

Komiya

Yamamoto

Yoshikawa

et al. 2022

Sci Rep

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Although lung involvement in aspiration pneumonia typically has a gravity-dependent distribution on chest images, which patient’s conditions contribute to its radiological pattern has not been fully elucidated. This study was designed to determine the factors associated with the gravity-dependent distribution of community-acquired pneumonia (CAP) on chest computed tomography (CT). This retrospective study included elderly patients aged ≥ 65 years with CAP who underwent chest CT within 1 week before or after admission. The factors associated with lower lobe- and posterior-predominant distributions of ground glass opacity or airspace consolidation were determined. Of the 369 patients with CAP, 348 (94%) underwent chest CT. Multivariate analyses showed that impaired consciousness, a low Barthel index of activities of daily living, and high hemoglobin levels were associated with lower lobe-predominant distribution, while male sex and impaired consciousness were associated with posterior-predominant distribution. Cerebrovascular diseases were unrelated to these distributions. While male sex, impaired consciousness, high hemoglobin levels, low albumin levels, and the number of involved lobes were associated with in-hospital mortality, gravity-dependent distributions were not. Impaired consciousness might be the most significant predictor of aspiration pneumonia; however, the gravity-dependent distribution of this disease is unlikely to affect disease prognosis.

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Chest CT findings in patients with dysphagia and aspiration: a systematic review

Cited by 9 publications

References 25 publications

COVID-19 and Aspiration Pneumonia: Similar Pulmonary Findings with Different Diagnoses—a Pitfall in [18F]FDG PET/CT

COVID-19 and Aspiration Pneumonia: Similar Pulmonary Findings with Different Diagnoses—a Pitfall in [18F]FDG PET/CT

High-resolution computed tomography features associated with differentiation of tuberculosis among elderly patients with community-acquired pneumonia: a multi-institutional propensity-score matched study

Factors associated with gravity-dependent distribution on chest CT in elderly patients with community-acquired pneumonia: a retrospective observational study

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