<b>How to perform a cardio-thoracic</b> magnetic resonance imaging <b>in COVID-19: comprehensive assessment of heart, pulmonary arteries, and lung parenchyma</b>

Galea, Nicola; Catapano, Federica; Marchitelli, Livia; Cundari, Giulia; Maestrini, Viviana; Panebianco, Valeria; Mancone, Massimo; Fedele, Francesco; Catalano, Carlo; Francone, Marco

doi:10.1093/ehjci/jeaa335

Cited by 12 publications

(9 citation statements)

References 5 publications

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“…According to cardiovascular findings, further examinations were requested including Cardiac Magnetic Resonance (CMR) ( 31 ), coronary angiography or CT pulmonary angiography.…”

Section: Methodsmentioning

confidence: 99%

Cardiac involvement in consecutive unselected hospitalized COVID-19 population: In-hospital evaluation and one-year follow-up

Maestrini

Birtolo

Francone

et al. 2021

International Journal of Cardiology

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Background Cardiovascular disease (CVD) can occur in COVID-19 and has impact on clinical course. Data on CVD prevalence in hospitalized COVID-19 patients and sequelae in survivors is limited. Aim of this prospective study carried out on consecutive unselected COVID-19 population, was to assess: 1) CVD occurrence among hospitalized COVID-19 patients, 2) persistence or new onset of CVD at one-month and one-year follow-up. Methods Over 30 days n = 152 COVID-19 patients underwent cardiovascular evaluation. Standard electrocardiogram (ECG), Troponin and echocardiography were integrated by further tests when indicated. Medical history, arterial blood gas, blood tests, chest computed tomography and treatment were recorded. CVD was defined as the occurrence of a new condition during the hospitalization for COVID-19. Survivors attended a one-month follow-up visit and a one-year telephone follow-up. Results Forty-two patients (28%) experienced a wide spectrum of CVD with acute myocarditis being the most frequent. Death occurred in 32 patients (21%) and more frequently in patients who developed CVD ( p = 0.032). After adjustment for confounders, CVD was independently associated with death occurrence. At one-month follow-up visit, 7 patients (9%) presented persistent or delayed CVD. At one-year telephone follow-up, 57 patients (48%) reported persistent symptoms. Conclusion Cardiovascular evaluation in COVID-19 patients is crucial since the occurrence of CVD in hospitalized COVID-19 patients is common (28%), requires specific treatment and increases the risk of in-hospital mortality. Persistence or delayed presentation of CVD at 1-month (9%) and persistent symptoms at 1-year follow-up (48%) suggest the need for monitoring COVID-19 survivors.

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“…According to cardiovascular findings, further examinations were requested including Cardiac Magnetic Resonance (CMR) ( 31 ), coronary angiography or CT pulmonary angiography.…”

Section: Methodsmentioning

confidence: 99%

Cardiac involvement in consecutive unselected hospitalized COVID-19 population: In-hospital evaluation and one-year follow-up

Maestrini

Birtolo

Francone

et al. 2021

International Journal of Cardiology

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“…The imaging protocol included an end-expiratory triggered, proton density (PD)weighted, fat-saturated sequence acquired on both the axial and coronal planes at a slice thickness of 4 mm and a DWI axial sequence with three different b values of 0, 500, and 1000 and ADC map computation. In case respiratory-triggered images were not of adequate quality due to irregular breathing, a breath-hold echo-planar, fast spin-echo, T2-weighted, fat-saturated axial sequence was alternatively acquired [20]. See Table 1 describing MRI parameters.…”

Section: Mri Protocolmentioning

confidence: 99%

Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

et al. 2021

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Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

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“…In this context, cardiovascular MRI (CMR) allows the visualization of several myocarditis characteristics, such as contractile dysfunction, inflammatory edema, pulmonary artery filling defects, and necrosis[ 92 , 93 ]. The main methods are conventional cine images, T2-weighted sequences, parametric T1 and T2 maps, and late gadolinium enhanced images.…”

Section: What Do the Imaging Exams Show About The Disease?mentioning

confidence: 99%

“…The main methods are conventional cine images, T2-weighted sequences, parametric T1 and T2 maps, and late gadolinium enhanced images. Thus, CMR allows an anatomical and functional evaluation, revealing the different patterns of cardiac tissue damage, whether inflammatory or ischemic[ 93 ].…”

Section: What Do the Imaging Exams Show About The Disease?mentioning

confidence: 99%

Highlighting COVID-19: What the imaging exams show about the disease

Carvalho

Júnior

Oliveira

et al. 2021

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Coronavirus disease 2019 (COVID-19), a global emergency, is caused by severe acute respiratory syndrome coronavirus 2. The gold standard for its diagnosis is the reverse transcription polymerase chain reaction, but considering the high number of infected people, the low availability of this diagnostic tool in some contexts, and the limitations of the test, other tools that aid in the identification of the disease are necessary. In this scenario, imaging exams such as chest X-ray (CXR) and computed tomography (CT) have played important roles. CXR is useful for assessing disease progression because it allows the detection of extensive consolidations, besides being a fast and cheap method. On the other hand, CT is more sensitive for detecting lung changes in the early stages of the disease and is also useful for assessing disease progression. Of note, ground-glass opacities are the main COVID-19-related CT findings. Positron emission tomography combined with CT can be used to evaluate chronic and substantial damage to the lungs and other organs; however, it is an expensive test. Lung ultrasound (LUS) has been shown to be a promising technique in that context as well, being useful in the screening and monitoring of patients, disease classification, and management related to mechanical ventilation. Moreover, LUS is an inexpensive alternative available at the bedside. Finally, magnetic resonance imaging, although not usually requested, allows the detection of pulmonary, cardiovascular, and neurological abnormalities associated with COVID-19. Furthermore, it is important to consider the challenges faced in the radiology field in the adoption of control measures to prevent infection and in the follow-up of post-COVID-19 patients.

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How to perform a cardio-thoracic magnetic resonance imaging in COVID-19: comprehensive assessment of heart, pulmonary arteries, and lung parenchyma

Cited by 12 publications

References 5 publications

Cardiac involvement in consecutive unselected hospitalized COVID-19 population: In-hospital evaluation and one-year follow-up

Cardiac involvement in consecutive unselected hospitalized COVID-19 population: In-hospital evaluation and one-year follow-up

Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

Highlighting COVID-19: What the imaging exams show about the disease

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