Correlation between Chest Computed Tomography and Lung Ultrasonography in Patients with Coronavirus Disease 2019 (COVID-19)

Abstract

There is growing evidence regarding chest X-ray and computed tomography (CT) findings for coronavirus disease 2019 (COVID-19). At present, the role of lung ultrasonography (LUS) has yet to be explored. The main purpose of this study was to evaluate the correlation between LUS findings and chest CT in patients confirmed to have (positive reverse transcription polymerase chain reaction [RT-PCR]) or clinically highly suspected of having (dyspnea, fever, myasthenia, gastrointestinal symptoms, dry cough, ageusia or anosmia) COVID-19. This prospective study was carried out in the emergency department, where patients confirmed of having or clinically highly suspected of having COVID-19 were recruited and underwent chest CT and concurrent LUS exam. An experienced emergency department physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). A compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations. Between March and April 2020, 51 patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism (41.2%). Radiologic signs compatible with COVID-19 were present in 37 patients (72.5%) on CT scan and 40 patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (odds ratio: 13.3, 95% confidence interval: 4.5–39.6, p < 0.001) with a sensitivity of 100.0%, specificity of 78.6%, positive predictive value of 92.5% and negative predictive value of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared with CT in our cohort. The correlation between LUS score and CT total severity score was good (intraclass correlation coefficient: 0.803, 95% confidence interval: 0.60–0.90, p < 0.001). LUS exhibited similar accuracy compared with chest CT in the detection of lung abnormalities in COVID-19 patients.

Combatting COVID-19: is ultrasound an important piece in the diagnostic puzzle?

“…LUS is a bedside test that is quick to perform and repeat, is low cost and avoids radiation exposure compared with thoracic CT. 5 15 Studies indicate that the sensitivity of LUS for COVID-19 diagnosis is close to 100% when performed by experienced operators, with a specificity of approximately 78.6%. 16 The relatively low specificity of LUS when compared with thoracic CT is because some sonographic findings suggestive of viral pneumonia can also be seen in chronic lung conditions resulting in pleural abnormalities, including pulmonary fibrosis and chronic obstructive pulmonary disease. This necessitates using LUS in conjunction with other confirmatory tests such as PCR.…”

Lung Assessment with Point-of-Care Ultrasound in Respiratory Coronavirus Disease (COVID-19): A Prospective Cohort Study

“…A majority of people with COVID-19 show a peripheral distribution of ground-glass opacities on chest computed tomography (CT) scans, making ultrasound assessment possible. Several studies show a high correlation of LUS and chest CT, which is the current gold standard in imaging of COVID-19 pulmonary disease, with a sensitivity of 95% ( Lomoro et al 2020 ; Tung-Chen et al 2020 ). The sensitivity of chest X-ray has been found to be considerably lower (69%; Wong et al 2020 ).…”

Monitorización del tratamiento rehabilitador de la disnea de esfuerzo por COVID-19

“…UU.). Se siguió un esquema de exploración de 12 zonas del tórax, 6 en cada hemitórax (anterior, lateral y posterior subdivididas en superior e inferior) 3 , mostrando una línea pleural engrosada e irregular con líneas B prominentes en el lóbulo postero-superior izquierdo, como único hallazgo patológico en la exploración.…”

“…Sin embargo, realizar este seguimiento mediante la TC de tórax planeta una serie de desventajas, como es el acceso limitado ante el elevado número de pacientes y la radiación a la que se exponen. Por otro lado, la ecografía pulmonar está consolidándose como una herramienta de imagen adecuada para el diagnóstico y seguimiento de este tipo de pacientes, es inocua, se completa rápidamente siguiendo protocolos simples y fáciles de aplicar y cuyos hallazgos tienen una buena correlacionan con la TC de tórax 3 .…”

“…La rehabilitación respiratoria tiene como objetivo, a corto plazo, aliviar la disnea y la ansiedad, mientras que, a largo plazo, es recuperar la máxima funcionalidad del paciente, mejorando su calidad de vida y facilitando su integración en la sociedad 6 . Es importante que se indiquen ejercicios de fisioterapia respiratoria de manera individualizada para lo que será necesario realizar una evaluación integral previa mediante un test de marcha de 6 min y una ergometría 3 .…”