Imaging in COVID-19-related myocardial injury

Cau, Riccardo; Bassareo, Pier Paolo; Mannelli, Lorenzo; Suri, Jasjit S.; Saba, Luca

doi:10.1007/s10554-020-02089-9

Cited by 47 publications

(45 citation statements)

References 76 publications

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“…Myocarditis-induced alterations may present with several LGE patterns, are typically localized at the sub-epicardial or intramural areas of LV and are frequently located in the basal to mid-inferolateral wall. LGE-positive patients are at increased risk of adverse cardiac events, while LGE-negative patients usually have an excellent prognosis, independently of their symptomatology [ 32 ]. The CMR diagnostic accuracy can increase significantly using the proposed updated LL criteria.…”

Section: Research Strategymentioning

confidence: 99%

The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C)

et al. 2021

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Multisystem Inflammatory Syndrome in Children (MIS-C) recently reported in a minority of children affected by SARS-CoV-2, mimics Kawasaki disease (KD), a medium vessel vasculitis of unknown cause. In contrast to acute COVID-19 infection, which is usually mild in children, 68% of patients with MIS-C will need intensive care unit. Myocarditis and coronary artery ectasia/aneurysm are included between the main cardiovascular complications in MIS-C. Therefore, close clinical assessment is need it both at diagnosis and during follow-up. Echocardiography is the cornerstone modality for myocardial function and coronary artery evaluation in the acute phase. Cardiovascular magnetic resonance (CMR) detects diffuse myocardial inflammation including oedema/fibrosis, myocardial perfusion and coronary arteries anatomy during the convalescence and in adolescents, where echocardiography may provide inadequate images. Brain involvement in MIS-C is less frequent compared to cardiovascular disease. However, it is not unusual and should be monitored by clinical evaluation and brain magnetic resonance (MRI), as we still do not know its effect in brain development. Brain MRI in MIS-C shows T2-hyperintense lesions associated with restricted diffusion and bilateral thalamic lesions. To conclude, MIS-C is a multisystem disease affecting many vital organs, such as heart and brain. Clinical awareness, application of innovative, high technology imaging modalities and advanced treatment protocols including supportive and anti-inflammatory medication will help physicians to prevent the dreadful complications of MIS-C.

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Section: Research Strategymentioning

confidence: 99%

The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C)

et al. 2021

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“…Cardiac MRI (cMRI) is the most sensitive imaging modality in detecting myocardial injury. Late gadolinium enhancement (LGE) has high sensitivity in detecting areas of myocardial fibrosis or necrosis and can also have prognostic value as it is associated with worse outcomes[ 113 ]. A typical cMRI protocol includes a short-axis CINE sequence for size and functional assessment, T1/T2 mapping for edema assessment, a delayed post-contrast scan for scar assessment and a T2 sequence.…”

Section: Extrapulmonary Manifestationsmentioning

confidence: 99%

Imaging in the COVID-19 era: Lessons learned during a pandemic

Sidéris

Nikolakea²,

Karanikola³

et al. 2021

WJR

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The first year of the coronavirus disease 2019 (COVID-19) pandemic has been a year of unprecedented changes, scientific breakthroughs, and controversies. The radiology community has not been spared from the challenges imposed on global healthcare systems. Radiology has played a crucial part in tackling this pandemic, either by demonstrating the manifestations of the virus and guiding patient management, or by safely handling the patients and mitigating transmission within the hospital. Major modifications involving all aspects of daily radiology practice have occurred as a result of the pandemic, including workflow alterations, volume reductions, and strict infection control strategies. Despite the ongoing challenges, considerable knowledge has been gained that will guide future innovations. The aim of this review is to provide the latest evidence on the role of imaging in the diagnosis of the multifaceted manifestations of COVID-19, and to discuss the implications of the pandemic on radiology departments globally, including infection control strategies and delays in cancer screening. Lastly, the promising contribution of artificial intelligence in the COVID-19 pandemic is explored.

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“…Several reports describe clinical signs associated with COVID-19, with disease expression ranging from mild infection to severe acute respiratory distress. 2,3 In most patients, symptoms are mild. 4 However, certain patients, most notably elderly and those with comorbidities, can develop acute respiratory distress syndrome (ARDS) and other complications.…”

Section: Introductionmentioning

confidence: 99%

Complications in COVID-19 patients: Characteristics of pulmonary embolism

et al. 2021

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The purpose of this study is to evaluate chest CT imaging features, clinical characteristics, laboratory values of COVID-19 patients who underwent CTA for suspected pulmonary embolism. We also examined whether clinical, laboratory or radiological characteristics could be associated with a higher rate of PE. Materials and methods: This retrospective study included 84 consecutive patients with laboratory-confirmed SARS-CoV-2 who underwent CTA for suspected PE. The presence and localization of PE as well as the type and extent of pulmonary opacities on chest CT exams were examined and correlated with the information on comorbidities and laboratory values for all patients. Results: Of the 84 patients, pulmonary embolism was discovered in 24 patients. We observed that 87% of PE was found to be in lung parenchyma affected by COVID-19 pneumonia. Compared with no-PE patients, PE patients showed an overall greater lung involvement by consolidation (p = 0.02) and GGO (p < 0.01) and a higher level of D-Dimer (p < 0,01). Moreover, the PE group showed a lower level of saturation (p = 0,01) and required more hospitalization (p < 0,01). Conclusion: Our study showed a high incidence of PE in COVID-19 pneumonia. In 87% of patients, PE was found in lung parenchyma affected by COVID-19 pneumonia with a worse CT severity score and a greater number of lung lobar involvement compared with non-PE patients. CT severity, lower level of saturation, and a rise in Ddimer levels could be an indication for a CTPA. Advances in knowledge: Certain findings of non-contrast chest CT could be an indication for a CTPA.

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Imaging in COVID-19-related myocardial injury

Cited by 47 publications

References 76 publications

The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C)

The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C)

Imaging in the COVID-19 era: Lessons learned during a pandemic

Complications in COVID-19 patients: Characteristics of pulmonary embolism

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