Severe Acute Respiratory Syndrome: Temporal Lung Changes at Thin-Section CT in 30 Patients

Ooi, G. C.; Khong, Pek Lan; Müller, Néstor L.; Yiu, Wai; Zhou, Lin; Ho, James Chung Man; Lam, Bing; Nicolaou, Savvas; Tsang, Kenneth W.

doi:10.1148/radiol.2303030853

Cited by 304 publications

(311 citation statements)

References 17 publications

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“…The involvement of pneumonia within each lung zone was evaluated by scoring each zone from 0 (normal) to 4, with 4 corresponding to nearly total involvement of the lung parenchyma. Total CT scores ranged from 0 to 24 when combined for all six zones (1719). …”

Section: Methodsmentioning

confidence: 99%

Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

et al. 2016

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ObjectiveTo describe radiologic findings of adenovirus pneumonia and to understand clinico-radiological features associated with progression to acute respiratory distress syndrome (ARDS) in patients with adenovirus pneumonia.Materials and MethodsThis study included 19 patients diagnosed with adenovirus pneumonia at a tertiary referral center, in the period between March 2003 and April 2015. Clinical findings were reviewed, and two radiologists assessed imaging findings by consensus. Chi-square, Fisher's exact, and Student's t tests were used for comparing patients with and without subsequent development of ARDS.ResultsOf 19 patients, nine were immunocompromised, and 10 were immunocompetent. Twelve patients (63%) progressed to ARDS, six of whom (32%) eventually died from the disease. The average time for progression to ARDS from symptom onset was 9.6 days. Initial chest radiographic findings were normal (n = 2), focal opacity (n = 9), or multifocal or diffuse opacity (n = 8). Computed tomography (CT) findings included bilateral (n = 17) or unilateral (n = 2) ground-glass opacity with consolidation (n = 14) or pleural effusion (n = 11). Patients having subsequent ARDS had a higher probability of pleural effusion and a higher total CT extent compared with the non-ARDS group (p = 0.010 and 0.007, respectively). However, there were no significant differences in clinical variables such as patient age and premorbid condition.ConclusionAdenovirus pneumonia demonstrates high rates of ARDS and mortality, regardless of patient age and premorbid conditions, in the tertiary care setting. Large disease extent and presence of pleural effusion on CT are factors suggestive of progression to ARDS.

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Section: Methodsmentioning

confidence: 99%

Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

et al. 2016

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“…Both focal and multifocal opacities most commonly involve the lower lobes and show a predilection for the peripheral aspects of the lungs. The most common findings on CT scanning are ground glass opacities (GGO), these occurring in about two-thirds of cases during the first week [10][11][12] (Fig. Several patterns of disease progression have been described, most patients showing peak radiographic abnormalities between 6 and 12 days after the onset of symptoms.…”

Section: Radiology Of Acute Sars Infectionmentioning

confidence: 99%

“…11 After this point both GGO and reticulation may linger for many months, particularly in patients with continued dyspnea. 11 After this point both GGO and reticulation may linger for many months, particularly in patients with continued dyspnea.…”

Section: Radiology Of Convalesce and Long-term Follow-upmentioning

confidence: 99%

Radiology of Severe Acute Respiratory Syndrome (SARS)

Ketai

Paul

Wong

2006

Journal of Thoracic Imaging

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Severe acute respiratory distress syndrome (SARS) caused by SARS-associated coronavirus (SARS-CoV) is a systemic infection that clinically manifests as progressive pneumonia. During the initial phases of infection the virus causes pauci-inflammatory alveolar and interstitial edema that result in imaging abnormalities dominated by ground glass opacities (GGO). Severe SARS cases can develop radiologic and pathologic findings of diffuse alveolar damage. Although radiologic evidence of acute bronchiolitis is absent, SARS-CoV also infects ciliated airway epithelium, probably accounting for respiratory transmissibility of the virus. Radiologic recovery from SARS can be complete, but computed tomography images often show persistent GGO and reticular opacities, some of which reflect pathologic findings of fibrosis. Long-term follow-up imaging of survivors shows gradual decrease of GGO and reticulation with persistent air trapping in some patients. The latter is evidence of small airway disease that is not radiologically evident at the onset of the disease.

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“…Therefore, localizing disease to the pulmonary acinus was the smallest structure that was discerned during CT in dogs in this study with lung disease. Common terms used to describe disease involving the pulmonary acini include ground‐glass opacity, consolidation, atelectasis, collapse, and nodules . Further classification of lung disease may be possible by defining categories based on lung expansion, the shape of the opacity, for example, nodules, and the localization within the secondary pulmonary lobule or larger structures.…”

Section: Discussionmentioning

confidence: 99%

Relationships Among Subgross Anatomy, Computed Tomography, and Histologic Findings in Dogs With Disease Localized to the Pulmonary Acini

Scrivani

Thompson

Dykes

et al. 2011

Vet Radiology Ultrasound

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During computed tomography (CT), the appearance of disease involving the pulmonary acinus may be described using terms such as atelectasis, ground-glass opacity, or consolidation. These CT signs, however, have not been correlated with histologic findings in canine pulmonary disease. To facilitate interpretation of lung diseases by CT signs, our goals were to review the morphologic organization of the lung and evaluate the medical records of four dogs with different types of pulmonary acinar disease. Anatomic review focused on understanding the pulmonary acinus and the secondary pulmonary lobule; the secondary pulmonary lobule is a fundamental unit for interpretation in people. All dogs had similar CT findings of fully expanded lungs with increased attenuation and partial-to-complete obscuring of the pulmonary blood vessels. Histologic findings varied between dogs and included partial-to-complete filling of airspaces with cells or fluid, interstitial thickening, increased capillary blood volume, or a combination of these findings. Final diagnoses were hemorrhagic pneumonia, bronchiolar carcinoma, metastatic mammary adenocarcinoma, and pulmonary edema. In summary, the morphologic organization of the lungs is complex and has implications for diagnostic interpretation needing further evaluation in dogs. In this study, increased lung attenuation during CT due to disease localized to the pulmonary acini was due to the displacement of air from the lungs and not to the microscopic distribution of lesions within the pulmonary acinus. Imaging descriptors that classify diseases according to structures larger than the pulmonary acini, for example, regions of the secondary pulmonary lobule or larger, may be appropriate for dogs.

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Severe Acute Respiratory Syndrome: Temporal Lung Changes at Thin-Section CT in 30 Patients

Cited by 304 publications

References 17 publications

Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients

Radiology of Severe Acute Respiratory Syndrome (SARS)

Relationships Among Subgross Anatomy, Computed Tomography, and Histologic Findings in Dogs With Disease Localized to the Pulmonary Acini

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