Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study

  • Hamidreza Hatamabadi ORCID Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical, Tehran, Iran
  • Majid Shojaee ORCID Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical, Tehran, Iran
  • Mohammad Bagheri ORCID Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical, Tehran, Iran
  • Masoomeh Raoufi ORCID Mail Department of Radiology, Imam Hossein Hospital, Shahid Beheshti University of Medical, Tehran, Iran
Keywords:
COVID-19, Lung, Tomography, X-Ray Computed, Ultrasonography

Abstract

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia. Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED). Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A 10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score. Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p <0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p <0.05) with CT scan findings. Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training.

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References

1. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3.
2. World Health organization. Coronavirus disease (COVID-2019) situation reports. April 17, 2020. [Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200417-sitrep-88-covid-191b6cccd94f8b4f219377bff55719a6ed.pdf?sfvrsn=ebe78315_6].
3. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
4. Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4.
5. Lei J, Li J, Li X, Qi X. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020;295(1):18.
6. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425-34.
7. Wongwaisayawan S, Suwannanon R, Sawatmongkorngul S, Kaewlai R. Emergency thoracic US: the essentials. Radiographics. 2016;36(3):640-59.
8. Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure*: the BLUE protocol. Chest. 2008;134(1):117-25.
9. Inchingolo R, Smargiassi A, Mormile F, Marra R, De Carolis S, Lanzone A, et al. Look at the lung: can chest ultrasonography be useful in pregnancy? Multidiscip Respir Med. 2014;9(1):32.
10. Mayo PH, Copetti R, Feller-Kopman D, Mathis G, Maury E, Mongodi S, et al. Thoracic ultrasonography: a narrative review. Intens Care Med. 2019;45(9):1200-11.
11. Lichtenstein DA. Lung ultrasound in the critically ill. Ann Intens Care. 2014;4(1):1.
12. Asefi H, Safaie A. The Role of Chest CT Scan in Diagnosis of COVID-19. Adv J Emerg Med. 2020;4(2s):e64.
13. Skolnick ML. Advantages of Real-time Imaging. In: Real-time Ultrasound Imaging in the Abdomen. Springer, New York, NY; 1981. p. 1-11.
14. Soldati G, Demi M, Smargiassi A, Inchingolo R, Demi L. The role of ultrasound lung artifacts in the diagnosis of respiratory diseases. Expert Rev Respir Med. 2019;13(2):163-72.
15. Moro F, Buonsenso D, Moruzzi MC, Inchingolo R, Smargiassi A, Demi L, et al. How to perform lung ultrasound in pregnant women with suspected COVID-19 infection. Ultrasound Obstet Gynecol. 2020 May;55(5):593-8.
16. Peng QY, Wang XT, Zhang LN, Chinese Critical Care Ultrasound Study Group (CCUSG). Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic. Intensive Care Med. 2020;46(5):849-50.
17. Wongwaisayawan S, Suwannanon R, Sawatmongkorngul S, Kaewlai R. Emergency thoracic US: the essentials. Radiographics. 2016;36(3):640-59.
18. Engeler CE, Tashjian JH, Trenkner SW, Walsh JW. Ground-glass opacity of the lung parenchyma: a guide to analysis with high-resolution CT. AJR Am J Roentgenol. 1993;160(2):249-51.
19. Walker CM, Abbott GF, Greene RE, Shepard J-AO, Vummidi D, Digumarthy SR. Imaging pulmonary infection: classic signs and patterns. AJR Am J Roentgenol. 2014;202(3):479-92.
20. Brogi E, Gargani L, Bignami E, Barbariol F, Marra A, Forfori F, et al. Thoracic ultrasound for pleural effusion in the intensive care unit: a narrative review from diagnosis to treatment. Crit Care. 2017;21(1):325.
21. Yu M, Hu M, Huang Y, Wang S, Liu Y, Zhang Y, et al. A preliminary study on the ultrasonic manifestations of peripulmonary lesions of non-critical novel coronavirus pneumonia (COVID-19). 2020; Preprint from Research Square.
22. Wang Y, Dong C, Hu Y, Li C, Ren Q, Zhang X, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology. 2020:200843.
23. Dietrich CF, Mathis G, Cui X-W, Ignee A, Hocke M, Hirche TO. Ultrasound of the pleurae and lungs. Ultrasound Med Biol. 2015;41(2):351-65.
24. Buonsenso D, Piano A, Raffaelli F, Bonadia N, de Gaetano Donati K, Franceschi F. Point-of-Care Lung Ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci. 2020;24(5):2776-80.
25. Peng QY, Wang XT, Zhang LN, Chinese Critical Care Ultrasound Study G. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic. Intensive Care Med. 2020 May;46(5):849-50.
26. Gargani L, Volpicelli G. How I do it: lung ultrasound. Cardiovasc Ultrasound. 2014;12(1):25.
27. Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Briganti DF, et al. Proposal for international standardization of the use of lung ultrasound for COVID‐19 patients; a simple, quantitative, reproducible method. J Ultrasound Med. 2020;39(7):1413-9.
28. Naderpour Z, Saeedi M. A Primer on COVID-19 for Clinicians: Clinical Manifestation and Natural Course. Adv J Emerg Med. 2020;4(2s):e62.
29. Lu W, Zhang S, Chen B, Chen J, Xian J, Lin Y, et al. A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound. Ultraschall Med. 2020;41(3):300-7.
Published
2020-06-26
How to Cite
1.
Hatamabadi H, Shojaee M, Bagheri M, Raoufi M. Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study. Adv J Emerg Med.
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Original article