Imaging findings of multisystem inflammatory syndrome in children associated with COVID-19.
Imaging findings of multisystem inflammatory syndrome in children associated with COVID-19.
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DOI：
10.1007/s00247-021-05065-0
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发表时间：
2021-08
影响因子：
2.3
通讯作者：
Kellenberger CJ
中科院分区：
文献类型：
--
作者：
Caro-Domínguez P;Navallas M;Riaza-Martin L;Ghadimi Mahani M;Ugas Charcape CF;Valverde I;D'Arco F;Toso S;Shelmerdine SC;van Schuppen J;Secinaro A;Gräfe D;Camacho M;Neth O;Goo HW;Kellenberger CJ
在暴露于严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的儿童中发现了一种高度炎症性免疫介导的休克综合征，该病毒导致2019冠状病毒病（COVID-19）。描述与COVID-19相关的多系统炎症综合征儿童的典型影像学表现。在COVID-19大流行的第一波期间，从多个中心收集了接受多系统炎症综合征治疗的儿童的成像研究和临床数据。标准化病例模板包括人口统计学、生化和影像学信息，由参与中心完成，并由儿科放射科医生和儿科医生进行审查。我们纳入了37名儿童（21名男孩;中位年龄8.0岁）。聚合酶链反应（PCR）检测结果显示，15/37（41%）名儿童的SARS-CoV-2呈阳性，13/19（68%）名儿童的免疫球蛋白呈阳性。常见临床表现为发热（100%）、腹痛（68%）、皮疹（54%）、结膜炎（38%）和咳嗽（32%）。33名儿童（89%）表现出心脏受累的实验室或影像学检查结果。37名儿童中有30名（81%）需要入住重症监护室，所有病例均恢复良好。胸部X线片显示54%的心脏肥大，73%的肺静脉高压/充血体征。最常见的胸部CT异常是磨玻璃影和间质影（83%），肺泡实变（58%），胸腔积液（58%）和支气管壁增厚（42%）。超声心动图显示一半的病例（51%）心功能受损，14%的病例冠状动脉异常。心脏MRI显示心肌水肿58%，心包积液42%，左心室功能下降25%。20名儿童因腹部症状需要成像，最常见的异常是游离液体（71%）和末端回肠壁增厚（57%）。12名儿童接受了脑成像，显示两例异常。多系统炎性综合征患儿的影像学表现包括肺、心、腹、脑等，反映了多系统炎性疾病。认识本病的影像学特征对早期诊断和治疗具有重要意义。在线版本包含补充材料，可通过10.1007/s 00247 -021-05065-0获得。
A hyperinflammatory immune-mediated shock syndrome has been recognised in children exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). To describe typical imaging findings in children with multisystem inflammatory syndrome associated with COVID-19. During the first wave of the COVID-19 pandemic, imaging studies and clinical data from children treated for multisystem inflammatory syndrome were collected from multiple centres. Standardised case templates including demographic, biochemical and imaging information were completed by participating centres and reviewed by paediatric radiologists and paediatricians. We included 37 children (21 boys; median age 8.0 years). Polymerase chain reaction (PCR) testing was positive for SARS-CoV-2 in 15/37 (41%) children and immunoglobulins in 13/19 children (68%). Common clinical presentations were fever (100%), abdominal pain (68%), rash (54%), conjunctivitis (38%) and cough (32%). Thirty-three children (89%) showed laboratory or imaging findings of cardiac involvement. Thirty of the 37 children (81%) required admission to the intensive care unit, with good recovery in all cases. Chest radiographs demonstrated cardiomegaly in 54% and signs of pulmonary venous hypertension/congestion in 73%. The most common chest CT abnormalities were ground-glass and interstitial opacities (83%), airspace consolidation (58%), pleural effusion (58%) and bronchial wall thickening (42%). Echocardiography revealed impaired cardiac function in half of cases (51%) and coronary artery abnormalities in 14%. Cardiac MRI showed myocardial oedema in 58%, pericardial effusion in 42% and decreased left ventricular function in 25%. Twenty children required imaging for abdominal symptoms, the commonest abnormalities being free fluid (71%) and terminal ileum wall thickening (57%). Twelve children underwent brain imaging, showing abnormalities in two cases. Children with multisystem inflammatory syndrome showed pulmonary, cardiac, abdominal and brain imaging findings, reflecting the multisystem inflammatory disease. Awareness of the imaging features of this disease is important for early diagnosis and treatment. The online version contains supplementary material available at 10.1007/s00247-021-05065-0.
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