Abdominal Imaging Findings in COVID-19: Preliminary Observations.
Abdominal Imaging Findings in COVID-19: Preliminary Observations.
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DOI：
10.1148/radiol.2020201908
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发表时间：
2020-10
期刊：
影响因子：
19.7
通讯作者：
Kambadakone A
中科院分区：
文献类型：
--
作者：
Bhayana R;Som A;Li MD;Carey DE;Anderson MA;Blake MA;Catalano O;Gee MS;Hahn PF;Harisinghani M;Kilcoyne A;Lee SI;Mojtahed A;Pandharipande PV;Pierce TT;Rosman DA;Saini S;Samir AE;Simeone JF;Gervais DA;Velmahos G;Misdraji J;Kambadakone A
血管紧张素转换酶 2 是严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的靶标，其在肺、小肠和脉管系统的表面表达量最高，表明腹部内脏可能容易受到损伤。报告 2019 年冠状病毒病患者的腹部影像学结果。在这项回顾性横断面研究中，纳入了 2020 年 3 月 27 日至 4 月 10 日连续入住一家四级护理中心且 SARS-CoV-2 检测呈阳性的患者。对这些患者进行的腹部影像学研究进行了回顾，并记录了显着的发现。审查医疗记录以获取临床数据。进行单变量分析和逻辑回归。共有 412 名患者（平均年龄 57 岁；范围 18 至 >90 岁；241 名男性，171 名女性）接受了评估。总共对 134 名患者 (33%) 进行了 224 项腹部影像学研究（放射线检查，n = 137；US，n = 44；CT，n = 42；MRI，n = 1）。腹部影像学检查与年龄（比值比 [OR]，每年增加 1.03；P = .001）和入住重症监护病房 (ICU) 相关（OR，17.3；P < .001）。 31% 的 CT 图像（42 张中的 13 张）显示肠壁异常，并且与 ICU 入住相关（OR，15.5；P = .01）。肠道检查结果包括积气或门静脉积气，在 ICU 患者获得的 CT 图像中，有 20% 可见（20 例中有 4 例）。手术相关性 (n = 4) 显示肠道异常黄变 (n = 3) 和肠梗塞 (n = 2)。病理结果显示缺血性肠炎，伴有小动脉内斑片状坏死和纤维蛋白血栓（n = 2）。进行右上象限超声检查主要是因为肝脏实验室检查结果（87%，37 人中的 32 人），54%（37 人中的 20 人）发现胆囊扩张，充满污泥，提示胆汁淤滞。放置胆囊造口管的患者（n = 4）细菌培养呈阴性。肠道异常和胆囊胆汁瘀滞是2019冠状病毒病患者腹部影像的常见发现。接受剖腹手术的患者经常出现缺血，可能是由于小血管血栓形成。 © 北美放射学会，2020
Angiotensin-converting enzyme 2, a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury. To report abdominal imaging findings in patients with coronavirus disease 2019. In this retrospective cross-sectional study, patients consecutively admitted to a single quaternary care center from March 27 to April 10, 2020, who tested positive for SARS-CoV-2 were included. Abdominal imaging studies performed in these patients were reviewed, and salient findings were recorded. Medical records were reviewed for clinical data. Univariable analysis and logistic regression were performed. A total of 412 patients (average age, 57 years; range, 18 to >90 years; 241 men, 171 women) were evaluated. A total of 224 abdominal imaging studies were performed (radiography, n = 137; US, n = 44; CT, n = 42; MRI, n = 1) in 134 patients (33%). Abdominal imaging was associated with age (odds ratio [OR], 1.03 per year of increase; P = .001) and intensive care unit (ICU) admission (OR, 17.3; P < .001). Bowel-wall abnormalities were seen on 31% of CT images (13 of 42) and were associated with ICU admission (OR, 15.5; P = .01). Bowel findings included pneumatosis or portal venous gas, seen on 20% of CT images obtained in patients in the ICU (four of 20). Surgical correlation (n = 4) revealed unusual yellow discoloration of the bowel (n = 3) and bowel infarction (n = 2). Pathologic findings revealed ischemic enteritis with patchy necrosis and fibrin thrombi in arterioles (n = 2). Right upper quadrant US examinations were mostly performed because of liver laboratory findings (87%, 32 of 37), and 54% (20 of 37) revealed a dilated sludge-filled gallbladder, suggestive of bile stasis. Patients with a cholecystostomy tube placed (n = 4) had negative bacterial cultures. Bowel abnormalities and gallbladder bile stasis were common findings on abdominal images of patients with coronavirus disease 2019. Patients who underwent laparotomy often had ischemia, possibly due to small-vessel thrombosis. © RSNA, 2020
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影响因子：
19.7
作者：
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