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Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study
RATIONALE AND OBJECTIVES: Few reports have studied lung aeration and perfusion in normal lungs, COVID-19, and ARDS from other causes (NC-ARDS) using dual-energy computed tomography pulmonary angiograms (DE-CTPA). To describe lung aeration and blood-volume distribution using DE-CTPAs of patients with...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Association of University Radiologists. Published by Elsevier Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035816/ https://www.ncbi.nlm.nih.gov/pubmed/36966073 http://dx.doi.org/10.1016/j.acra.2023.01.016 |
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author | Bogot, Naama R. Steiner, Roee Helviz, Yigal Weiss, Chedva Cherniavsky, Konstantin Pichkhadze, Olga Ball, Lorenzo Frank, Yigal Levin, Philip Pelosi, Paolo Benjaminov, Ofer Einav, Sharon |
author_facet | Bogot, Naama R. Steiner, Roee Helviz, Yigal Weiss, Chedva Cherniavsky, Konstantin Pichkhadze, Olga Ball, Lorenzo Frank, Yigal Levin, Philip Pelosi, Paolo Benjaminov, Ofer Einav, Sharon |
author_sort | Bogot, Naama R. |
collection | PubMed |
description | RATIONALE AND OBJECTIVES: Few reports have studied lung aeration and perfusion in normal lungs, COVID-19, and ARDS from other causes (NC-ARDS) using dual-energy computed tomography pulmonary angiograms (DE-CTPA). To describe lung aeration and blood-volume distribution using DE-CTPAs of patients with NC-ARDS, COVID-19, and controls with a normal DE-CTPA (“healthy lungs”). We hypothesized that each of these conditions has unique ranges of aeration and pulmonary blood volumes. MATERIALS AND METHODS: This retrospective, single-center study of DE-CTPAs included patients with COVID-19, NC-ARDS (Berlin criteria), and controls. Patients with macroscopic pulmonary embolisms were excluded. The outcomes studied were the (1) lung blood-volume in areas with different aeration levels (normal, ground glass opacities [GGO], consolidated lung) and (2) aeration/blood-volume ratios. RESULTS: Included were 20 patients with COVID-19 (10 milds, 10 moderate-severe), six with NC-ARDS, and 12 healthy-controls. Lung aeration was lowest in patients with severe COVID-19 24% (IQR13%–31%) followed by those with NC-ARDS 40%(IQR21%–46%). Blood-volume in GGO was lowest in patients with COVID-19 [moderate-severe:-28.6 (IQR-33.1–23.2); mild: -30.1 (IQR-33.3–23.4)] and highest in normally aerated areas in NC-ARDS -37.4 (IQR-52.5–30.2-) and moderate-severe COVID-19 -33.5(IQR-44.2–28.5). The median aeration/blood-volume ratio was lowest in severe COVID-19 but some values overlapped with those observed among patients with NC-ARDS. CONCLUSION: Severe COVID-19 disease is associated with low total aerated lung volume and blood-volume in areas with GGO and overall aeration/blood volume ratios, and with high blood volume in normal lung areas. In this hypothesis-generating study, these findings were most pronounced in severe COVID disease. Larger studies are needed to confirm these preliminary findings. |
format | Online Article Text |
id | pubmed-10035816 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Association of University Radiologists. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100358162023-03-24 Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study Bogot, Naama R. Steiner, Roee Helviz, Yigal Weiss, Chedva Cherniavsky, Konstantin Pichkhadze, Olga Ball, Lorenzo Frank, Yigal Levin, Philip Pelosi, Paolo Benjaminov, Ofer Einav, Sharon Acad Radiol Original Investigation RATIONALE AND OBJECTIVES: Few reports have studied lung aeration and perfusion in normal lungs, COVID-19, and ARDS from other causes (NC-ARDS) using dual-energy computed tomography pulmonary angiograms (DE-CTPA). To describe lung aeration and blood-volume distribution using DE-CTPAs of patients with NC-ARDS, COVID-19, and controls with a normal DE-CTPA (“healthy lungs”). We hypothesized that each of these conditions has unique ranges of aeration and pulmonary blood volumes. MATERIALS AND METHODS: This retrospective, single-center study of DE-CTPAs included patients with COVID-19, NC-ARDS (Berlin criteria), and controls. Patients with macroscopic pulmonary embolisms were excluded. The outcomes studied were the (1) lung blood-volume in areas with different aeration levels (normal, ground glass opacities [GGO], consolidated lung) and (2) aeration/blood-volume ratios. RESULTS: Included were 20 patients with COVID-19 (10 milds, 10 moderate-severe), six with NC-ARDS, and 12 healthy-controls. Lung aeration was lowest in patients with severe COVID-19 24% (IQR13%–31%) followed by those with NC-ARDS 40%(IQR21%–46%). Blood-volume in GGO was lowest in patients with COVID-19 [moderate-severe:-28.6 (IQR-33.1–23.2); mild: -30.1 (IQR-33.3–23.4)] and highest in normally aerated areas in NC-ARDS -37.4 (IQR-52.5–30.2-) and moderate-severe COVID-19 -33.5(IQR-44.2–28.5). The median aeration/blood-volume ratio was lowest in severe COVID-19 but some values overlapped with those observed among patients with NC-ARDS. CONCLUSION: Severe COVID-19 disease is associated with low total aerated lung volume and blood-volume in areas with GGO and overall aeration/blood volume ratios, and with high blood volume in normal lung areas. In this hypothesis-generating study, these findings were most pronounced in severe COVID disease. Larger studies are needed to confirm these preliminary findings. The Association of University Radiologists. Published by Elsevier Inc. 2023-01-19 /pmc/articles/PMC10035816/ /pubmed/36966073 http://dx.doi.org/10.1016/j.acra.2023.01.016 Text en © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Investigation Bogot, Naama R. Steiner, Roee Helviz, Yigal Weiss, Chedva Cherniavsky, Konstantin Pichkhadze, Olga Ball, Lorenzo Frank, Yigal Levin, Philip Pelosi, Paolo Benjaminov, Ofer Einav, Sharon Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study |
title | Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study |
title_full | Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study |
title_fullStr | Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study |
title_full_unstemmed | Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study |
title_short | Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study |
title_sort | distribution of aeration and pulmonary blood volume in healthy, ards and covid-19 lungs: a dual-energy computed tomography retrospective cohort study |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035816/ https://www.ncbi.nlm.nih.gov/pubmed/36966073 http://dx.doi.org/10.1016/j.acra.2023.01.016 |
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