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Lung ultrasonography and computed tomography comparison in convalescent athletes after Sars-CoV-2 infection – a preliminary study

Maria Binkiewicz-Orluk
Maria Binkiewicz-Orluk
, 
Marcin Konopka
Marcin Konopka
, 
Agnieszka Jakubiak
Agnieszka Jakubiak
, 
Wojciech Król
Wojciech Król
, 
Wojciech Braksator
Wojciech Braksator
 oraz 
Marek Kuch
Marek Kuch
   | 01 wrz 2022
Journal of Ultrasonography's Cover Image
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Article Category: research-paper
Data publikacji: 01 wrz 2022
Zakres stron: e153 - e160
Otrzymano: 20 gru 2021
Przyjęty: 22 lut 2022
DOI: https://doi.org/10.15557/jou.2022.0025
Słowa kluczowe
© 2022 Maria Binkiewicz-Orluk et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

The distribution of A-line pattern and LUS changes. A. The scheme of 14- anatomical scanning locations for ultrasound- places of probe applications. B. Distribution of the A-line artifacts. The number within each square refers to the amount of examinations with the only A-line artifacts in this localization (percentage value given in parenthesis, n-31). The data are presented in the diagram. C. Distribution of the ultrasound changes in the particular areas. First number within the square refers to the number of examinations with consolidations or B-pattern in the particular localization. The value within () refers to the all found changes in LUS (consolidations, B-pattern, pleura abnormalities, multiple Z-lines). Percentage values are given in () below. The data are presented in the diagrams.
The distribution of A-line pattern and LUS changes. A. The scheme of 14- anatomical scanning locations for ultrasound- places of probe applications. B. Distribution of the A-line artifacts. The number within each square refers to the amount of examinations with the only A-line artifacts in this localization (percentage value given in parenthesis, n-31). The data are presented in the diagram. C. Distribution of the ultrasound changes in the particular areas. First number within the square refers to the number of examinations with consolidations or B-pattern in the particular localization. The value within () refers to the all found changes in LUS (consolidations, B-pattern, pleura abnormalities, multiple Z-lines). Percentage values are given in () below. The data are presented in the diagrams.

Fig. 2.

The normal lung parenchyma. A. Ultrasound A-line pattern of the lungs corresponding with B. normal lung parenchyma visible in a high resolution computed tomography
The normal lung parenchyma. A. Ultrasound A-line pattern of the lungs corresponding with B. normal lung parenchyma visible in a high resolution computed tomography

Fig. 3.

A typical ultrasound view of Z-lines. A. First patient a) High resolution computed tomography: the small area of increasing density. b) Lung ultrasonography: two subpleural scarring changes with thick C-lines with two accompanying short, thin Z-lines. B. Second patient: a) High resolution computed tomography: small, subpleural adhesion. b) Lung ultrasonography a group of short, vertical Z-line artifacts
A typical ultrasound view of Z-lines. A. First patient a) High resolution computed tomography: the small area of increasing density. b) Lung ultrasonography: two subpleural scarring changes with thick C-lines with two accompanying short, thin Z-lines. B. Second patient: a) High resolution computed tomography: small, subpleural adhesion. b) Lung ultrasonography a group of short, vertical Z-line artifacts

Fig. 4.

The examples of the ultrasound view of consolidations. A. Subpleural annular post- inflammatory change with thick C-line, comparable to subpleural small consolidation. B. Small subpleural hyperechogenic change with thick C-line described then in HRCT as calcification. C. Small, hypoechogenic subpleural consolidation, comparable to the change visible then in HRCT. D. Paravertebral irregular consolidation, visible then in HRCT
The examples of the ultrasound view of consolidations. A. Subpleural annular post- inflammatory change with thick C-line, comparable to subpleural small consolidation. B. Small subpleural hyperechogenic change with thick C-line described then in HRCT as calcification. C. Small, hypoechogenic subpleural consolidation, comparable to the change visible then in HRCT. D. Paravertebral irregular consolidation, visible then in HRCT

Fig. 5.

Lung ultrasonound patterns of the abnormal pleura line. A. Irregularity of the pleura due to presence post inflammatory change with accompanying Z-lines. B. Interrupted line of the pleura with concomitant Z-line. C. Irregularity of the pleura due to the presence of small fibrotic changes. In all figures, abnormalities coexist with a normal, A-line pattern- the phenomenon typical for COVID-19
Lung ultrasonound patterns of the abnormal pleura line. A. Irregularity of the pleura due to presence post inflammatory change with accompanying Z-lines. B. Interrupted line of the pleura with concomitant Z-line. C. Irregularity of the pleura due to the presence of small fibrotic changes. In all figures, abnormalities coexist with a normal, A-line pattern- the phenomenon typical for COVID-19

Fig. 6.

The abnormalities not available for lung ultrasonography, visible in high resolution computed tomography. A. Peri-hilar small tumor. B. Consolidation near the base of the lung, close to spleen, with poor connection with the pleura line C. Small air cyst within the normal aerated lung parenchyma, D. Para-costal and para-vertebral small subpleural change
The abnormalities not available for lung ultrasonography, visible in high resolution computed tomography. A. Peri-hilar small tumor. B. Consolidation near the base of the lung, close to spleen, with poor connection with the pleura line C. Small air cyst within the normal aerated lung parenchyma, D. Para-costal and para-vertebral small subpleural change

Pattern of changes visible on HRCT

Total Asymptomatic (−) Mild (+) Moderate (++) Severe (+++)
Number of patients (N) 31 4 17 9 1
Number of assessed slices (N × 14) 434 56 238 126 14
Normal parenchyma 363 (83.6%) 49 (87.5%) 200 (84.0%) 103 (81.7%) 11 (78.6%)
Minor changes (adhesions, small scars and fibrotic changes, small consolidations) 38 (8.6%) 2 (3.6%) 19 (4.3%) 15 (11.9%) 2 (14.3%)
Major changes (ground glass opacifications, big consolidations) 10 (2.3%) 3 (5.4%) 2 (0.8%) 3 (2.4%) 2 (14.3%)
Non-specific changes (nodules, small tumors) 25 (5.8%) 3 (5.4%) 15 (7.6%) 6 (4.8%) 1 (7.1%)

Pattern of changes visible on LUS

Total Asymptomatic (−) Mild (+) Moderate (++) Severe (+++)
Number of patients (N) 31 4 17 9 1
Number of assessed areas (N × 14) 434 56 238 126 14
Number of areas with A-line pattern (only) 265 (61%) 36 (64.3%) 151 (63.4%) 73 (57.9%) 5 (35.7%)
Number of patients with dominant A-line pattern** A-pattern in ≥50% areas (percentage for each group) 24 (77.4%) 4 (100%) 14 (82.6%) 6 (66.7%) 0 (0%)
Number of patients with dominant “abnormal” pattern** A-pattern in <50% areas (percentage for each group) 7 (22.6%) 0 (0%) 3 (17.6%) 3 (33.3%) 1 (100%)
Number of areas with consolidations 59 7 (12.5%) 29 (12.6%) 21 (16.7%) 2 (14.3%)
All consolidations 70 8 36 24 2
Index: consolidation per patient 2.3 2.0 2.1 2.7 2.0
1) Big consolidations with thick C-line 25 2 12 10 1
2) Small consolidations 45 6 24 14 1

Study group

Characteristics of study group N = 31
Mean age, SD, (range) 26.0 ± 5.6 (17-38)
Height (cm) 190.3 (173-203)
Weight (kg) 86.6 (67-104)
Numbers of days after infection, SD (range) 28.8 ± 15.3 (11-50)
Sports discipline n (%)
    football 15 (48.4%)
    rowing 10 (32.3%)
    volleyball 5 (16.1%)
    basketball 1 (3.2%)
Course of infection n (%)
    asymptomatic (-) 4 (12.9%)
    mild symptoms (+) 17 (54.8%)
    moderate symptoms (++) 9 (29.0%)
    severe symptoms (hospitalization) (+++) 1 (3.2%)
eISSN:
2451-070X
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Basic Medical Science, other
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