Open AccessDifferential Diagnosis of Lungs Lesions in a New Coronavirus Infection COVID-19 and Diseases of Non-Viral Etiology on the Clinical Cases by Computed Tomography Scans in Outpatient CT Centers
Author(s) -
M. N Lobanov,
Олег Бронов,
Yu. A. Abovich,
Н. В. Ледихова,
Elena V. Turavilova,
Sergey P. Morozov,
Н Н Камынина
Publication year - 2020
Publication title -
vestnik rossijskoj akademii medicinskih nauk
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.122
H-Index - 15
eISSN - 2414-3545
pISSN - 0869-6047
DOI - 10.15690/vramn1429
Subject(s) - medicine , differential diagnosis , pneumonia , viral pneumonia , radiology , etiology , radiological weapon , ground glass opacity , lung , pathology , covid-19 , infectious disease (medical specialty) , disease , adenocarcinoma , cancer
New coronavirus infection (COVID-19) viral pneumonia diagnosed by a complex assessment of the epidemiological history, clinical symptoms, radiological and laboratory tests. Radiologists often play a leading role in diagnosis of viral pneumonia, since they may encounter suspicious changes according to radiological studies before clinicians. However, in a number of diseases, including diseases of non-infectious non-viral etiology with a corresponding similar clinical symptoms, it may be difficult to correctly assess the changes detected by computed tomography. This study uses clinical cases to show the main differential diagnostic criteria for COVID-19 viral pneumonia and non-infectious lesions such as pulmonary edema, pulmonary embolism, acute hypersensitive pneumonitis, drug-induced pneumonitis, non-specific interstitial pneumonia, and adenocarcinoma. All patients were hospitalized based on the results of computed tomography, where a diagnosis of non-infectious non-viral lung injuries was established based on morphological and/or typical clinical symptoms, laboratory or radiological data. We examined clinical cases with radiological signs similar to viral pneumonia, such as areas of ground glass opacities with the presence or absence of areas of consolidation, as well as thickening of the lung interstitium with decreased lung attenuation (crazy paving symptom). In a difficult epidemiological situation, it is important for a radiologist to suspect the above-mentioned pathological conditions in patients who are urgently admitted to outpatient CT centers.