Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1401
6
1
gregorian
2022
9
1
29
6
online
1
fulltext
fa
بررسی تفسیر سی تی اسکن قفسه سینه بیماران مبتلا به کووید-19 بیمارستان امام خمینی دانشگاه علوم پزشکی جیرفت از اسفند 98 تا خرداد 99
Interpretation of chest CT scan of patints with COVID-19 in Imam Khomeini Hospital of Jiroft University of Medical Sciences from December to March 2019
بیماریهای عفونی
Infectious Disease
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:#0070c0">زمینه و هدف:</span></span></span></span></b> <span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">با توجه به اهمیت تشخیص زودهنگام این بیماری، تصویربرداری توسط سی تی اسکن قفسه سینه به عنوان یک روش غیر تهاجمی می</span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">تواند ابزاری با دقت بالا برای تشخیص زودهنگام موارد مشکوک باشد</span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">.</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"></span></span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:#0070c0">روش کار:</span></span></span></span></b> <span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">در این</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">مطالعه گذشتهنگر، دادهها شامل مشخصات دموگرافیک و یافتههای سی تی اسکن قفسه سینه از 224 بیمار با تست </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">PCR</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> مثبت برای </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">19</span></span></span></span> <span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">COVID-</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> از </span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">اسفندماه 1398</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">تا خردادماه 1399 از بیمارستان امام خمینی دانشگاه علوم پزشکی جیرفت جمع آوری شد و در یک پرسشنامه طراحی شده ثبت شد و برای ارزیابی دادهها از نرمافزار </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">SPSS</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">نسخه 18 استفاده شد.</span></span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:#0070c0">یافتهها:</span></span></span></span></b> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">بیشترین تعداد افراد مبتلا به کووید-19 در رده سنی 30 تا 59 سال و مردان بودند. در بررسی یافتههای سی تی اسکن، بیشترین یافته تصویربرداری سی تی اسکن و همچنین بیشترین میزان مرگ در افراد مبتلا، نمای </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">PGGO</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> و</span></span></span></span> <span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">درگیری بهصورت </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">Peripheral</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> و </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">Bilateral</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> و کمترین فراوانی مربوط به یافته </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">Cavitation</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> بود. </span></span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:#0070c0">نتیجهگیری:</span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> با شناسایی یافته</span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">های شایع در سی تی اسکن قفسه سینه در افراد مبتلا به کروناویروس، می</span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black">توان موارد </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">COVID-19</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> را به موقع شناسایی نمود و اقدامات پیشگیرانه فوری را انجام داد. بنابراین با توجه به دقت این ابزار تشخیصی و نتایج سریع آن، باید تصویربرداری </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">CT</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> در خط مقدم ابزارهای غربالگری </span></span></span></span><span dir="LTR" style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">COVID-19</span></span></span></span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:115%"><span b="" mitra="" style="font-family:"><span style="color:black"> قرار گیرد و سهولت دسترسی گسترده به آن در مناطق مختلف فراهم گردد.</span></span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><span style="font-size:9.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0070c0">Background & Aims:</span></span></span></span></b> <span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection. Due to their availability and rapid turnaround time, the role of chest computed tomography (CT) scan is growing for early diagnosis of patients with COVID-19. However, due to the low efficiency of viral nucleic acid detection as well as low specificity of chest CT scan for detecting COVID-19 pneumonia, this method shows incomplete clinical performance for proper COVID-19 disease diagnosis. Due to the highly contagious nature of the Coronavirus 2019 and the importance of early detection of the disease, a limited number of nucleic acid test kits, such as rRT-PCR and the possibility of false-negative rRT-PCR results, chest CT scan as a non-invasive method, it can be a highly accurate tool for early detection of suspected COVID-19 cases. The purpose of this study was the Interpretation of chest CT scan of patints with COVID-19 in Imam Khomeini Hospital of Jiroft University of Medical Sciences from December to March 2019</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0070c0">Methods:</span></span></span></span></b> <span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">This research is a retrospective study that was conducted with the aim of interpreting CT scans of the chest in patients with covid-19 in Imam Khomeini Hospital, Jiroft University of Medical Sciences from March 2018 to June 2019. After obtaining permission from the ethics committee of the university, the researcher appeared in the research environment according to the pre-determined schedule for sampling. The desired data were extracted from the patients' files and recorded in a questionnaire form that was designed for this purpose. The criteria for entering the study included cases whose demographic information, clinical and laboratory data were complete and the positive PCR test along with chest CT imaging findings were available in the file, the exclusion criterion was the presence of low quality chest images.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">The data were extracted from the hospital information system based on clinical electronic medical records. including demographic information including age, sex, level of education and data related to the underlying disease, disease symptoms (cough, fever, phlegm, shortness of breath, chest pain, etc.) and the frequency of imaging findings in the chest CT scan that They were examined and evaluated according to age, gender, level of education, clinical symptoms, underlying disease and based on lymphopenia and lymphocytosis. and chest CT scan report of patients with COVID-19, which was available in the PACS system of this hospital, were evaluated. In this way, all the CT images of the chest by a radiologist as well as a lung specialist who were not aware of the clinical and laboratory data of the patients, in terms of the types of findings include, Patchy ground glass opcification, diffuse ground glass opacification, Air space opacity, Consolidation, pleural effusion, Atelectasis, Bronchiectasis, Fibrotic change, Cavitation, Lymphadenopathy. And the distribution of conflict was investigated as peripheral, central, bilateral, and unilateral. </span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0070c0">Results:</span></span></span></span></b><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"> The highest number of people with Covid-19 were in the age range of 30 to 59 years and men. In CT scan findings, the highest CT scan imaging findings as well as the highest mortality rate in patients were PGGO view (63.3%) and peripheral and bilateral involvement and the lowest frequency was related to Cavitation findings. In the examination of CT scan findings, PGGO and peripheral and bilateral involvement were the most frequent and Cavitation was the least frequent. Also, the findings of PGGO, Peripheral and Bilateral in the CT scan of the people who died had the highest frequency.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">In none of the imaging findings of the chest scan, there was no statistically significant relationship with the level of education, the level of education and death of patients due to COVID-19 . There was no significant difference between gender and the findings of PGGO and Cavitation and peripheral involvement and Bilateral , but between the findings of DGGO and gender and there was a significant relationship between Bronchiectasis and gender. In general, the results showed that there is no significant relationship between gender and death of patients due to COVID-19. In terms of symptoms, the findings showed that there is no significant relationship between the symptoms of myalgia, chest pain, loss of sense of smell and taste, and digestive symptoms and CT scan findings, but between the feeling of weakness and Peripheral involvement, there was a statistically significant difference between the decrease in level of consciousness and the finding of Pleural effusion and the finding of CavitationP, and in general, a statistically significant relationship was observed between the death of patients and myalgia and the decrease in level of consciousness.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0070c0">Conclusion:</span></span></span></span></b> <span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">Among findings of this research, the symptoms of cough, fever, shortness of breath, and headache were present in most of the patients. In line with this finding, Kazemini and colleagues also concluded in their study that fever and cough are two important factors in identifying patients with Covid-19 is high . In this study, CT scan findings in the form of PGGO, Peripheral and Bilateral had the most frequency, which was also reported in a study that at the time of the onset of the disease, the findings of PGGO and Bilateral distribution were the most frequent in CT scans of patients . The reason that the lesions have a marginal distribution and are not limited to certain parts of the lung lobes can probably be due to the small size of the virus, which has a greater tendency to deposit in the peripheral lobes of the lung and thus cause damage to the epi The telium becomes alveolar and affects several adjacent lobules . Also, according to Wei li et al.'s study, GGO is the most common chest CT imaging manifestation in pneumonia caused by the corona virus, which indicates that the pneumonia of COVID-19 mainly includes interstitial secretions. This means that the pathological mechanism of the disease is secondary to the expansion and congestion of alveolar capillaries and interstitial edema in the interlobular septum . unlike COVID-19, in SARS, most cases of lung involvement are unilateral.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black">In the present study, the findings of Air space opacity and Consolidation imaging were also found to be of high frequency compared to other findings, in the study of SONG et al., it was also reported that GGO image is more frequent in young people and Consolidation image is more frequent with increasing age. This issue is also evident in the present study, so that Consolidation was less frequent at ages less than 30 years compared to ages 30-59 years. Consolidation is one of the characteristics of CT in patients with COVID-19, which is a sign of disease progression, Pan et al. found that consolidation is rare in the early stages of the disease. Consolidation begins to appear with the progress of the disease and gradually becomes the main imaging feature. Therefore, the analysis of chest CT imaging can help the doctor in identifying the early stages or the progress of the disease. By identifying the common findings in chest CT scan in people with coronavirus, based on appropriate epidemiological and demographic characteristics, COVID-19 cases can be identified in a timely manner and immediate preventive measures can be taken. Therefore, due to the accuracy of this diagnostic tool and its rapid results, CT imaging should be at the forefront of COVID-19 screening tools and easy access to it in different areas compared to rRT-PCR kits should be provided.</span></span></span></span><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="tab-stops:10.5pt"><span style="line-height:115%"><span style="font-family:Calibri,sans-serif"><span style="font-size:8.5pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
سی تی اسکن, کووید-19, کرونا ویروس, ایران
CT scan, COVID-19, Coronavirus, Iran
1
11
http://rjms.iums.ac.ir/browse.php?a_code=A-10-2781-2&slc_lang=fa&sid=1
amin
saeedi
امین
سعیدی
3900319475328460067591
3900319475328460067591
No
Assistant Professor of Internal Medicine, Department of Internal Medicine, School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran
استادیار بیماریهای داخلی، گروه داخلی، بیمارستان امام خمینی دانشگاه علوم پزشکی جیرفت، جیرفت، ایران
Fatemeh
Jalalifar
فاطمه
جلالی فر
3900319475328460067592
3900319475328460067592
No
School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran
دانشجوی پزشکی، دانشکده پزشکی دانشگاه علوم پزشکی جیرفت، جیرفت، ایران
leila
karimi
لیلا
کریمی
3900319475328460067593
3900319475328460067593
No
Assistant Professor, Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
استادیار، مرکز تحقیقات علوم رفتاری، انستیتو سبک زندگی، دانشکده پرستاری، دانشگاه علوم پزشکی بقیه ا...، تهران، ایران
Sepideh
Mirzaei
سپیده
میرزایی
3900319475328460067594
3900319475328460067594
No
Department of Biology, Faculty of Science, Islamic Azad University, Science and Research Branch, Tehran, Iran
گروه زیست شناسی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
Mehdi
Raei
مهدی
راعی
3900319475328460067595
3900319475328460067595
No
Assistant Professor, Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
استادیار آمار زیستی، مرکز تحقیقات بهداشت، پژوهشکده سبک زندگی، دانشگاه علوم پزشکی بقیه ا...، تهران، ایران
Salman
Daneshi
سلمان
دانشی
salmandaneshi008@gmail.com
3900319475328460067596
3900319475328460067596
Yes
Instructor of Epidemiology, Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
گروه بهداشت عمومی، دانشکده بهداشت، دانشگاه علوم پزشکی جیرفت، جیرفت، ایران