Alban Gervaise

Pulmonary embolism (PE) and deep vein thrombosis (DVT) occurred in 16.5% and 14.8% of patients with coronavirus disease 2019, respectively, and more than half of patients with PE lacked DVT. Background The association of pulmonary embolism (PE) with deep vein thrombosis (DVT) in patients with coronavirus disease 2019 (COVID-19) remains unclear, and the diagnostic accuracy of D-dimer te...

Background The role and performance of chest CT in the diagnosis of the coronavirus disease 2019 (COVID-19) pandemic remains under active investigation. Purpose To evaluate the French national expe...

Objectives To evaluate the prevalence of acute pulmonary embolism (APE) in non-hospitalized COVID-19 patients referred to CT pulmonary angiography (CTPA) by the emergency department. Methods From March 14 to April 6, 2020, 72 non-hospitalized patients referred by the emergency department to CTPA for COVID-19 pneumonia were retrospectively identified. Relevant clinical and laboratory data and CT scan findings were collected for each patient. CTPA scans were reviewed by two radiologists to determinate the presence or absence of APE. Clinical classification, lung involvement of COVID-19 pneumonia, and CT total severity score were compared between APE group and non-APE group. Results APE was identified in 13 (18%) CTPA scans. The mean age and D-dimer of patients from the APE group were higher in comparison with those from the non-APE group (74.4 vs. 59.6 years, p = 0.008, and 7.29 vs. 3.29 μg/ml, p = 0.011). There was no significant difference between APE and non-APE groups concerning clinical type, COVID-19 pneumonia lung lesions (ground-glass opacity: 85% vs. 97%; consolidation: 69% vs. 68%; crazy paving: 38% vs. 37%; linear reticulation: 69% vs. 78%), CT severity score (6.3 vs. 7.1, p = 0.365), quality of CTPA (1.8 vs. 2.0, p = 0.518), and pleural effusion (38% vs. 19%, p = 0.146). Conclusions Non-hospitalized patients with COVID-19 pneumonia referred to CT scan by the emergency departments are at risk of APE. The presence of APE was not limited to severe or critical clinical type of COVID-19 pneumonia. Key Points • Acute pulmonary embolism was found in 18% of non-hospitalized COVID-19 patients referred by the emergency department to CTPA. Two (15%) patients had main, four (30%) lobar, and seven (55%) segmental acute pulmonary embolism. • Five of 13 (38%) patients with acute pulmonary embolism had a moderate clinical type. • Severity and radiological features of COVID-19 pneumonia showed no significant difference between patients with or without acute pulmonary embolism.

Objectives: To evaluate the prevalence of acute pulmonary embolism (APE) in non-hospitalized COVID-19 patients referred to CT pulmonary angiography (CTPA) by Emergency Department.Methods: From March 14 to April 6, 2020, 72 non-hospitalized patients referred by Emergency Department to CTPA for COVID-19 pneumonia were retrospectively identified. Relevant clinical and laboratory data and CT scan findings were collected for each patient. CTPA scans were reviewed by two radiologists to determinate the presence or absence of APE. Clinical classification, lung involvement of COVID-19 pneumonia and CT total severity score were compared between APE group and Non-APE group.Results: APE was identified in 13 (18%) CTPA scans. The mean age and D-dimer of patients from APE group were higher in comparison with Non-APE group (74.4 vs. 59.6 years, p=0.008 and 7.29 vs. 3.29 µg/ml, p=0.011). There was no significant difference between APE and Non-APE groups concerning clinical type, COVID-19 pneumonia lung lesions (ground-glass opacity: 85 vs. 97%; consolidation: 69 vs. 68%; crazy paving: 38% vs. 37%; linear reticulation: 69 vs. 78%), CT severity score (6.3 vs. 7.1, p=0.365), quality of CTPA (1.8 vs. 2.0, p=0.518) and pleural effusion (38% vs. 19%, p=0.146).Conclusions: Non-hospitalized patients with COVID-19 pneumonia referred to CT-scan by Emergency Departments are at risk of APE. Presence of APE was not limited to severe or critical clinical type of COVID-19 pneumonia.

To evaluate an alternative method to reduce the acquisition coverage of urinary tract CT. This retrospective study included 365 abdominopelvic CT studies. Three radiographers simulated shortened acquisition coverages using three methods to determine the upper limit of the acquisition: Method 1 used the renal contours; Method 2 used the inferior margin of the 10th thoracic vertebra; and Method 3 used the point of intersection of the left diaphragmatic dome and the anterior margin of the vertebral bodies. Reductions in acquisition coverage and number of CT scans with a portion of the kidney excluded from the simulated reduced acquisition were compared between the three methods. The mean ± standard deviation reduction of acquisition coverage for the three readers with Methods 1, 2 and 3 were 20.5 ± 4.8, 15.1 ± 6.5 and 18.2 ± 5.3%, respectively. Compared with Method 2, Method 3 allowed a mean scan length reduction of 3.6%. The proportions of CT scans with a portion of the kidney excluded from the simulated reduced acquisition with Methods 1, 2 and 3 and averaged over the three readers were 6.7, 0.7 and 1.4%, respectively, with no significant difference between Methods 2 and 3. Interreader and intrareader agreements were excellent with all methods, but interclass correlation coefficients were higher with Method 3. The method using the renal contours should not be used owing to its high proportion of kidneys with a portion excluded from the acquisition. Using the intersection of the left diaphragmatic dome and the anterior margin of the vertebral bodies for proximal landmark for urinary tract CT represents a new alternative method with a better reduction of scan length compared with the method using the inferior margin of T10 and with no significant increase in the number of kidneys with a portion excluded from the reduced acquisition. A new method using the point of intersection of the left diaphragmatic dome and the anterior border of the vertebral bodies on the lateral scout radiograph is introduced to reduce the z-axis coverage of urinary tract CT scans.

OBJECTIVE. The purpose of this study was to evaluate the frequency of gastric wall fatty infiltration in patients without overt gastrointestinal disease. MATERIALS AND METHODS. A retrospective study included patients who underwent unenhanced MDCT for renal colic. Two radiologists reviewed all of the images and evaluated for the presence of gastric wall fatty infiltration. The following patient characteristics were also recorded: sex, age, body mass index, total and visceral fat area, and presence of colic or ileal fat halo sign, or hepatic steatosis. A t test and Fisher test were used to compare the results between patients with and patients without gastric wall fatty infiltration. RESULTS. Gastric wall fatty infiltration was present in 25 of 120 (21%) patients in the study. Mean age, weight, body mass index, visceral and total fat areas, proportion of hepatic steatosis, number of men, and frequency of the presence of colic and ileal fat halo signs were significantly higher among patients with gastric wal...