Severe COVID-19 pneumonia: Perfusion analysis in correlation with pulmonary embolism and vessel enlargement using dual-energy CT data

Gas exchange in COVID-19 pneumonia is impaired and vessel obstruction has been suspected to cause ventilation-perfusion mismatch. Dual-energy CT (DECT) can depict pulmonary perfusion by regional assessment of iodine uptake. The purpose of this study was the analysis of pulmonary perfusion using dual...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2021-06, Vol.16 (6), p.e0252478-e0252478
Main Authors: Poschenrieder, Florian, Meiler, Stefanie, Lubnow, Matthias, Zeman, Florian, Rennert, Janine, Scharf, Gregor, Schaible, Jan, Stroszczynski, Christian, Pfeifer, Michael, Hamer, Okka W
Format: Article
Language:English
Subjects:
Analysis
Anticoagulants
Autopsies
Autopsy
Biology and Life Sciences
Blood
Care and treatment
Coronaviruses
COVID-19
Embolism
Energy
Enlargement
Ethics
Internal medicine
Medicine and Health Sciences
Patients
Perfusion
Perfusion (Physiology)
Physical Sciences
Pneumonia
Pulmonary arteries
Pulmonary embolism
Pulmonary embolisms
Radiology
Research and Analysis Methods
Severe acute respiratory syndrome coronavirus 2
Software
Thromboembolism
Thrombosis
Veins & arteries
Ventilation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133
cites cdi_FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133
container_end_page e0252478
container_issue 6
container_start_page e0252478
container_title PloS one
container_volume 16
creator Poschenrieder, Florian
Meiler, Stefanie
Lubnow, Matthias
Zeman, Florian
Rennert, Janine
Scharf, Gregor
Schaible, Jan
Stroszczynski, Christian
Pfeifer, Michael
Hamer, Okka W
description Gas exchange in COVID-19 pneumonia is impaired and vessel obstruction has been suspected to cause ventilation-perfusion mismatch. Dual-energy CT (DECT) can depict pulmonary perfusion by regional assessment of iodine uptake. The purpose of this study was the analysis of pulmonary perfusion using dual-energy CT in a cohort of 27 consecutive patients with severe COVID-19 pneumonia. We retrospectively analyzed pulmonary perfusion with DECT in 27 consecutive patients (mean age 57 years, range 21-73; 19 men and 8 women) with severe COVID-19 pneumonia. Iodine uptake (IU) in regions-of-interest placed into normally aerated lung, ground-glass opacifications (GGO) and consolidations was measured using a dedicated postprocessing software. Vessel enlargement (VE) within opacifications and presence of pulmonary embolism (PE) was assessed by subjective analysis. Linear mixed models were used for statistical analyses. Compared to normally aerated lung 106/151 (70.2%) opacifications without upstream PE demonstrated an increased IU, 9/151 (6.0%) an equal IU and 36/151 (23.8%) a decreased IU. The estimated mean iodine uptake (EMIU) in opacifications without upstream PE (GGO 1.77 mg/mL; 95%-CI: 1.52-2.02; p = 0.011, consolidations 1.82 mg/mL; 95%-CI: 1.56-2.08, p = 0.006) was significantly higher compared to normal lung (1.22 mg/mL; 95%-CI: 0.95-1.49). In case of upstream PE, EMIU of opacifications (combined GGO and consolidations) was significantly decreased compared to normal lung (0.52 mg/mL; 95%-CI: -0.07-1.12; p = 0.043). The presence of VE in opacifications correlated significantly with iodine uptake (p
doi_str_mv 10.1371/journal.pone.0252478
format article
fullrecord <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2539284646</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A664519213</galeid><doaj_id>oai_doaj_org_article_ddb3c209d25d49e58f060ac9bb92cb67</doaj_id><sourcerecordid>A664519213</sourcerecordid><originalsourceid>FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133</originalsourceid><addsrcrecordid>eNqNk12L1DAUhoso7rr6DwQDgujFjPlo02YvhGX8GlgYcde9DWl62smQJmPSjs4P8H-b2RllR_ZCSmg4ec57cl5ysuw5wVPCSvJ25cfglJ2uvYMppgXNy-pBdkoEoxNOMXt4Z3-SPYlxhXHBKs4fZycsJ5iULD_Nfl3BBgKg2eJm_n5CBFo7GHvvjDpHXyC0YzTeIZUKbaOJyDikfQhg1bCL_zDDEq1HmxJU2CLoa29N7BPfoA3ECBaBsyp00IMbUBJzHWpGZSfgIHRbNLtGjRrU0-xRq2yEZ4f_Wfbt44fr2efJ5eLTfHZxOdGFEMNE1y1QXGOBiWgoaFBUkboCRtqccEJIQzEnUAjGcFMqUEVF0yJclXXLCWNn2Yu97tr6KA8ORkkLJmiV85wnYr4nGq9Wch1MnxqTXhl5G_ChkyoMRluQTVMzTXG6SdHkAoqqxRwrLepaUF3zMmm9O1Qb6x4anSwIyh6JHp84s5Sd38iKVLwUVRJ4fRAI_vsIcZC9iRqsVQ78uL93QUuMd7Ve_oPe392B6lRqwLjWp7p6JyovOM8LIuitS9N7qPQ10BudnltrUvwo4c1RQmIG-Dl0aoxRzq--_j-7uDlmX91hl6DssIzejru3F4_BfA_q4GMM0P41mWC5m5Y_bsjdtMjDtLDfBCEGxg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2539284646</pqid></control><display><type>article</type><title>Severe COVID-19 pneumonia: Perfusion analysis in correlation with pulmonary embolism and vessel enlargement using dual-energy CT data</title><source>Publicly Available Content Database</source><source>PubMed Central</source><source>Coronavirus Research Database</source><creator>Poschenrieder, Florian ; Meiler, Stefanie ; Lubnow, Matthias ; Zeman, Florian ; Rennert, Janine ; Scharf, Gregor ; Schaible, Jan ; Stroszczynski, Christian ; Pfeifer, Michael ; Hamer, Okka W</creator><contributor>Kirchmair, Rudolf</contributor><creatorcontrib>Poschenrieder, Florian ; Meiler, Stefanie ; Lubnow, Matthias ; Zeman, Florian ; Rennert, Janine ; Scharf, Gregor ; Schaible, Jan ; Stroszczynski, Christian ; Pfeifer, Michael ; Hamer, Okka W ; Kirchmair, Rudolf</creatorcontrib><description>Gas exchange in COVID-19 pneumonia is impaired and vessel obstruction has been suspected to cause ventilation-perfusion mismatch. Dual-energy CT (DECT) can depict pulmonary perfusion by regional assessment of iodine uptake. The purpose of this study was the analysis of pulmonary perfusion using dual-energy CT in a cohort of 27 consecutive patients with severe COVID-19 pneumonia. We retrospectively analyzed pulmonary perfusion with DECT in 27 consecutive patients (mean age 57 years, range 21-73; 19 men and 8 women) with severe COVID-19 pneumonia. Iodine uptake (IU) in regions-of-interest placed into normally aerated lung, ground-glass opacifications (GGO) and consolidations was measured using a dedicated postprocessing software. Vessel enlargement (VE) within opacifications and presence of pulmonary embolism (PE) was assessed by subjective analysis. Linear mixed models were used for statistical analyses. Compared to normally aerated lung 106/151 (70.2%) opacifications without upstream PE demonstrated an increased IU, 9/151 (6.0%) an equal IU and 36/151 (23.8%) a decreased IU. The estimated mean iodine uptake (EMIU) in opacifications without upstream PE (GGO 1.77 mg/mL; 95%-CI: 1.52-2.02; p = 0.011, consolidations 1.82 mg/mL; 95%-CI: 1.56-2.08, p = 0.006) was significantly higher compared to normal lung (1.22 mg/mL; 95%-CI: 0.95-1.49). In case of upstream PE, EMIU of opacifications (combined GGO and consolidations) was significantly decreased compared to normal lung (0.52 mg/mL; 95%-CI: -0.07-1.12; p = 0.043). The presence of VE in opacifications correlated significantly with iodine uptake (p&lt;0.001). DECT revealed the opacifications in a subset of patients with severe COVID-19 pneumonia to be perfused non-uniformly with some being hypo- and others being hyperperfused. Mean iodine uptake in opacifications (both ground-glass and consolidation) was higher compared to normally aerated lung except for areas with upstream pulmonary embolism. Vessel enlargement correlated with iodine uptake: In summary, in a cohort of 27 consecutive patients with severe COVID-19 pneumonia, dual-energy CT demonstrated a wide range of iodine uptake in pulmonary ground-glass opacifications and consolidations as a surrogate marker for hypo- and hyperperfusion compared to normally aerated lung. Applying DECT to determine which pathophysiology is predominant might help to tailor therapy to the individual patient's needs.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0252478</identifier><identifier>PMID: 34101734</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Analysis ; Anticoagulants ; Autopsies ; Autopsy ; Biology and Life Sciences ; Blood ; Care and treatment ; Coronaviruses ; COVID-19 ; Embolism ; Energy ; Enlargement ; Ethics ; Internal medicine ; Medicine and Health Sciences ; Patients ; Perfusion ; Perfusion (Physiology) ; Physical Sciences ; Pneumonia ; Pulmonary arteries ; Pulmonary embolism ; Pulmonary embolisms ; Radiology ; Research and Analysis Methods ; Severe acute respiratory syndrome coronavirus 2 ; Software ; Thromboembolism ; Thrombosis ; Veins &amp; arteries ; Ventilation</subject><ispartof>PloS one, 2021-06, Vol.16 (6), p.e0252478-e0252478</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Poschenrieder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Poschenrieder et al 2021 Poschenrieder et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133</citedby><cites>FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133</cites><orcidid>0000-0001-7848-9991</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2539284646/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2539284646?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,38516,43895,44590,53791,53793,74412,75126</link.rule.ids></links><search><contributor>Kirchmair, Rudolf</contributor><creatorcontrib>Poschenrieder, Florian</creatorcontrib><creatorcontrib>Meiler, Stefanie</creatorcontrib><creatorcontrib>Lubnow, Matthias</creatorcontrib><creatorcontrib>Zeman, Florian</creatorcontrib><creatorcontrib>Rennert, Janine</creatorcontrib><creatorcontrib>Scharf, Gregor</creatorcontrib><creatorcontrib>Schaible, Jan</creatorcontrib><creatorcontrib>Stroszczynski, Christian</creatorcontrib><creatorcontrib>Pfeifer, Michael</creatorcontrib><creatorcontrib>Hamer, Okka W</creatorcontrib><title>Severe COVID-19 pneumonia: Perfusion analysis in correlation with pulmonary embolism and vessel enlargement using dual-energy CT data</title><title>PloS one</title><description>Gas exchange in COVID-19 pneumonia is impaired and vessel obstruction has been suspected to cause ventilation-perfusion mismatch. Dual-energy CT (DECT) can depict pulmonary perfusion by regional assessment of iodine uptake. The purpose of this study was the analysis of pulmonary perfusion using dual-energy CT in a cohort of 27 consecutive patients with severe COVID-19 pneumonia. We retrospectively analyzed pulmonary perfusion with DECT in 27 consecutive patients (mean age 57 years, range 21-73; 19 men and 8 women) with severe COVID-19 pneumonia. Iodine uptake (IU) in regions-of-interest placed into normally aerated lung, ground-glass opacifications (GGO) and consolidations was measured using a dedicated postprocessing software. Vessel enlargement (VE) within opacifications and presence of pulmonary embolism (PE) was assessed by subjective analysis. Linear mixed models were used for statistical analyses. Compared to normally aerated lung 106/151 (70.2%) opacifications without upstream PE demonstrated an increased IU, 9/151 (6.0%) an equal IU and 36/151 (23.8%) a decreased IU. The estimated mean iodine uptake (EMIU) in opacifications without upstream PE (GGO 1.77 mg/mL; 95%-CI: 1.52-2.02; p = 0.011, consolidations 1.82 mg/mL; 95%-CI: 1.56-2.08, p = 0.006) was significantly higher compared to normal lung (1.22 mg/mL; 95%-CI: 0.95-1.49). In case of upstream PE, EMIU of opacifications (combined GGO and consolidations) was significantly decreased compared to normal lung (0.52 mg/mL; 95%-CI: -0.07-1.12; p = 0.043). The presence of VE in opacifications correlated significantly with iodine uptake (p&lt;0.001). DECT revealed the opacifications in a subset of patients with severe COVID-19 pneumonia to be perfused non-uniformly with some being hypo- and others being hyperperfused. Mean iodine uptake in opacifications (both ground-glass and consolidation) was higher compared to normally aerated lung except for areas with upstream pulmonary embolism. Vessel enlargement correlated with iodine uptake: In summary, in a cohort of 27 consecutive patients with severe COVID-19 pneumonia, dual-energy CT demonstrated a wide range of iodine uptake in pulmonary ground-glass opacifications and consolidations as a surrogate marker for hypo- and hyperperfusion compared to normally aerated lung. Applying DECT to determine which pathophysiology is predominant might help to tailor therapy to the individual patient's needs.</description><subject>Analysis</subject><subject>Anticoagulants</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Care and treatment</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Embolism</subject><subject>Energy</subject><subject>Enlargement</subject><subject>Ethics</subject><subject>Internal medicine</subject><subject>Medicine and Health Sciences</subject><subject>Patients</subject><subject>Perfusion</subject><subject>Perfusion (Physiology)</subject><subject>Physical Sciences</subject><subject>Pneumonia</subject><subject>Pulmonary arteries</subject><subject>Pulmonary embolism</subject><subject>Pulmonary embolisms</subject><subject>Radiology</subject><subject>Research and Analysis Methods</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Software</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><subject>Veins &amp; arteries</subject><subject>Ventilation</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7rr6DwQDgujFjPlo02YvhGX8GlgYcde9DWl62smQJmPSjs4P8H-b2RllR_ZCSmg4ec57cl5ysuw5wVPCSvJ25cfglJ2uvYMppgXNy-pBdkoEoxNOMXt4Z3-SPYlxhXHBKs4fZycsJ5iULD_Nfl3BBgKg2eJm_n5CBFo7GHvvjDpHXyC0YzTeIZUKbaOJyDikfQhg1bCL_zDDEq1HmxJU2CLoa29N7BPfoA3ECBaBsyp00IMbUBJzHWpGZSfgIHRbNLtGjRrU0-xRq2yEZ4f_Wfbt44fr2efJ5eLTfHZxOdGFEMNE1y1QXGOBiWgoaFBUkboCRtqccEJIQzEnUAjGcFMqUEVF0yJclXXLCWNn2Yu97tr6KA8ORkkLJmiV85wnYr4nGq9Wch1MnxqTXhl5G_ChkyoMRluQTVMzTXG6SdHkAoqqxRwrLepaUF3zMmm9O1Qb6x4anSwIyh6JHp84s5Sd38iKVLwUVRJ4fRAI_vsIcZC9iRqsVQ78uL93QUuMd7Ve_oPe392B6lRqwLjWp7p6JyovOM8LIuitS9N7qPQ10BudnltrUvwo4c1RQmIG-Dl0aoxRzq--_j-7uDlmX91hl6DssIzejru3F4_BfA_q4GMM0P41mWC5m5Y_bsjdtMjDtLDfBCEGxg</recordid><startdate>20210608</startdate><enddate>20210608</enddate><creator>Poschenrieder, Florian</creator><creator>Meiler, Stefanie</creator><creator>Lubnow, Matthias</creator><creator>Zeman, Florian</creator><creator>Rennert, Janine</creator><creator>Scharf, Gregor</creator><creator>Schaible, Jan</creator><creator>Stroszczynski, Christian</creator><creator>Pfeifer, Michael</creator><creator>Hamer, Okka W</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-7848-9991</orcidid></search><sort><creationdate>20210608</creationdate><title>Severe COVID-19 pneumonia: Perfusion analysis in correlation with pulmonary embolism and vessel enlargement using dual-energy CT data</title><author>Poschenrieder, Florian ; Meiler, Stefanie ; Lubnow, Matthias ; Zeman, Florian ; Rennert, Janine ; Scharf, Gregor ; Schaible, Jan ; Stroszczynski, Christian ; Pfeifer, Michael ; Hamer, Okka W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analysis</topic><topic>Anticoagulants</topic><topic>Autopsies</topic><topic>Autopsy</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Care and treatment</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Embolism</topic><topic>Energy</topic><topic>Enlargement</topic><topic>Ethics</topic><topic>Internal medicine</topic><topic>Medicine and Health Sciences</topic><topic>Patients</topic><topic>Perfusion</topic><topic>Perfusion (Physiology)</topic><topic>Physical Sciences</topic><topic>Pneumonia</topic><topic>Pulmonary arteries</topic><topic>Pulmonary embolism</topic><topic>Pulmonary embolisms</topic><topic>Radiology</topic><topic>Research and Analysis Methods</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Software</topic><topic>Thromboembolism</topic><topic>Thrombosis</topic><topic>Veins &amp; arteries</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poschenrieder, Florian</creatorcontrib><creatorcontrib>Meiler, Stefanie</creatorcontrib><creatorcontrib>Lubnow, Matthias</creatorcontrib><creatorcontrib>Zeman, Florian</creatorcontrib><creatorcontrib>Rennert, Janine</creatorcontrib><creatorcontrib>Scharf, Gregor</creatorcontrib><creatorcontrib>Schaible, Jan</creatorcontrib><creatorcontrib>Stroszczynski, Christian</creatorcontrib><creatorcontrib>Pfeifer, Michael</creatorcontrib><creatorcontrib>Hamer, Okka W</creatorcontrib><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science &amp; Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>Agricultural &amp; Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials science collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poschenrieder, Florian</au><au>Meiler, Stefanie</au><au>Lubnow, Matthias</au><au>Zeman, Florian</au><au>Rennert, Janine</au><au>Scharf, Gregor</au><au>Schaible, Jan</au><au>Stroszczynski, Christian</au><au>Pfeifer, Michael</au><au>Hamer, Okka W</au><au>Kirchmair, Rudolf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe COVID-19 pneumonia: Perfusion analysis in correlation with pulmonary embolism and vessel enlargement using dual-energy CT data</atitle><jtitle>PloS one</jtitle><date>2021-06-08</date><risdate>2021</risdate><volume>16</volume><issue>6</issue><spage>e0252478</spage><epage>e0252478</epage><pages>e0252478-e0252478</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Gas exchange in COVID-19 pneumonia is impaired and vessel obstruction has been suspected to cause ventilation-perfusion mismatch. Dual-energy CT (DECT) can depict pulmonary perfusion by regional assessment of iodine uptake. The purpose of this study was the analysis of pulmonary perfusion using dual-energy CT in a cohort of 27 consecutive patients with severe COVID-19 pneumonia. We retrospectively analyzed pulmonary perfusion with DECT in 27 consecutive patients (mean age 57 years, range 21-73; 19 men and 8 women) with severe COVID-19 pneumonia. Iodine uptake (IU) in regions-of-interest placed into normally aerated lung, ground-glass opacifications (GGO) and consolidations was measured using a dedicated postprocessing software. Vessel enlargement (VE) within opacifications and presence of pulmonary embolism (PE) was assessed by subjective analysis. Linear mixed models were used for statistical analyses. Compared to normally aerated lung 106/151 (70.2%) opacifications without upstream PE demonstrated an increased IU, 9/151 (6.0%) an equal IU and 36/151 (23.8%) a decreased IU. The estimated mean iodine uptake (EMIU) in opacifications without upstream PE (GGO 1.77 mg/mL; 95%-CI: 1.52-2.02; p = 0.011, consolidations 1.82 mg/mL; 95%-CI: 1.56-2.08, p = 0.006) was significantly higher compared to normal lung (1.22 mg/mL; 95%-CI: 0.95-1.49). In case of upstream PE, EMIU of opacifications (combined GGO and consolidations) was significantly decreased compared to normal lung (0.52 mg/mL; 95%-CI: -0.07-1.12; p = 0.043). The presence of VE in opacifications correlated significantly with iodine uptake (p&lt;0.001). DECT revealed the opacifications in a subset of patients with severe COVID-19 pneumonia to be perfused non-uniformly with some being hypo- and others being hyperperfused. Mean iodine uptake in opacifications (both ground-glass and consolidation) was higher compared to normally aerated lung except for areas with upstream pulmonary embolism. Vessel enlargement correlated with iodine uptake: In summary, in a cohort of 27 consecutive patients with severe COVID-19 pneumonia, dual-energy CT demonstrated a wide range of iodine uptake in pulmonary ground-glass opacifications and consolidations as a surrogate marker for hypo- and hyperperfusion compared to normally aerated lung. Applying DECT to determine which pathophysiology is predominant might help to tailor therapy to the individual patient's needs.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34101734</pmid><doi>10.1371/journal.pone.0252478</doi><tpages>e0252478</tpages><orcidid>https://orcid.org/0000-0001-7848-9991</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1932-6203
ispartof PloS one, 2021-06, Vol.16 (6), p.e0252478-e0252478
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_2539284646
source Publicly Available Content Database; PubMed Central; Coronavirus Research Database
subjects Analysis
Anticoagulants
Autopsies
Autopsy
Biology and Life Sciences
Blood
Care and treatment
Coronaviruses
COVID-19
Embolism
Energy
Enlargement
Ethics
Internal medicine
Medicine and Health Sciences
Patients
Perfusion
Perfusion (Physiology)
Physical Sciences
Pneumonia
Pulmonary arteries
Pulmonary embolism
Pulmonary embolisms
Radiology
Research and Analysis Methods
Severe acute respiratory syndrome coronavirus 2
Software
Thromboembolism
Thrombosis
Veins & arteries
Ventilation
title Severe COVID-19 pneumonia: Perfusion analysis in correlation with pulmonary embolism and vessel enlargement using dual-energy CT data
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T20%3A43%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Severe%20COVID-19%20pneumonia:%20Perfusion%20analysis%20in%20correlation%20with%20pulmonary%20embolism%20and%20vessel%20enlargement%20using%20dual-energy%20CT%20data&rft.jtitle=PloS%20one&rft.au=Poschenrieder,%20Florian&rft.date=2021-06-08&rft.volume=16&rft.issue=6&rft.spage=e0252478&rft.epage=e0252478&rft.pages=e0252478-e0252478&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0252478&rft_dat=%3Cgale_plos_%3EA664519213%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c599t-cbfe20b09019d2ecea2a1b8e31f416111d2061e59330d7aea582a5816a7bf6133%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2539284646&rft_id=info:pmid/34101734&rft_galeid=A664519213&rfr_iscdi=true