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

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

Journal of Ultrasonography
Volume 22 (2022): Issue 90 (September 2022)
By: Maria Binkiewicz-Orluk,  Marcin Konopka,  Agnieszka Jakubiak,  Wojciech Król,  Wojciech Braksator and  Marek Kuch  
Open Access
|Sep 2022

Figures & Tables

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

TotalAsymptomatic (−)Mild (+)Moderate (++)Severe (+++)
Number of patients (N)3141791
Number of assessed slices (N × 14)4345623812614
Normal parenchyma363 (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

TotalAsymptomatic (−)Mild (+)Moderate (++)Severe (+++)
Number of patients (N)3141791
Number of assessed areas (N × 14)4345623812614
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 consolidations597 (12.5%)29 (12.6%)21 (16.7%)2 (14.3%)
All consolidations70836242
Index: consolidation per patient2.32.02.12.72.0
1) Big consolidations with thick C-line25212101
2) Small consolidations45624141

Study group

Characteristics of study groupN = 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 disciplinen (%)
    football15 (48.4%)
    rowing10 (32.3%)
    volleyball5 (16.1%)
    basketball1 (3.2%)
Course of infectionn (%)
    asymptomatic (-)4 (12.9%)
    mild symptoms (+)17 (54.8%)
    moderate symptoms (++)9 (29.0%)
    severe symptoms (hospitalization) (+++)1 (3.2%)
DOI: https://doi.org/10.15557/jou.2022.0025 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
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Language: English
Page range: e153 - e160
Submitted on: Dec 20, 2021
Accepted on: Feb 22, 2022
Published on: Sep 1, 2022
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
lung ultrasonography,
SARS-Cov-2,
multimodality imaging,
sports medicine,
diagnostic
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2022 Maria Binkiewicz-Orluk, Marcin Konopka, Agnieszka Jakubiak, Wojciech Król, Wojciech Braksator, Marek Kuch, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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