Highlighting COVID-19: What the imaging exams show about the disease

Abstract

Coronavirus disease 2019 (COVID-19), a global emergency, is caused by severe acute respiratory syndrome coronavirus 2. The gold standard for its diagnosis is the reverse transcription polymerase chain reaction, but considering the high number of infected people, the low availability of this diagnostic tool in some contexts, and the limitations of the test, other tools that aid in the identification of the disease are necessary. In this scenario, imaging exams such as chest X-ray (CXR) and computed tomography (CT) have played important roles. CXR is useful for assessing disease progression because it allows the detection of extensive consolidations, besides being a fast and cheap method. On the other hand, CT is more sensitive for detecting lung changes in the early stages of the disease and is also useful for assessing disease progression. Of note, ground-glass opacities are the main COVID-19-related CT findings. Positron emission tomography combined with CT can be used to evaluate chronic and substantial damage to the lungs and other organs; however, it is an expensive test. Lung ultrasound (LUS) has been shown to be a promising technique in that context as well, being useful in the screening and monitoring of patients, disease classification, and management related to mechanical ventilation. Moreover, LUS is an inexpensive alternative available at the bedside. Finally, magnetic resonance imaging, although not usually requested, allows the detection of pulmonary, cardiovascular, and neurological abnormalities associated with COVID-19. Furthermore, it is important to consider the challenges faced in the radiology field in the adoption of control measures to prevent infection and in the follow-up of post-COVID-19 patients.

Keywords: SARS-CoV-2; COVID-19; Pneumonia; Pandemic; Radiology; Tomography

Core Tip: Imaging exams have played an important role in the current coronavirus disease 2019 pandemic. Thus, even though reverse transcription polymerase chain reaction is the gold standard method for the diagnosis, the use of computed tomography (CT) in the management of severe acute respiratory syndrome coronavirus 2-infected individuals has been highlighted. On the other hand, X-Ray, positron emission tomography combined with CT, and magnetic resonance imaging, along with ultrasound, can also assist in this process. We herein discuss the main evidence on the use of such exams and the challenges to the radiology field in that context as well.