Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.210052
Jornal Vascular Brasileiro
Original Article

Achados cardiovasculares incidentais em tomografias de tórax solicitadas para suspeita de COVID-19

Incidental cardiovascular findings on chest CT scans requested for suspected COVID-19

José Maciel Caldas dos Reis; Glauco dos Santos Melo; Murilo Vasconcelos de Oliveira; Mariana Morgado Fernandez; Tereza Maria Meireles Fernandes da Silva; Hugo Luis da Silva Ferreira; Mariseth Carvalho de Andrade

Downloads: 2
Views: 643

Resumo

Resumo: Contexto: As tomografias de tórax são frequentemente solicitadas como exames complementares para avaliação de suspeita clínica de afecção pulmonar pelo novo coronavírus 19 (COVID-19).

Objetivos: Nosso objetivo foi analisar a prevalência dos achados cardiovasculares incidentais em tomografias de tórax solicitadas para avaliar sinais radiológicos sugestivos de COVID-19.

Métodos: Por meio de um estudo transversal, descritivo e retrospectivo, foram revisadas 1.444 tomografias de tórax realizadas no setor de radiologia do Hospital de Clínicas Gaspar Vianna, no período de 1° de março a 30 de julho de 2020, com a descrição da prevalência de imagens sugestivas de pneumonia viral pelo COVID-19, além de achados pulmonares e cardiovasculares incidentais.

Resultados: A média de idade dos pacientes foi 50,6±16,4 anos, sendo o sexo feminino o mais frequente. A tomografia sem contraste foi o método mais utilizado (97,2%), e opacidades em vidro fosco foram identificadas em 56,0% dos casos. Achados incidentais cardiovasculares ocorreram em 51,2% (intervalo de confiança 48,7%-53,8%) das tomografias, prevalecendo calcificação da parede aórtica (21,8%), cardiomegalia (10,5%), e calcificação coronária (5,0%). Nas tomografias com contraste, evidenciaram-se aneurismas de aorta (9,7%), dissecção de aorta (7,3%) e úlceras de aorta torácica (2,4%).

Conclusões: Achados cardiovasculares incidentais ocorreram em aproximadamente metade das tomografias de tórax de pacientes com suspeita de COVID-19, mais especificamente, calcificações da parede da aorta, cardiomegalia e calcificação coronária.

Palavras-chave

achados incidentais, achado cardiovascular, tomografia, COVID-19

Keywords

incidental finding; cardiovascular finding; tomography; COVID-19

References

1 Lumbreras B, Donat L, Hernandez-Aguado I. Incidental findings in imaging diagnostic tests: a systematic review. Br J Radiol. 2010;83(988):276-89. http://dx.doi.org/10.1259/bjr/98067945. PMid:20335439.

2 Surov A, Bach AG, Schramm D. Clinically relevant cardiovascular findings detected on staging computed tomography in oncological patients. Angiology. 2016;67:630-7. http://dx.doi.org/10.1177/0003319715605971. PMid:26399716.

3 Schramm D, Bach AG, Meyer HJ, Surov A. Thrombotic events as incidental finding on computed tomography in intensive care unit patients. Thromb Res. 2016;141:171-4. http://dx.doi.org/10.1016/j.thromres.2016.03.030. PMid:27058274.

4 Jacobs PCA, Willem PTM, Diederick EG, van der Graaf Y. Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review. J Comput Assist Tomogr. 2008;32(2):214-20. http://dx.doi.org/10.1097/RCT.0b013e3181585ff2. PMid:18379305.

5 Furtado CD, Aguirre DA, Sirlin CB, et al. Whole-body CT screening: spectrum of findings and recommendations in 1192 patients. Radiology. 2005;237(2):385-94. http://dx.doi.org/10.1148/radiol.2372041741. PMid:16170016.

6 Kanne JP, Chest CT. Findings in 2019 Novel Coronavirus (2019- nCoV) Infections from Wuhan, China: Key Points for the Radiologist. Radiology. 2020;200241(1):16-7. http://dx.doi.org/10.1148/radiol.2020200241. PMid:32017662.

7 Orme NM, Fletcher JG, Siddiki HA, et al. Incidental findings in imaging research: evaluating incidence, benefit, and burden. Arch Intern Med. 2010;170(17):1525-32. http://dx.doi.org/10.1001/archinternmed.2010.317. PMid:20876402.

8 Moyle P, Sonoda L, Britton P, Sinnatamby R. Incidental breast lesions detected on CT: what is their significance? Br J Radiol. 2010;83(987):233-40. http://dx.doi.org/10.1259/bjr/58729988. PMid:19546179.

9 Lee JH, Jeong SY, Kim YH. Clinical significance of incidental thyroid nodules identified on low-dose CT for lung cancer screening. Multidiscip Respir Med. 2013;8(1):56. http://dx.doi.org/10.1186/2049-6958-8-56. PMid:23985215.

10 Koos R, Kühl HP, Mühlenbruch G, Wildberger JE, Günther RW, Mahnken AH. Prevalence and clinical importance of aortic valve calcification detected incidentally on CT scans: comparison with echocardiography. Radiology. 2006;241(1):76-82. http://dx.doi.org/10.1148/radiol.2411051163. PMid:16908682.

11 Bertolazzi P, Homero JF. A importância da Tomografia Computadorizada no diagnóstico da COVID-19. Arq Med. 2020;65(1):1-4. http://dx.doi.org/10.26432/1809-3019.2020.65.011.

12 Seo SG, Sung KH, Chung CY, et al. Incidental findings on knee radiographs in children and adolescents. Clin Orthop Surg. 2014;6(3):305-11. http://dx.doi.org/10.4055/cios.2014.6.3.305. PMid:25177456.

13 Rosa ME, Matos MJ, Furtado RS, et al. Achados da COVID-19 identificados na tomografia computadorizada de tórax: ensaio pictórico. Einstein. 2020;18:eRW5741. http://dx.doi.org/10.31744/einstein_journal/2020RW5741.

14 Foley PWX, Hamaad A, El-Gendi H, Levya F. Incidental cardiac findings on computed tomography imaging of the thorax. BMC Res Notes. 2010;3(1):326. http://dx.doi.org/10.1186/1756-0500-3-326. PMid:21126380.

15 Takasu J, Budoff MJ, O’Brien KD, et al. Relationship between coronary artery and descending thoracic aortic calcification as detected by computed tomography: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2009;204(2):440-6. http://dx.doi.org/10.1016/j.atherosclerosis.2008.09.041. PMid:19027115.

16 Ojha V, Mani A, Pandey NN, Sharma S, Kumar S. CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. Eur Radiol. 2020;30(11):6129-38. http://dx.doi.org/10.1007/s00330-020-06975-7. PMid:32474632.

17 Takasu J, Katz R, Nasir K, et al. Relationships of thoracic aortic wall calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J. 2008;155(4):765-71. http://dx.doi.org/10.1016/j.ahj.2007.11.019. PMid:18371491.

18 Sverzellati N, Arcadi T, Salvolini L, et al. Under-reporting of cardio-vascular findings on chest CT. Radiol Med. 2016;121(3):190-9. http://dx.doi.org/10.1007/s11547-015-0595-0. PMid:26519045.

19 Choy G, Kropil P, Scherer A, et al. Pertinent reportable incidental cardiac findings on chest CT without electrocardiography gating: review of 268 consecutive cases. Acta Radiol. 2013;54(4):396-400. http://dx.doi.org/10.1177/0284185113475918. PMid:23436832.

20 Munden RF, Carter BW, Chiles C, et al. Managing Incidental Findings on Thoracic CT: Mediastinal and Cardiovascular Findings. A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2018;15(8):1087-96. http://dx.doi.org/10.1016/j.jacr.2018.04.029. PMid:29941240.

21 Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpa- tients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. http://dx.doi.org/10.1016/S0140-6736(20)30566-3. PMid:32171076.

22 Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368:m1091. http://dx.doi.org/10.1136/bmj.m1091. PMid:32217556.
 


Submitted date:
04/02/2021

Accepted date:
09/07/2021

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
61f44370a953954b36719bf3 jvb Articles

J Vasc Bras

Share this page
Page Sections