RSNA-STR-ACR Consensus Statement for COVID-19 CT Patterns: Interreader Agreement in 240 Consecutive Patients and Association With RT-PCR Status.

PURPOSE: The aim of this study was to study interreader agreement of the RSNA-STR-ACR (Radiological Society of North America/Society of Thoracic Radiology/American College of Radiology) consensus statement on reporting chest computed tomography (CT) findings related to COVID-19 on a sample of consecutive patients confirmed with reverse transcriptase-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2. MATERIALS AND METHODS: This institutional review board-approved retrospective study included 240 cases with a mean age of 47.6 ± 15.9 years, ranging from 20 to 90 years, who had a chest CT and RT-PCR performed. Computed tomography images were independently analyzed by 2 thoracic radiologists to identify patterns defined by the RSNA-STR-ACR consensus statement, and concordance was determined with weighted κ tests. Also, CT findings and CT severity scores were tabulated and compared. RESULTS: Of the 240 cases, 118 had findings on CT. The most frequent on the RT-PCR-positive group were areas of ground-glass opacities (80.5%), crazy-paving pattern (32.2%), and rounded pseudonodular ground-glass opacities (22.9%). Regarding the CT patterns, the most frequent in the RT-PCR-positive group was typical in 75.9%, followed by negative in 17.1%. The interreader agreement was 0.90 (95% confidence interval, 0.80-0.96) in this group. The CT severity score had a mean difference of -0.07 (95% confidence interval, -0.48 to 0.34) among the readers, showing no significant differences regarding visual estimation. CONCLUSIONS: The RSNA-STR-ACR consensus statement on reporting chest CT patterns for COVID-19 presents a high interreader agreement, with the typical pattern being more frequently associated with RT-PCR-positive examinations.

Epipericardial Fat Necrosis: Sonographic Findings and Their Correlation With Computed Tomography.

Epipericardial fat necrosis is a rare cause of chest pain. It presents as pleuritic pain in an otherwise healthy patient. Computed tomography has proved to be the most effective diagnostic imaging technique because of its ability to reveal typical alterations in the cardiophrenic space. As far as we know, sonographic findings concerning this entity have not been reported in the literature. We report 4 cases admitted to our institutional emergency department with chest pain. Among other tests, chest wall sonography was requested in these patients and showed special findings that should be evaluated with chest computed tomography.

"NASCI case of the month: left ventricular apical hypoplasia".

Left ventricular apical hypoplasia is a rare congenital condition. It can cause nonspecific symptoms and can be accompanied by cardiac conduction system alterations such as bundle branch block, atrial flutter (AF) or atrial fibrillation. The diagnosis mostly is made by imaging.

Crossing the barrier: when the diaphragm is not a limit.

OBJECTIVE: The purpose of this article is to depict the anatomic pathways along which transphrenic spread of diseases and entities can disseminate. CONCLUSION: The abdomen and thorax form a continuum on which the diaphragm is an important but incomplete barrier to disease migration.

Dolor tóraco-abdominal: "Si miras el corazón, encontrarás la razón". Serie de casos / Thoracic and abdominal pain, if you look at the heart you may find its cause: a case series

La isquemia miocárdica es un fenómeno secundario a la perfusión insuficiente del músculo cardíaco que en algunos casos puede ocurrir de forma aguda llevando a la necrosis celular y constituyendo el infarto agudo al miocardio (IAM). A pesar de que el diagnóstico de IAM es principalmente clínico, en ciertos casos en que no se sospeche de forma activa por presentar síntomas no típicos de isquemia miocárdica, el diagnóstico puede sugerirse por la Tomografía Computarizada (TC), que puede mostrar hallazgos sugerentes de IAM. A continuación, se comunica una serie de 4 casos clínicos con diagnóstico imagenológico incidental de IAM.

Myocardial ischemia is secondary to myocardial under perfusion. It can develop acutely leading to cell necrosis and myocardial infarction (AMI), or have a chronic course. Though the diagnosis of AMI is mainly clinical, in certain cases the symptoms may be atypical and the diagnosis can be suggested by images such as Computed Tomography (CT). Herein we report a series of 4 clinical cases with diagnosis of AMI following incidental CT imaging. There was an abdominal pain in 3 patients and a cervical pain in the remaining one. CT scan showed a hypodense myocardial image. The final diagnosis was confirmed by the appropriate laboratory and angiographic methods.

Revisando un órgano olvidado: Evaluación del timo en PET-CT / Revisiting a Forgotten Organ: Thymus Evaluation in PET-CT

Resumen La pesquisa incidental de lesiones tímicas ha aumentado. Una adecuada aproximación a esas lesiones en la tomografía computada por emisión de positrones (PET-CT) es fundamental, pues se usa como parte de la mayoría de los procedimientos de planificación oncológica. Se han seleccionado casos representativos respecto de los aspectos más importantes de las imágenes de timo en PET-CT y cómo esa técnica puede contribuir a un diagnóstico preciso o a la planificación del tratamiento. Específicamente, presentamos una descripción general de las lesiones tímicas comunes y los imitadores de enfermedad, con énfasis en los hallazgos en PET-CT, incorporando también ejemplos de resonancia magnética (RM).

Abstract Incidental thymic lesion findings have increased. An adequate characterization of these lesions in positron emission computed tomography (PET-CT) is essential, since it is used as part of most oncological planning procedures. Representative cases have been selected regarding the most important aspects of thymus imaging in PET-CT and how this technique can contribute to an accurate diagnosis or treatment planning. Specifically, we present a general description of common thymic lesions and disease mimics, with an emphasis on PET-CT findings, also incorporating examples of magnetic resonance imaging.