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OBJECTIVES: This study is aimed to determine the location and distribution of pulmonary embolism (PE) and presence of signs potentially indicative of right heart overload on computed tomography pulmonary angiography (CTPA) in COVID-19 and non-COVID-19 patients. We also evaluated the extent and severity of COVID-19-associated lung changes in relation to PE. METHODS: The total number of 1,698 patients with CTPA included in the study were divided into 2 groups according to their COVID-19 status and each group was divided into 2 subgroups based on their PE status. These groups and subgroups were compared in terms of location of PE, diameter of pulmonary artery, right heart strain, ground-glass opacities (GGO), consolidations and other imaging features. RESULTS: In COVID-19 patients, there was a significant predominance of PE in peripheral branches of pulmonary artery (p < 0.001). There was an increased right-to-left ratio of ventricular diameters in cases with PE (p = 0.032 in patients with COVID-19 and p < 0.001 in non-COVID-19 patients). There was no association between the extent and severity of the disease and distribution of PE. CONCLUSION: COVID-19 is associated with a higher incidence of peripheral location of PE and presence of GGO. There were signs indicative of right heart overload in cases with PE regardless of COVID-19 (Tab. 3, Fig. 1, Ref. 29) Keywords: COVID-19, computed tomography, CTPA, pneumonia, pulmonary embolism.
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COVID-19 , Embolia Pulmonar , Humanos , COVID-19/complicações , COVID-19/diagnóstico por imagem , Embolia Pulmonar/diagnóstico por imagem , Ventrículos do Coração , Tomografia Computadorizada por Raios X , AngiografiaRESUMO
OBJECTIVES: Lung ultrasound reduces the number of chest X-rays after thoracic surgery and thus the radiation. COVID-19 pandemic has accelerated research in lung ultrasound artifacts detection using artificial intelligence. This study evaluates the accuracy of artificial intelligence in A-lines detection in thoracic surgery patients using a novel hybrid solution that combines convolutional neural networks and analytical approach and compares it with a radiology resident and radiology experts' results. DESIGN: Prospective observational study. MATERIAL AND METHODS: Single-center study evaluates the accuracy of artificial intelligence and a radiology resident in A-line detection on lung ultrasound footages compared with the consensual opinion of two expert radiologists as the reference. After resident's first reading, the artificial intelligence results were presented to the resident and he was asked to revise the results based on artificial intelligence. RESULTS: 82 consecutive patients underwent 82 ultrasound examinations. 328 ultrasound recordings were evaluated. Accuracy, sensitivity, specificity, positive and negative predictive values of artificial inelligence in A-line detection were 0.866, 0.928, 0.834, 0.741 and 0.958 respectively. The resident's values were 0.558, 0.973, 0.346, 0.432 and 0.962 respectively. The resident's values after correction based on artificial intelligence results were 0.854, 0.991, 0.783, 0.701 and 0.994 respectively. CONCLUSION: Artificial intelligence showed high accuracy in A-line detection in thoracic surgery patients and was more accurate compared to a resident. Artificial intelligence could play important role in lung ultrasound artifact detection in thoracic surgery patients and in residents' education.
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BACKGROUND: Chest X-ray (CXR) remains the standard imaging modality in postoperative care after non-cardiac thoracic surgery. Lung ultrasound (LUS) showed promising results in CXR reduction. The aim of this review was to identify areas where the evaluation of LUS videos by artificial intelligence could improve the implementation of LUS in thoracic surgery. METHODS: A literature review of the replacement of the CXR by LUS after thoracic surgery and the evaluation of LUS videos by artificial intelligence after thoracic surgery was conducted in Medline. RESULTS: Here, eight out of 10 reviewed studies evaluating LUS in CXR reduction showed that LUS can reduce CXR without a negative impact on patient outcome after thoracic surgery. No studies on the evaluation of LUS signs by artificial intelligence after thoracic surgery were found. CONCLUSION: LUS can reduce CXR after thoracic surgery. We presume that artificial intelligence could help increase the LUS accuracy, objectify the LUS findings, shorten the learning curve, and decrease the number of inconclusive results. To confirm this assumption, clinical trials are necessary. This research is funded by the Slovak Research and Development Agency, grant number APVV 20-0232.
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OBJECTIVES: The current retrospective study focused on evaluation of the relationship between pulmonary embolism during COVID-19 pandemic and demographic, presenting symptoms, comorbidities and laboratory results in patients who underwent CT angiography of the pulmonary arteries. METHODS: The study enrolled all adult patients with suspected acute pulmonary embolism (PE) who underwent computed tomography pulmonary angiography (CTPA) between March 1, 2020, and April 30, 2022, during the SARS-CoV-2 pandemic. 1698 CTPAs were reviewed and various data were collected. Based on examination results, patients were divided into 4 groups: a group with positive PE and a group with negative PE for both COVID-19 and non-COVID-19 patients. RESULTS: When comparing different predictors of COVID-19 patients and non-COVID-19 patients we noticed lower probability of PE in female gender (OR 0.77, 95% CI: 0.60-1.00, p = 0.052) and in chronic obstructive pulmonary disease (COPD) patients (OR 0.6, 95% CI: 0.38-0.90, p = 0.017). Higher probability of PE was in cases of older age (OR 1.02, 95% CI: 1.01-1.02, p < 0.001), increased heart rate (OR 1.01, 95% CI: 1.01-1.02, p < 0.001) and increased D-dimer levels (OR 1.03, 95% CI: 1.02-1.04, p < 0.001). CONCLUSION: Considering predictors of PE there was a significantly lower risk of PE in the female gender and COPD, and a higher risk with increasing age, heart rate, and D-dimer levels.
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COVID-19 , Doença Pulmonar Obstrutiva Crônica , Embolia Pulmonar , Adulto , Humanos , Feminino , COVID-19/complicações , SARS-CoV-2 , Estudos Retrospectivos , Pandemias , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/epidemiologiaRESUMO
PURPOSE: The aim of this study was to report intermediate-term results of duplex ultrasound follow-up of carotid artery stenting performed with the dual-layer stent as compared to concurrent patients treated with other commercially available single-layer carotid stents. MATERIALS AND METHODS: A single centre, retrospective, nonrandomized study including 162 non-consecutive patients with 199 implanted carotid stents treated over a 7-year period was conducted. Patients with at least one ultrasound examination after treatment were included. Procedural and follow-up data for patients treated with the dual-layer stent implantation (83 stents) vs first-generation carotid stents implantations (116 stents) were compared. RESULTS: The median follow-up time was 24.0 months (IQR 10-32 months) for dual-layer stents and 27.5 months (IQR 10.3-59 months) for single-layer stents. The rate of severe restenosis was significantly higher in the dual-layer stent group than in the single-layer group (13.3% [11/83] vs 3.4% [4/116], p = 0.01). Seven reinterventions were performed in 5 patients with dual-layer stents. The rate of reintervention was significantly higher compared to no reinterventions in single-layer stents (6% [5/83] vs 0% [0/116], p = 0.012). Patients with restenosis had significantly higher presence of dyslipidaemia (100% [12/12] vs 63.3% [95/150], p = 0.009). CONCLUSIONS: In this real-world cohort of patients undergoing carotid artery stenting, the patients treated with low-profile dual-layer micromesh stent showed higher rates of restenosis and reinterventions compared to first-generation single-layer stents.
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Estenose das Carótidas , Stents , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Constrição Patológica , Humanos , Recidiva , Estudos Retrospectivos , Stents/efeitos adversos , Resultado do Tratamento , Ultrassonografia Doppler DuplaRESUMO
Echinococcosis is a serious parasitic disease that ends lethally in 95% of untreated infected patients. It was first diagnosed in Slovakia in the year 2000. It is caused by the larval stage of a tapeworm belonging to the genus Echinococcus, which was assigned to the group "A" of zoonoses in the year 2004. The number of new infections is rising because of increasing percentage of infected red foxes (Vulpes vulpes). Early and accurate diagnosis of infections with this parasite is essential for proper initiation of adequate therapy. Thanks to professional multidisciplinary efforts and new laboratory procedures, the number of correctly diagnosed cases has increased. Antimicrobial therapeutic approaches can lead to improved quality of life and better prognosis even if radical surgery is refused by the patient.