Evaluation of the relationship between inpatient COVID-19 mortality and chest CT severity score.

OBJECTIVES: There is scarce data available on the prognostic application of chest CT. The main purpose of this study was to evaluate the performance of a semi-quantitative CT severity score in identifying the risk of mortality in COVID-19 patients. METHODS: This retrospective cohort study was performed on 262 hospitalized COVID-19 patients. The CT severity score was assessed by two independent radiologists using a method previously used to score the severity of acute respiratory distress syndrome on thin slice lung CT. RESULTS: Multivariate regression analysis showed increasing odds of in-hospital death associated with older age, and the presence of coronary artery disease at the time of admission. The mean CT severity score was 7.5 in the survivor group and 14.5 in the deceased group. Overall, the lower zones were the most frequently affected sites in COVID-19. There was significant difference between the survivor and deceased groups regarding CT severity scores. Multivariate regression analysis showed increasing odds of in-hospital death associated with higher CT severity score at admission. CONCLUSIONS: Our results show that mortality was significantly higher in patients with higher CT severity score even after adjustment for clinical, demographics and laboratory parameters. However, this study is performed retrospectively and needs to be validated in a prospective study.

Predicting round window visibility by HRCT during cochlear implantation in children.

Objective: The present study aimed to radiologically evaluate the visibility of round window during cochlear implantation by high-resolution computed tomography (HRCT) imaging of temporal bone. Study design: This was a cross-sectional descriptive analytic study. Methods: Two new radiologic measurements were evaluated on the presurgical HRCT of temporal bone, including (1) the angle between the line parallel to coronal axis that passes through the middle of the round window niche (RWN) and the line that connects the anterior portion of facial nerve (FN) to the middle of the RWN (RWN angle) and (2) the vertical distance between this coronal plane and the anterior portion of the FN, modified facial recess distance (MFRD). The measurements were then compared with the visibility of the round window (RW) during operation, as reported by the surgeon. Result: The present study compared the abovementioned CT scan findings of cochlear implanted children in visible (n = 21) and nearly invisible (n = 21) RW during surgery, as reported by the surgeon. The analysis revealed that both MFRD (P < 0.01) and RWN angle (P < 0.04) were significantly different between the two groups. Conclusion: the RWN angle and MFRD are fairly reliable predictors of round window visibility during cochlear implantation.

Hemorrhagic Colloid Cyst Presenting with Acute Hydrocephaly.

Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected. Acute hemorrhage in colloid cysts is extremely rare and may present with symptoms of acute increase in the intracranial pressure. Intracystic hemorrhage is very rarely reported as a complication of colloid cyst presenting with paroxysmal symptoms of acute hydrocephaly.

Hepatic alveolar echinococcosis.

 Alveolar hydatid disease is a highly malignant form of echinococcosis caused by the larvae of the cestode echinococcus multilocularis. Alveolar hydatid disease always affects the liver and can metastasise to the lung and brain. Early diagnosis and precise evaluation of the localization as well as the extent of lesions are essential for treatment. In this report, we present ultrasound and computed tomography findings in a patient with hepatic alveolar echinococcosis. The patient, who was presented with hepatomegaly, jaundice, and an infiltrative solid tumor, diagnosed by ultrasound and computed tomography. In contrast to hydatid cyst caused by echinococcus granulosus, this is a rare disease in Iran.