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Yakubov N.
Karimov Z.
Sarikov S.
Republican Emergency Medical Science Center
Andijan branch Yakubova R. the applicant Andijan State Medical Institute
THE ROLE OF MSCT IN THE DIAGNOSIS OF PATIENTS WITH
COVID-19
Annotation. This article examined MSCT and its significance in the diagnosis of360 patients with COVID-19, which today is one of the problems of medicine due to its prevalence, complications and complexity of timely diagnosis.
Keywords: COVID-19, MSCT, diagnostics, pneumonia.
The smaller the volume of lung consolidation on CT of the chest organs, the greater the probability of false negative results in the primary polymerase chain reaction (PCR) on COVID-19. This is the conclusion reached by researchers from China. To date, PCR is considered the gold standard for the diagnosis of SARS-CoV-2, however, researchers note a high frequency of false negative results, which may be due to low detection of the disease in the early stages, differences in the testing method, insufficient amount of cellular material, as well as low qualification of the operator.
The scientists compared the CT data of the chest organs of patients with confirmed COVID-19 in the initial PCR study and patients with false negative initial laboratory test results (n = 21). According to CT data, consolidation in the second group of patients was less common (3 patients out of 7, compared with 12 patients out of 14; p < 0.05). Thus, CT plays a key role in the early diagnosis of COVID-19. The results of the study are published in the American Journal of Radiology. Another proof of the high efficiency of CT in the early diagnosis of COVID-19 is the experience of Chinese doctors. After the release of the National Guidelines for the Treatment of a New Coronavirus Infection by the Chinese Health Commission, where CT was named a key diagnostic tool for COVID-19, the use of the method has greatly increased. This has also led to the detection of more cases of the disease at an early stage.
Experts of the Center for Diagnostics and Telemedicine are convinced that CT should not be considered the main and final method of diagnosis of COVID-19. However, positive CT results should be the basis for isolating the patient and conducting repeated laboratory tests. The staff of the Center for Diagnostics and Telemedicine — leading specialists in the field of radiation diagnostics, anesthesiology, resuscitation and infectious diseases — has created guidelines for
radiation diagnostics COVID-19. The materials describe in detail the semiotics of viral lung damage, differential diagnosis, protocol for describing the results of CT of the chest organs, as well as the organization of the work of the radiology department in the conditions of a pandemic coronavirus infection.
Multispiral computed tomography (MSCT) of the lungs is recommended for all patients with suspected pneumonia. Lung MSCT is a more sensitive method for the diagnosis of viral pneumonia. The main findings in pneumonia are bilateral infiltrates in the form of "frosted glass" or consolidation, which have a predominant distribution in the lower and middle zones of the lungs.
In the absence of the possibility of performing MSCT, an overview X-ray of the chest organs is performed in the anterior straight and lateral projections (if the localization of the inflammatory process is unknown, it is advisable to take a picture in the right lateral projection). Chest radiography reveals bilateral drain
infiltrative darkening. Most often, the most pronounced changes are localized in the basal parts of the lungs. A small pleural effusion may also be present.
All patients were treated according to the established standard. Antiplatelet, anticoagulant, vitamin therapy, hormone
therapy, antibacterial and oxygen therapy were used in the treatment. Oxygen therapy was used in all tuberculosis patients. Inpatient treatment of patients ranged from 10 to 21 days. In patients with concomitant diseases, the disease was relatively severe, and was treated in a hospital for a long time. Despite intensive treatment, 4 (2%) deaths were registered. Among the deceased patients were over 60 years old and had more than one concomitant disease.
MSCT in the diagnosis of patients with lung lesions in COVID-19. In all patients with high-resolution MSCT, a pattern typical for COVID-19 pneumonia (bilateral changes in the type of "frosted glass").
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