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Radu RA, Cagnazzo F, Derraz I, Dargazanli C, Gascou G, Lefevre PH, Arquizan C, Costalat V. Use of optical coherence tomography in selected patients with recurrent cryptogenic stroke: A case series and technical discussion. Interv Neuroradiol 2023:15910199221150472. [PMID: 36628417 DOI: 10.1177/15910199221150472] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite advances in secondary stroke prevention during the last several years, cryptogenic stroke remains associated with a high risk of recurrence. Studies have shown that the recurrence risk is higher in patients with large artery disease in which complex carotid plaques and carotid WEBs are identified. METHODS This is a case series of six patients with cryptogenic recurrent stroke in which conventional imaging and extensive workup did not identify an etiology. Intravascular optic coherence tomography (OCT) was performed using a ballon-guided flow-arrest technique to identify possible covert carotid lesions. RESULTS We present six cases in which, with the help of OCT, we identified three carotid WEBs with associated thrombosis and two ulcerated carotid artery plaques. Four patients were subsequently treated with endovascular stent placement without complications. OCT permitted the distinction between complicated carotid artery plaque and carotid WEB. CONCLUSION Intravascular OCT is a feasible and safe approach to identifying patients with covert carotid wall abnormalities, like carotid WEBs and ulcerated plaques, that are amenable to carotid stenting to reduce recurrent stroke risk.
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Affiliation(s)
- Răzvan Alexandru Radu
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Federico Cagnazzo
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Imad Derraz
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Cyril Dargazanli
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Grégory Gascou
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Pierre-Henri Lefevre
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Caroline Arquizan
- 568017Department of Neurology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
| | - Vincent Costalat
- Department of Neuroradiology, 56224Gui de Chauliac Hospital, 26905Montpellier University Medical Center, Montpellier, France
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Rockwell H, Keller EJ, Tadros A, Newton I. VIP Patients in Interventional Radiology: Do Some Patients Deserve "Better" Care? Semin Intervent Radiol 2022; 39:454-458. [PMID: 36406034 PMCID: PMC9671680 DOI: 10.1055/s-0042-1757316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Helena Rockwell
- School of Medicine, University of California – San Diego, La Jolla, California
| | - Eric J. Keller
- Division of Interventional Radiology, Stanford University, Stanford, California
| | - Anthony Tadros
- Department of Radiology, University of California – San Diego, La Jolla, California
| | - Isabel Newton
- Department of Radiology, University of California – San Diego, La Jolla, California
- Division of Interventional Radiology, Veterans Administration San Diego Healthcare System, La Jolla, California
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Majumder MAA, Gaur U, Singh K, Kandamaran L, Gupta S, Haque M, Rahman S, Sa B, Rahman M, Rampersad F. Impact of COVID-19 pandemic on radiology education, training, and practice: A narrative review. World J Radiol 2021; 13:354-370. [PMID: 34904050 PMCID: PMC8637607 DOI: 10.4329/wjr.v13.i11.354] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/26/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Radiology education and training is of paramount clinical importance given the prominence of medical imaging utilization in effective clinical practice. The incorporation of basic radiology in the medical curriculum has continued to evolve, focusing on teaching image interpretation skills, the appropriate ordering of radiological investigations, judicious use of ionizing radiation, and providing exposure to interventional radiology. Advancements in radiology have been driven by the digital revolution, which has, in turn, had a positive impact on radiology education and training. Upon the advent of the corona virus disease 2019 (COVID-19) pandemic, many training institutions and hospitals adhered to directives which advised rescheduling of non-urgent outpatient appointments. This inevitably impacted the workflow of the radiology department, which resulted in the reduction of clinical in-person case reviews and consultations, as well as in-person teaching sessions. Several medical schools and research centers completely suspended face-to-face academic activity. This led to challenges for medical teachers to complete the radiology syllabus while ensuring that teaching activities continued safely and effectively. As a result, online teaching platforms have virtually replaced didactic face-to-face lectures. Radiology educators also sought other strategies to incorporate interactive teaching sessions while adopting the e-learning approach, as they were cognizant of the limitations that this may have on students’ clinical expertise. Migration to online methods to review live cases, journal clubs, simulation-based training, clinical interaction, and radiology examination protocolling are a few examples of successfully addressing the limitations in reduced clinical exposure. In this review paper, we discuss (1) The impact of the COVID-19 pandemic on radiology education, training, and practice; (2) Challenges and strategies involved in delivering online radiology education for undergraduates and postgraduates during the COVID-19 pandemic; and (3) Difference between the implementation of radiology education during the COVID-19 pandemic and pre-COVID-19 era.
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Affiliation(s)
- Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Cave Hill BB23034, Barbados
| | - Uma Gaur
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Cave Hill BB23034, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Cave Hill BB23034, Barbados
| | - Latha Kandamaran
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Cave Hill BB23034, Barbados
| | - Subir Gupta
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Cave Hill BB23034, Barbados
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sugai Besi, Kuala Lumpur 57000, Malaysia
| | - Sayeeda Rahman
- School of Medicine, American University of Integrative Sciences (AUIS), Bridgetown BB11318, Barbados
| | - Bidyadhar Sa
- Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, St Augustine 33178, Trinidad and Tobago
| | - Mizanur Rahman
- Principal's Office, International Medical College, Dhaka 1207, Bangladesh
| | - Fidel Rampersad
- Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, St Augustine 33178, Trinidad and Tobago
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Autrusseau PA, Garnon J, Bertucci G, Dalili D, De Marini P, Auloge P, Koch G, Caudrelier J, Weiss J, Cazzato RL, Gangi A. Complications of percutaneous image-guided screw fixation: An analysis of 94 consecutive patients. Diagn Interv Imaging 2021; 102:347-353. [PMID: 33516740 DOI: 10.1016/j.diii.2021.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to retrospectively assess the safety profile of percutaneous image-guided screw fixation (PIGSF) for insufficiency, impending or pathological fractures. MATERIALS AND METHODS From July 2012 to April 2020, all consecutive patients who underwent PIGSF were retrospectively included in the study. Patient characteristics, fracture type, procedural data and complications were analyzed. Complications were divided into per-procedural, early (<24hours) and delayed (>24hours) and classified into minor (grade 1-2) and major complications (grade 3-5) according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0. RESULTS A total of 110 fractures (40 insufficiency [36%], 53 pathological [48.5%] and 17 impending [15.5%] fractures) in 94 patients (48 women, 46 men; mean age, 62.7±12.7 [SD] years; age range: 32-88 years) were treated with PIGSF during 95 procedures. Twenty-four-hours follow-up was available for all patients, and>24-hours follow-up was available for 79 (79/110; 71.8%) fractures in 69 (69/94; 73.4%) patients. Per-procedural complications occurred in 3/110 fractures (2.7%, all minor). Early complications were reported in 4/110 fractures (3.6%, 1 major and 3 minor) and delayed ones in 14/79 fractures (17.7%, 5 major and 9 minor). The most frequent major delayed complication was infection (3/79; 3.8%). CONCLUSION The rate of per-procedural and early (within 24hours) complications following PIGSF is extremely low with most complications being minor, with major complications being delayed ones (>24hours).
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Affiliation(s)
- Pierre-A Autrusseau
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
| | - Julien Garnon
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Grégory Bertucci
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Danoob Dalili
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, OX3 7LD Oxford, United Kingdom; School of Biomedical Engineering and Imaging Sciences, King's College London, WC2R 2LS London, United Kingdom
| | - Pierre De Marini
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Pierre Auloge
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Guillaume Koch
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Jean Caudrelier
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Julia Weiss
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Roberto L Cazzato
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Afshin Gangi
- Department of Interventional Imaging, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
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Cazzato RL, De Marini P, Leonard-Lorant I, Dalili D, Koch G, Autrusseau PA, Mayer T, Weiss J, Auloge P, Garnon J, Gangi A. Percutaneous thermal ablation of sacral metastases: Assessment of pain relief and local tumor control. Diagn Interv Imaging 2021; 102:355-361. [PMID: 33487588 DOI: 10.1016/j.diii.2020.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To retrospectively report on safety, pain relief and local tumor control achieved with percutaneous ablation of sacral bone metastases. MATERIALS AND METHODS From February 2009 to June 2020, 23 consecutive patients (12 women and 11 men; mean age, 60±8 [SD] years; median, 60; range: 48-80 years) with 23 sacral metastases underwent radiofrequency (RFA) or cryo-ablation (CA), with palliative or curative intent at our institution. Patients' demographics and data pertaining to treated metastases, procedure-related variables, safety, and clinical evolution following ablation were collected and analyzed. Pain was assessed with numerical pain rating scale (NPRS). RESULTS Sixteen (70%) patients were treated with palliative and 7 (30%) with curative intent. Mean tumor diameter was 38±19 (SD) mm (median, 36; range: 11-76). External radiation therapy had been performed on five metastases (5/23; 22%) prior to ablation. RFA was used in 9 (39%) metastases and CA in the remaining 14 (61%). Thermo-protective measures and adjuvant bone consolidation were used whilst treating 20 (87%) and 8 (35%) metastases, respectively. Five (22%) minor complications were recorded. At mean 31±21 (SD) (median, 32; range: 2-70) months follow-up mean NPRS was 2±2 (SD) (median, 1; range: 0-6) vs. 5±1 (median, 5; range: 4-8; P<0.001) at the baseline. Three metastases out of 7 (43%) undergoing curative ablation showed local progression at mean 4±4 (SD) (median, 2; range: 1-8) months follow-up. CONCLUSION Percutaneous ablation of sacral metastases is safe and results in significant long-lasting pain relief. Local tumor control seems sub-optimal; however, further investigations are needed to confirm these findings due to paucity of data.
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Affiliation(s)
- Roberto L Cazzato
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France.
| | - Pierre De Marini
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Ian Leonard-Lorant
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Danoob Dalili
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, OX37LD Oxford, United Kingdom; School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, WC2R 2LS London, United Kingdom
| | - Guillaume Koch
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Pierre A Autrusseau
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Theo Mayer
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Julia Weiss
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Pierre Auloge
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Julien Garnon
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Afshin Gangi
- Department of Interventional Radiology, University Hospital of Strasbourg, 67000 Strasbourg, France; School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, WC2R 2LS London, United Kingdom
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Devie A, Kanagaratnam L, Perotin JM, Jolly D, Ravey JN, Djelouah M, Hoeffel C. COVID-19: A qualitative chest CT model to identify severe form of the disease. Diagn Interv Imaging 2020; 102:77-84. [PMID: 33419693 PMCID: PMC7746121 DOI: 10.1016/j.diii.2020.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023]
Abstract
Chest CT helps identify patients with severe COVID-19 using only three qualitative features. A qualitative model based on three qualitative variables can avoid calculating semi-quantitative total CT score. New Early Warning Score 2 is comparable to the CT score for identification of severe forms of COVID-19.
Purpose The purpose of this study was to identify clinical and chest computed tomography (CT) features associated with a severe form of coronavirus disease 2019 (COVID-19) and to propose a quick and easy to use model to identify patients at risk of a severe form. Materials and methods A total of 158 patients with biologically confirmed COVID-19 who underwent a chest CT after the onset of the symptoms were included. There were 84 men and 74 women with a mean age of 68 ± 14 (SD) years (range: 24–96 years). There were 100 non-severe and 58 severe cases. Their clinical data were recorded and the first chest CT examination was reviewed using a computerized standardized report. Univariate and multivariate analyses were performed in order to identify the risk factors associated with disease severity. Two models were built: one was based only on qualitative CT features and the other one included a semi-quantitative total CT score to replace the variable representing the extent of the disease. Areas under the ROC curves (AUC) of the two models were compared with DeLong's method. Results Central involvement of lung parenchyma (P < 0.001), area of consolidation (P < 0.008), air bronchogram sign (P < 0.001), bronchiectasis (P < 0.001), traction bronchiectasis (P < 0.011), pleural effusion (P < 0.026), large involvement of either one of the upper lobes or of the middle lobe (P < 0.001) and total CT score ≥ 15 (P < 0.001) were more often observed in the severe group than in the non-severe group. No significant differences were found between the qualitative model (large involvement of either upper lobes or middle lobe [odd ratio (OR) = 2.473], central involvement [OR = 2.760], pleural effusion [OR = 2.699]) and the semi-quantitative model (total CT score ≥ 15 [OR = 3.342], central involvement [OR = 2.344], pleural effusion [OR = 2.754]) with AUC of 0.722 (95% CI: 0.638–0.806) vs. 0.739 (95% CI: 0.656–0.823), respectively (P = 0.209). Conclusion We have developed a new qualitative chest CT-based multivariate model that provides independent risk factors associated with severe form of COVID-19.
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Affiliation(s)
- Antoine Devie
- Department of Radiology, Reims University Hospital, 51092 Reims, France.
| | - Lukshe Kanagaratnam
- Clinical Research Department, Reims University Hospital, 51092 Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, INSERM UMRS 1250, Reims University Hospital, 51092 Reims, France
| | - Damien Jolly
- Clinical Research Department, Reims University Hospital, 51092 Reims, France
| | - Jean-Noël Ravey
- Department of Radiology, Grenoble University Hospital, 38700 Grenoble, France
| | - Manel Djelouah
- Department of Radiology, Reims University Hospital, 51092 Reims, France
| | - Christine Hoeffel
- Department of Radiology, Reims University Hospital, 51092 Reims, France; CRESTIC, University of Reims Champagne-Ardenne, 51100 Reims, France
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How GY, Pua U. Trends of interventional radiology procedures during the COVID-19 pandemic: the first 27 weeks in the eye of the storm. Insights Imaging 2020; 11:131. [PMID: 33296046 PMCID: PMC7724451 DOI: 10.1186/s13244-020-00938-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
Objectives While the Novel Coronavirus (COVID-19) pandemic looks to persist, institutions promote delaying procedures. Understanding trends and demands of interventional radiology (IR) procedures in the infected and COVID-free populations are needed in long-term planning. We detail IR procedure trends in the first 27 weeks of the pandemic and compare with the pre-pandemic era. Methods In this IRB approved retrospective electronic case review, all IR patients in our institution from 1 January to 9 July 2020, the same period in 2019 pre-pandemic and the Severe Acute Respiratory Syndrome (SARS-CoV) outbreak were included. IR procedures were classified using Interventional Radiology—Procedure Acuity Scale (IR-PAS) and category of IR procedures. Along with descriptive frequencies, the Mann–Whitney U test and Chi-square test of independence were performed. Results During the pandemic, 3655 IR procedures were performed compared to 3851 procedures pre-pandemic. No statistically significant difference in weekly IR caseloads across IR-PAS tiers between both periods (p = .088) and category of procedure (p = .054) were noted. General intervention procedures remained the largest proportion and musculoskeletal procedures the minority, in both periods. More general intervention radiology and oncology procedures were performed during the COVID-19 pandemic compared to the SARS-CoV outbreak. Thirty-four (0.93%) IR procedures were performed on 30 COVID-19 patients. There was no IR procedure-related COVID-19 cross-transmission. Conclusions Demand for IR procedures among COVID-free patients remains high, and IR procedures involving COVID-19 represents a fraction of the IR caseload. A sustainable model in providing timely IR services to COVID-free patients needs to be considered.
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Affiliation(s)
- Guo Yuan How
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Uei Pua
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
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Li J, Long X, Wang X, Fang F, Lv X, Zhang D, Sun Y, Hu S, Lin Z, Xiong N. Radiology indispensable for tracking COVID-19. Diagn Interv Imaging 2020; 102:69-75. [PMID: 33281082 PMCID: PMC7685040 DOI: 10.1016/j.diii.2020.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/20/2022]
Abstract
Currently, chest computed tomography is recommended as the first-line imaging test for detecting COVID-19 pneumonia. The most typical CT imaging finding of COVID-19 patients is ground-glass opacity, combined with reticular and/or interlobular septal thickening and consolidation. CT is useful for monitoring patients with COVID-19, identifying associated vascular abnormalities and making differential diagnosis.
With the rapid spread of COVID-19 worldwide, early detection and efficient isolation of suspected patients are especially important to prevent the transmission. Although nucleic acid testing of SARS-CoV-2 is still the gold standard for diagnosis, there are well-recognized early-detection problems including time-consuming in the diagnosis process, noticeable false-negative rate in the early stage and lacking nucleic acid testing kits in some areas. Therefore, effective and rational applications of imaging technologies are critical in aiding the screen and helping the diagnosis of suspected patients. Currently, chest computed tomography is recommended as the first-line imaging test for detecting COVID-19 pneumonia, which could allow not only early detection of the typical chest manifestations, but also timely estimation of the disease severity and therapeutic effects. In addition, other radiological methods including chest X-ray, magnetic resonance imaging, and positron emission computed tomography also show significant advantages in the detection of COVID-19 pneumonia. This review summarizes the applications of radiology and nuclear medicine in detecting and diagnosing COVID-19. It highlights the importance for these technologies to curb the rapid transmission during the pandemic, considering findings from special groups such as children and pregnant women.
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Affiliation(s)
- Jingwen Li
- Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, Union Hospital, Wuhan, Hubei, China
| | - Xi Long
- Department of Radiology, Tongji Medical College, Huazhong University of Science and Technology, Union Hospital, Wuhan, Hubei, China
| | - Xinyi Wang
- Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, Union Hospital, Wuhan, Hubei, China
| | - Fang Fang
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Xuefei Lv
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Dandan Zhang
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Yu Sun
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Shaoping Hu
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Zhicheng Lin
- Harvard Medical School, Mclean Hospital, 02478 Belmont, MA, USA
| | - Nian Xiong
- Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, Union Hospital, Wuhan, Hubei, China; Wuhan Red Cross Hospital, Wuhan, Hubei, China.
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