Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Expert Opinion Questionnaire About Chest CT Scan Using A Negative Pressure Isolation Strecher in COVID-19 Patients: Image Quality and Infection Risk

COVID-19 환자에서 음압격리들것을 이용한 흉부 CT 검사에 대한 전문가 의견 설문: 영상품질과 감염위험

  • Kwang Nam Jin (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Bo Da Nam (Department of Radiology, Soonchunhyang University Hospital) ;
  • Jaemin Shin (Department of Radiology, Incheon St. Mary's Hospital of Catholic University) ;
  • Sung Ho Hwang (Department of Radiology, Korea University Anam Hospital)
  • 진광남 (서울특별시 보라매병원 영상의학과) ;
  • 남보다 (순천향대학교 서울병원 영상의학과) ;
  • 신재민 (가톨릭대학교 인천성모병원 영상의학과) ;
  • 황성호 (고려대학교 안암병원 영상의학과)
  • Received : 2022.08.04
  • Accepted : 2022.11.13
  • Published : 2023.07.01
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Abstract

Purpose To survey perceptions of certified physicians on the protocol of chest CT in patients with coronavirus (COVID-19) using a negative pressure isolation stretcher (NPIS). Materials and Methods This study collected questionnaire responses from a total of 27 certified physicians who had previously performed chest CT with NPIS in COVID-19 isolation hospitals. Results The nine surveyed hospitals performed an average of 116 chest CT examinations with NPIS each year. Of these, an average of 24 cases (21%) were contrast chest CT. Of the 9 pulmonologists we surveyed, 5 (56%) agreed that patients who showed abnormalities in serum D-dimer required contrast chest CT. All 9 surveyed radiologists agreed that the image quality of the chest CT with NPIS was sufficient for CT image interpretation regarding pneumonia or pulmonary embolism. Furthermore, in our 9 surveyed infectionologists, 5 (56%) agreed that a risk of secondary infection in the CT room after temporary opening of NPIS could be prevented through a process of disinfection. Conclusion Experienced physicians considered that the effects of NIPS on chest CT image quality was minimal in patients with COVID-19, and the risk of CT room contamination was easily controlled.

목적 급성호흡기질환인 코로나바이러스감염증-19 (coronavirus disease 2019; 이하 COVID-19) 환자를 대상으로 한 음압격리들것(negative presurre isolation stretcher; 이하 NPIS)을 이용한 흉부 전산화단층촬영(이하 CT) 방식에 대해 전문의들의 경험과 의견을 확인하고자 하였다. 대상과 방법 격리입원 중인 COVID-19 환자에게 NPIS를 이용한 흉부 CT 검사를 시행했던 9개 의료기관 소속 27명의 전문의들을 대상으로 1) 조영증강 흉부 CT가 필요한 경우, 2) NPIS를 이용한 흉부 CT의 영상품질, 그리고 3) CT 조영제주사를 위한 NPIS 개방과 CT 검사실의 오염을 주제로 설문조사를 진행하였다 결과 조사대상인 9개의 의료기관들은 기관당 한 해 평균 116건의 COVID-19관련 흉부 CT 검사를 NPIS와 함께 진행했으며. 전체 검사 건수 중 평균 24건(21%)이 조영증강 흉부 CT였다. 설문에 참여한 호흡기내과 전문의 9명 중 5명(56%)은 환자의 혈중 D-dimer 이상이 확인되면 조영증강 CT가 필요하다고 의견을 밝혔다. 한편 영상의학과 전문의 9명 모두는 NPIS로 인한 흉부 CT 영상의 품질은 폐렴 또는 폐혈전 진단이 가능한 수준이라 답하였다. 또한 감염내과 전문의 9명 중 5명(56%)은 NPIS의 개방으로 인한 CT 검사실의 이차감염은 소독을 통해 예방할 수 있는 수준으로 생각하고 있었다. 결론 격리입원 중인 COVID-19 환자에서 NPIS와 함께 흉부 CT를 진행하더라도 CT의 품질은 진단이 가능한 수준이며 NPIS가 CT 검사실 내에서 잠시 개방되더라도 CT 검사실의 감염확산 위험은 높지 않은 것으로 전문의들은 인식하고 있었다.

Keywords

Acknowledgement

This work could not have been possible without enthusiastic colleagues: Professor Park, Chul Hwan (Yonsei University), Seo, Young-joo (Yonsei University), Lee, Sang Min (Ulsan University), Lee, Jong-Hyuk (Seoul National University), Chang, Suyon (Catholic University), and Chae, Geum Ju (Jeonbuk National University). I would like to express my gratitude for all that they have done.

References

  1. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology 2020;296:E15-E25 https://doi.org/10.1148/radiol.2020200490
  2. Akl EA, Blazic I, Yaacoub S, Frija G, Chou R, Appiah JA, et al. Use of chest imaging in the diagnosis and management of COVID-19: a WHO rapid advice guide. Radiology 2021;298:E63-E69 https://doi.org/10.1148/radiol.2020203173
  3. Jung HK, Kim JY, Lee MS, Lee JY, Park JS, Hyun M, et al. Characteristics of COVID-19 patients who progress to pneumonia on follow-up chest radiograph: 236 patients from a single isolated cohort in Daegu, South Korea. Korean J Radiol 2020;21:1265-1272 https://doi.org/10.3348/kjr.2020.0564
  4. Lee SE, Kim YS. Clinical and radiological findings of coronavirus disease 2019 pneumonia: 51 adult patients from a single center in Daegu, South Korea. J Korean Soc Radiol 2020;81:591-603 https://doi.org/10.3348/jksr.2020.81.3.591
  5. Cheah PK, Krisnan T, Abdul Kadir MH, Steven EM. Use of negative pressure individual isolation system for CT scan of patients with suspected COVID-19. Emerg Med J 2020;37:467
  6. Kim SC, Kong SY, Park GJ, Lee JH, Lee JK, Lee MS, et al. Effectiveness of negative pressure isolation stretcher and rooms for SARS-CoV-2 nosocomial infection control and maintenance of South Korean emergency department capacity. Am J Emerg Med 2021;45:483-489 https://doi.org/10.1016/j.ajem.2020.09.081
  7. Chiarenza A, Esposto Ultimo L, Falsaperla D, Travali M, Foti PV, Torrisi SE, et al. Chest imaging using signs, symbols, and naturalistic images: a practical guide for radiologists and non-radiologists. Insights Imaging 2019;10:114
  8. Jin KN, Yoon SH, Park CH, Beck KS, Do KH, Yong HS. KSR/KSTR guidelines for the use of diagnostic imaging for COVID-19. J Korean Soc Radiol 2020;81:577-582 https://doi.org/10.3348/jksr.2020.81.3.577
  9. Molton JS, Leek FA, Ng LH, Totman JJ, Paton NI. A novel approach to CT, MR, and PET examination of patients with infections requiring stringent airborne precautions. Radiology 2016;278:881-887 https://doi.org/10.1148/radiol.2015150289
  10. Suh YJ, Hong H, Ohana M, Bompard F, Revel MP, Valle C, et al. Pulmonary embolism and deep vein thrombosis in COVID-19: a systematic review and meta-analysis. Radiology 2021;298:E70-E80 https://doi.org/10.1148/radiol.2020203557
  11. Wittram C, Maher MM, Yoo AJ, Kalra MK, Shepard JA, McLoud TC. CT angiography of pulmonary embolism: diagnostic criteria and causes of misdiagnosis. Radiographics 2004;24:1219-1238 https://doi.org/10.1148/rg.245045008
  12. Revel MP, Beeker N, Porcher R, Jilet L, Fournier L, Rance B, et al. What level of D-dimers can safely exclude pulmonary embolism in COVID-19 patients presenting to the emergency department? Eur Radiol 2022;32:2704-2712 https://doi.org/10.1007/s00330-021-08377-9
  13. Hutchinson BD, Navin P, Marom EM, Truong MT, Bruzzi JF. Overdiagnosis of pulmonary embolism by pulmonary CT angiography. AJR Am J Roentgenol 2015;205:271-277 https://doi.org/10.2214/AJR.14.13938
  14. Gohler F, Corman VM, Bleicker T, Stroux A, Dewey M, Diekhoff T. Contamination of CT scanner surfaces with SARS-CoV-2 and infective potential after examination of invasively ventilated, non-invasively ventilated and non-ventilated patients with positive throat swabs: prospective investigation using real-time reverse-transcription PCR and viral cell culture. Insights Imaging 2022;13:61