The application value of low-dose CT scan in pregnant women with corona virus disease 2019

Objective To explore the value of low-dose CT in pregnancy with corona virus disease 2019(COVID-19). Methods A retrospective analysis was performed on the clinical characteristics, laboratory tests, and chest CT findings of 12 patients with pregnancy and COVID-19 diagnosed by nucleic acid testing from Renmin Hospital of Wuhan University from January 20, 2020 to February 16, 2020. Two radiologists blinded to the reconstruction algorithm independently scored subjective image quality on a 5-point Likert scale (grade 1, major noise, heavy artifacts, almost not visible, no diagnosis possible; grade 2, above average noise, poor, substantial, diagnostic confidence substantially reduced; grade 3, average image noise, moderate, but sufficient for diagnosis; grade 4, less than average noise, good, below average; grade 5, minimal noise, excellent). A clinical diagnosis of ≥3 was acceptable. The doctors recorded the CT radiation dose, including CT volume dose index (CTDIvol), dose length product (DLP), and effective radiation dose (E). Then two radiologists observed the distribution, shape, density, and other characteristics of lung lesions, and decided whether hilar, mediastinal lymphadenopathy, and pleural changes. Results Of the 12 pregnancy with COVID-19, 8 had cough, 4 had fever, 2 had chest tightness, and 1 had dyspnea and diarrhea each. The CT image quality score of all patients was (3-4), with an average of 3.46, which fully met the clinical diagnosis requirements. The CTDIvol value was (1.13 - 4.31) mGy, with an average of 3.02 mGy. The DLP value was (34.48 -75.29) mGy • cm, with an average of 55.48 mGy • cm. The E value was (0.48 - 1.05) mSv, with an average of 0.78 mSv. In all cases, chest CT examination showed abnormal manifestations after clinical symptoms, including unilateral lung lesions in 5 cases and bilateral lung lesions in 7 cases. 1 case of ground-glass opacity, 1 case of solidification, 7 cases of ground-glass and consolidation, 1 case of strip opacity, ground-glass, consolidation and strip cable shadow coexisted in 2 cases. Conclusions The application of low-dose CT scan in pregnancy with COVID-19 is completely feasible. CT mainly manifested as bilateral lung patchy, flaky ground-glass opacity with consolidation. Active and effective treatment can completely recover, prognosis better. Key words: Radiation dose; Pregnancy; Novel coronavirus infection; Pneumonia; Tomography, X-ray computed