Extensive Nonsegmental Pulmonary Perfusion Defects on SPECT/CT as an Early Sign of COVID-19 Infection.

Area of Science:

• Radiology
• Nuclear Medicine
• Pulmonology

Background:

• Coronavirus disease 2019 (COVID-19) is a significant global health concern.
• Accurate and timely diagnosis of COVID-19 complications is crucial for patient management.
• Initial imaging modalities may not always detect subtle or early-stage pulmonary involvement.

Purpose of the Study:

• To report a case of COVID-19 where initial chest CT was negative.
• To highlight the utility of subsequent perfusion SPECT/CT in diagnosing pulmonary abnormalities in COVID-19.
• To discuss the potential mechanisms behind these imaging findings in severe acute respiratory syndrome coronavirus 2 infection.

Main Methods:

• Case report of a hospitalized patient with confirmed COVID-19.
• Initial chest computed tomography (CT) imaging.
• Subsequent perfusion single-photon emission computed tomography/computed tomography (SPECT/CT) imaging.

Main Results:

• Initial chest CT scan was negative for significant findings.
• Perfusion SPECT/CT revealed extensive nonsegmental pulmonary perfusion defects.
• Newly developing parenchymal densities were observed on SPECT/CT.

Conclusions:

• Perfusion SPECT/CT can detect pulmonary abnormalities in COVID-19 patients missed by initial chest CT.
• Nonsegmental perfusion defects may represent a pattern of lung injury in severe acute respiratory syndrome coronavirus 2 infection.
• Advanced imaging techniques are valuable for comprehensive assessment of COVID-19-related lung disease.