Identification and Follow-up of COVID-19 Related Matching Ventilation and Perfusion Defects on Functional Imaging...

Area of Science:

• Radiology and Imaging
• Pulmonary Medicine
• Infectious Diseases

Background:

• Coronavirus disease 2019 (COVID-19) is linked to pulmonary microthrombosis and small airway disease.
• Patients with COVID-19 often exhibit varying degrees of lung perfusion abnormalities.
• Accurate detection and follow-up of these abnormalities are crucial for patient management.

Purpose of the Study:

• To evaluate the utility of ventilation/perfusion single-photon emission computed tomography/computed tomography (VQ SPECT/CT).
• To assess VQ SPECT/CT's role in detecting persistent lung perfusion abnormalities.
• To determine VQ SPECT/CT's effectiveness in the follow-up of suspected pulmonary microthrombosis or small airway disease post-COVID-19.

Main Methods:

• Retrospective study of 78 non-hospitalized COVID-19 patients.
• VQ SPECT/CT or perfusion-only SPECT/CT studies were reviewed.
• Pulmonary embolism was suspected in all cases; studies conducted between July 2020 and June 2021.

Main Results:

• Seventy-eight patients (88.5% female, median age 45) were included.
• Twenty-eight percent (28.2%) showed matching VQ defects with mosaic attenuation on CT.
• Persistent abnormalities were observed in all nine patients who underwent follow-up after one year.

Conclusions:

• VQ SPECT/CT is a safe and effective imaging modality.
• It aids in identifying and monitoring persistent ventilation and perfusion abnormalities in recovered COVID-19 patients.
• The findings support VQ SPECT/CT for suspected small airway disease and pulmonary microthrombosis.