732
PŘEHLEDOVÉ425202011151111167232285340403465523580
ČLÁNKY1031202011154107169233293349
/1405202011133
REVIEW1463202011157113173207263347
ARTICLES1835202011158120175208264317372423
Imaging4253230971986126171190235281
of7233230974367
COVID-1980732309747100144165219247284321
in11453230971863
critical1225323097366282109128165204224
care14663230973675102142
with16253230975979106151
a179332309738
focus18483230972468105150182
on20473230974489
chest21533230973681122154182
ultrasound2352323097446390117156188233278323369
6220820201114591
|343202011126
ANESTEZIOLOGIE4268043010753112155200245290342362425467527586607650
A10988043010753
INTENZIVNÍ1172804301071978123168227276296345405426
MEDICÍNA16198043010770114174195248268328382
/20468043010732
Anest21238043010753101145179208
intenziv235180430107186693136184221240281
Med.26528043010770114164180
2023;34(2):61-682852804301074487128172186230275299342364379423461484532576
/34738043010732
www.aimjournal.cz48358043010765133201214257275349367415463490539579598614654693
For56562301074289116
many706623010773114162201
years,93162301074083123150184200
CUS1156623010751107147
has132862301074889122
been147562301074994139187
thought168762301072876125173222270297
of200962301074872
as210662301074074
impossible220562301071892141190224257276325345389
and261862301074189139
not278262301074896124
feasible42576301072365104137154202221264
due70476301074894137
to85776301072772
the94576301072774117
very107776301074082108150
nature124276301074887113160185227
of148476301074871
the157076301072774117
lungs170376301071864111159191
being190976301074993111157205
air‑containing21307630107405883107148194241267307325371389436484
structures.2629763010733618713417320324942590301072770103120
CUS565903010752107147
can73390301074082130
be88390301075095
performed99890301075095121148196223297341391
at141090301074168
the149890301072876121
bedside163990301075095145178196245289
when1949903010765113158206
needed217590301074993137188232282
and247790301074189138
waiting2636903010765106125153172220269
for42510430107247198
a5461043010741
radiology610104301072769118137185204253303343
report976104301072770119169196226
is1226104301071951
eliminated130010430107446382155174222262289332382
as1705104301074174
clinical180310430107405977125143184225244
information207010430107196790138165239280307326374423
is2516104301071951
acquired2591104301074081129176195221264314
within425118301076584112161179227
a6721183010741
few733118301072468132
minutes883118301077492139185212254287
if1188118301071942
not1249118301074896122
seconds.1389118301073477118163211260292307
CUS17151183010751106145
is1879118301071950
a19481183010741
portable,2007118301075098124154195243262305319
mobile23441183010774122171189207250
imaging2613118301071991131179197244293
tool425132301072874122140
with581132301076583110158
a7541323010741
steep810132301073462103147196
learning1021132301071962101127175193240288
curve1324132301074087113156198
in1537132301071966
contrast1619132301074085133159185226258286
to1920132301072874
other2009132301074875122165191
imaging2215132301071991131180197244293
modalities.25231323010774121171210228246273291334367383
Furthermore,425146301074287112142189233258332379405447461
the910146301072875118
combination1052146301074086159208226273313339357404452
of1528146301074871
CUS16231463010751106145
and1792146301074188136
echocardiography1952146301074484131179219260285332350397446472513561609647
is2622146301071951
extremely26971463010744821121381804251603010774117135175
valuable61716030107418199146186234253296
in931160301071865
the1014160301072875118
assessment1150160301074173106149182214286330377403
of1570160301074871
not1659160301074896122
only1798160301074896114153
lung1969160301071965112161
pathology,2147160301075091117164212231278327367377
but2542160301074997124
also268416030107405990138
in2839160301071966
assessing425174301074173106149182214232279327
the770174301072875118
haemodynamic906174301074988131204252301340389428501519558
parameters1482174301075090116157229273300341367400
of1900174301074871
a19891743010741
patient.2048174301074990116134177224250266
CUS5651883010751106145
is732188301071850
also80318830107415991139
excellent963188301074482121162181198241289315
in1299188301071966
the1386188301072875119
diagnosis1526188301074967106154202249282299331
of1878188301074871
pleural1971188301074968111158183224242
and2234188301074188137
diaphragmatic2392188301074967106155203228269317390430456474513
pathologies,425202301074989114160206224270318335377409423
guiding862202301074894111158175220268
thoracentesis1143202301072874120145185224264310335376407424455
and1612202301074086133
aiding1759202301074057104121167214
in1987202301071864
the2065202301072773115
evaluation2194202301074382121138184222248265311357
of2565202301074770
pulmonary2648202301074995113183230425216301074887111153
consolidations592216301073984131162209227244291330356373419466497
[1–4].110421610109256710715517712782163010715
This1308216301074189106137
reduces1459216301072667115161200241273
serial1746216301073375100118156174
bedside1934216301074992140172188236278
CXRs,2226216301075199142176190
thus2430216301072874120151
reducing2595216301072667116161200217263311
unnecessary425230301074793139182221261293325365390431
radiation870230301072666113130169194211257304
exposure1188230301074381129176208253278319
(for152023030107244590115
reference,164923030107266890131156197243282323336
one1998230301074894137
non‑contrast2149230301074794140167207252299324349389420448
chest2610230301074086128160188
CT2811230301075194
(an425244301072461108
effective55024430107436693135176205223263305
dose872244301074996129172
of1060244301074871
about1147244301074190138185213
813762443010744
millisieverts1436244301077492109127145176194237276319344374408
(mSv))1860244301072495135173194214
equals2091244301074392139179197228
about2336244301074089137185212
4002564244301074489134
chest2714244301074087130163191
anterior‑posterior425258301074189115157183201249275299349397430459501526545592619
(AP)1068258301072476120142
CXR12342583010752102146
examinations1405258301074483124197215262302329347394442475
as1904258301074174
one2003258301074896140
CXR21672583010752102146
has2338258301074888121
an2484258301074188
effective259725830107446794137177207225266308
dose425272301074996129172
of619272301074871
about711272301074190138185212
0.02945272301074458102142
mSv).11092723010773114151173185
There1316272301074190134159201
is1539272301071850
also161127230107415990138
a17702723010741
reduction1832272301072769118165204234252299347
in2200272301071966
the2287272301072875119
potential2427272301075098124166213239257297315
side276327230107345199142
effects42528630107446794138179209243
of693286301074972
contrast790286301074187136162189230263292
administration1107286301074190164182230248280309335377404422470518
during1650286301075097123142190239
CT,1914286301075297107
notably2046286301074897124165214233273
hypersensitivity2344286301074987138183209243287335367385413431472491519561
reactions425300301072769108147177194242289321
to761300301072874
contrast850300301074085133159185225258286
medium,11513003010773117166183230302317
contrast‑induced1483300301074085133159185225258286309328375423470509551600
nephropathy2098300301074891140188213259308349375422460
(CIN),257330030107247290146169181
and2769300301074188136
rarely,42531430107276793135153192203
contrast‑induced646314301074086133159185226258286310329376424471511552601
thyroid1265314301072875113139186204252
dysfunction1535314301074988121145193240280310327375422
[5–8].197531410109266911516318621593143010716
Bedside565328301074588136167184231273
CXR8523283010751100143
is1009328301071849
limited1072328301071936107125151192240
in1326328301071965
diagnosing1405328301074865104151197244276293339386
pulmonary1805328301074996113184231278317341383
consolidations,2202328301073984131162209227244291330356373419466497512
small27283283010733104143161178
to425342301072873
moderate5123423010773120169211236276302343
pleural869342301075068110157182222239
effusions,112334230107436591139170187234281312327
small14643423010734105144162179
to1658342301072772
moderate‑sized17443423010774120169212237277303344371404421456497546
pneumothoraces2304342301074996139185257304330376423449489528569601
or425356301074874
alveolar‑interstitial52335630107405999141189208247273296315362388430455489517535562580619637
syndrome1184356301073474122170196242315359
[7–10]1567356101092672112153194218
due1808356301074996139
to1970356301072874
technical2068356301072769109156204221261301319
complications2411356301074086159207226244283324350368415463495
which4253703010765114132171219
arise66937030107416785117161
when8553703010765113157205
a10853703010741
bedside1151370301075094144176194242286
CXR14623703010751101146
is1633370301071851
performed.1708370301075095121147194221295338388403
The2136370301074292135
spatial2296370301073483124150168208227
resolution2547370301072770103151170217244262310358
of425384301074871
bedside516384301075094143175192240284
CXR8193843010752101145
is984384301071951
compromised1055384301074086159207233280353371402446495
by1570384301074988
the1678384301072875118
fact1816384301072465105134
that1970384301072875115141
the2131384301072875118
patient2269384301075091117135178225251
cannot2540384301074080128175222249
do2808384301074997
a4253983010741
breath484398301075076118157183231
hold;733398301074896114163177
thus,928398301072875121154169
there1115398301072875118144186
is1319398301071951
movement13883983010774121161203276319366392
of1799398301074871
the1888398301072875118
thorax.2025398301072775122148189228244
Furthermore,2287398301074287112142190233259332380406448461
due2767398301074995138
to425412301072873
film51341230107244260132
cassette660412301074080112145188215244286
positioning960412301075098130148175192239287304351399
(between1374412301072473117143210252296343
the1732412301072775118
bed1864412301075094143
and2021412301074188136
the2172412301072875118
patient),2305412301074990116134176224249272284
the2604412301072875118
x‑ray273741230107386490131168
beam425426301074992130202
is641426301071849
shortened704426301073379126151180221267310358
because1076426301074992131171217248290
of1380426301074770
a14644263010740
shorter1518426301073379126151180221246
acquisition1778426301074079125170188219235262279325372
distance216442630107486596124163209248289
(3).24674263010723648395
This2576426301074189106137
leads2727426301071961100147178
to425440301072874
suboptimal515440301073480128177226252270343383401
images932440301071991131180223256
which12044403010765113131170217
can1438440301074080127
be1582440301075094
challenging1692440301074087127145163206253302319366415
to2123440301072874
accurately2213440301074181119166191232258300318357
interpret.258744030107186591133158208234276303318
In565454301071965
critically64545430107396583109127166206223241279
ill93945430107183653
patients1006454301075090116133175222248281
who13014543010765112159
are1474454301074166107
extensively1596454301074381111152198230247286328346385
monitored19954543010773120167185211257282324372
by2381454301075088
a24834543010741
number2538454301074894166214257282
of2835454301074770
invasive425468301071964102141173189228270
devices,708468301074991129147186226258272
CT994468301075194
scanning1101468301073372112158203220266313
not1428468301074894120
only1561468301074894111149
is1724468301071950
cumbersome,1787468301074086157204247272304350422464477
but2278468301074995122
transportation241346830107285392138170217264289318357383400446492
to425482301072874
the522482301072775118
CT663482301075296
suite78248230107338097125166
and971482301074188137
positioning1131482301075098130148175193240288305352401
of1555482301074871
such1649482301073480119167
patients1839482301074990116134177224250284
in2146482301071966
the2235482301072875119
gantry2377482301074989136162188230
is2630482301071950
a27044823010740
task2768482301072768100137
in425496301071966
itself,51349630107194680123142165177
with712496301076583111158
a8924963010741
potential955496301075098125166214240257297315
for129249630107247097
significant141149630107335199146164187206245286333359
respiratory1792496301072769101150168193234260306332374
and2189496301074188136
haemodynamic2347496301074989132204252301341389429501519558
derangements425510301074992118159206255298371414462488522
for97151030107247097
the1092510301072875119
patients1235510301075091117135178225251285
[11–13].154551010109266810514618722624817915103010716
The1831510301074291134
limitations1990510301071937109127154195221239286334366
brought2381510301074976122169218265291
on2696510301074896
by2817510301075088
the304762301072875118
aforementioned318962301074164111137179251295342368386433481524573
radiology378662301072767116134181199247296335
methods4145623010774117144192239288320
make4489623010774114151193
CUS4706623010751106145
the487562301072875119
go-to501762301074997125152198
method5239623010774117144191239288
of304776301074871
assessing313676301074173106149182214231278327
critically34817630107406684111129168209227245284
ill37837630107183654
patients.385576301075090116134177225250284300
COVID-1930471007015377160241286372412470534
pneumonia36041007015369143202274378443516557622
and42491007015362138208
ARDS44801007015381167253321
During30471183010759109136156205255
the3330118301072877122
worldwide34801183010766115142162213279299349395
pandemic3902118301075093142193238313332373
due4303118301074998143
to4473118301072876
COVID-19,45761183010753111157178238268308347359
there4963118301072877123150194
has5184118301074991125
been5336118301075197142192
a30471323010740
greater3103132301074974116156182224250
need3369132301074791135184
for356913230107237096
accessible,3681132301074080118159192225243291310354368
reproducible,4064132301072769117144190239286325343392411454468
and4548132301074088136
safer470013230107337497140166
means48811323010773117156203236
of5132132301074871
imaging.5219132301071991131179197244293308
In3047146301071967
this313814630107287695127
regard,3289146301072770120161187235251
CUS35641463010751107147
can3735146301074081129
be3888146301075095
extremely4007146301074483114141184257302321361
useful4392146301074881125149198217
(just463314630107234492125154
as4811146301074174
it4909146301071947
was49801463010765106139
during5144146301074896122142189239
the5407146301072876120
H1N13047160301075796149188
pandemic)3255160301075091139189233307325365388
to3663160301072875
evaluate3757160301074485126145193233260303
patients4080160301074991118137181229256291
at4390160301074168
the4478160301072876120
bedside4618160301075095145178196245289
for492716030107247198
the5045160301072876120
evolution5185160301074484132151199227246294342
(either304717430107246685113162207234
progression3307174301075178126176203246281314333382431
or3764174301074976
regression)3867174301072770121147191225259277326375397
of4291174301074872
the4390174301072877122
disease4538174301075069102147187221266
and4831174301074189139
the4997174301072877122
efficacy514517430107446896116157199240283
of5455174301074872
any3047188301074189127
supportive3196188301073381130180229256287306347390
treatment360818830107285497137165238283331358
initiated398718830107196785113132173200242292
for430118830107237198
COVID-1944201883010752109154175233262301339
pneumonia,4780188301075099143191264313361380420436
and5237188301074189139
can5397188301074082130
confer3047202301074087135159202229
an3298202301074088
easier,3408202301074484117136179206218
dynamic3647202301074990139179253271312
method39812023010773117145194242292
of4295202301074872
assessment4389202301074074107151185218292336384411
since482220230107335199140182
an5026202301074189
ultrasound513720230107476694121163196244293341390
machine30472163010774114155203222269314
is3380216301071952
widely3452216301076584133177196236
available3708216301074181122141160200250269313
in4041216301071967
specialised4127216301073483128169188228247266298342393
ICUs.4539216301071971126159175
It3187230301071947
needs3255230301074893137187220
to3497230301072774
be3592230301075095
stressed,370823030107346390133166200244294309
however,4039230301074896161205245289315327
that4387230301072876117144
imaging4552230301071993133183201249299
findings487223030107234391141159207256289
related518323030107266988129156199249
to5453230301072874
COVID-1930472443010751109154174232262301338
are3403244301074167110
not3530244301074897124
specific3671244301073483128169188212232272
to3960244301072875
COVID-1940522443010751109154174232262301338
and4408244301074189138
a45632443010741
definitive4621244301074993117137185203231250291335
diagnosis4973244301074967108157205254287305338
inevitably53282443010719671111521713047258301072869118137177
involves3240258301071966105152171212255288
other3544258301074875123166192
methods37532583010773117144192240290322
such4092258301073379120167
as4275258301074174
microbiology4365258301077392132158204254273320340388437477
sampling,4858258301073475148197217235282331346
serology5221258301073377103149169217266306
and3047272301074189138
bronchoscopy,3206272301074976123172212260309342383430480519531
as3757272301074174
similar3851272301073452126144163203230
imaging4101272301071992133182201249298
findings442027230107234391140159207256289
can4729272301074082130
be4879272301075095
seen4994272301073378122171
in5185272301071967
cardiac5272272301074081108156175215255
and3047286301074189138
other3206286301074875124168194
pulmonary3421286301075098117190239288328355398
pathologies,3840286301074991118166215234283333351395429445
e.g.4306286301074358107123
in4450286301071967
cardiac4538286301074081108156174215255
failure,481428630107246685103151177220235
other5069286301074876124168195
viral528428630107416187128147
or5452286301074875
bacterial3047300301075091132162205231250291310
pneumonias,3376300301075099143191264313361380420453469
and3865300301074189138
chronic4023300301074088115162210229269
pulmonary4312300301074998117190238287328354397
diseases4729300301074967100144185218262296
[13,5045300101092669109127
14].519130010109478811253013003010716
Chest30473247015377150210264316
radiographic33863247015359123193235300363424488558630672730
imaging41393247015338143207272313388452
(CXR46143247015338113190276
and49133247015362137208
CT)51433247015377156196
CXR30473423010751102147
can3217342301074081129
help3369342301074993112161
to3553342301072875
guide3651342301074996115164208
therapy3882342301072876121147189238278
after418334230107406496138165
the4371342301072776120
first451434230107234370104133
484670342301074489
hours4782342301074997145171206
(hrs)501134230107247299133154
of5188342301074872
clinical528334230107405977125144184225244
COVID-19.30473563010752111158179238269309348362
Nonetheless,34363563010759109159204233283328348393428463479
CXR39433563010752104150
performs4121356301075096124152201228305339
inferiorly448735630107196993138165185235262283324
to4838356301072977
CUS49423563010752110151
in5120356301071969
terms521635630107287299176210
of5453356301074974
diagnosing3047370301074968108157205254287306353403
COVID-1934683703010752109154174232262301339
associated3825370301074174108156197216256283326376
pulmonary4220370301074998117190238287328354397
findings463637030107234391140159207256289
[1,494437010109266983
2,5045370101094665
4,5128370101094665
5,5211370101094663
15,5292370101094787105
16]5415370101094688113
(Figs.304738430107246482130162178
132413843010743
and3300384301074188136
2).345238430107436578
Changes3546384301075097137184233276309
seen3871384301073376120167
on4054384301074895
lung4165384301071966113161
ultrasound434238430107476693119160192240287334383
and4741384301074087136
clinical489238430107405876123141181221240
presentation51483843010749751171501932412673073343523047398301074795
(Fig.315739830107246482130145
2)3317398301074465
precede3398398301074975117157198247290
those3704398301072774122154197
seen3917398301073376120167
on4100398301074794
CXR42103983010750100144
and4369398301074187136
CT4520398301075195
(Figs.463139830107236381129161177
148233983010744
and4882398301074087136
3).503339830107446476
Beyond5125398301074588127173221269
the5410398301072774117
first304741230107244370104133
483198412301074389
hrs,3305412301074874108124
CT3447412301075196
has3561412301074889122
shown3701412301073481130195243
far396241230107246692
more40724123010773122149192
sensitivity4282412301073377125158177205224265284312355
than4654412301072876117165
CXR48374123010751102147
where50014123010765114158185227
discrete5246412301074968100141168211238281
lung3047426301071966115164
changes3231426301074088128176226270304
are3554426301074168110
involved3684426301071967106154173214258308
[17].401242610109266910813541454263010716
COVID-1931874403010751108153174231261300337
pneumonia3541440301074998142189263311359378418
has3976440301074888121
an4114440301074189
evolution,4219440301074484131151198226245293341357
starting4592440301073463104130161180227277
off488544030107487299
as5000440301074174
microvascular5091440301077492132159205246287320361408304745430107196086
damage3157454301074989163204253297
which34784543010765113132172220
then3722454301072776120168
progresses3914454301074976123173200243276310354388
to4325454301072875
acute4423454301074182129158200
fibrinous464745430107234392119139187235283316
and4987454301074189138
organising5149454301074874123163211230263281329378
pneumonitis30474683010750100145194269318368387416435468
(AFOP)3542468301072578120181228250
or,381946830107497789
less393546830107196498133
commonly,4095468301074088163238288337357397409
to4532468301072875
diffuse463446830107506994122172205250
alveolar4911468301074261103147197218259286
damage5224468301075091166208258303
(DAD).3047482301072482132190212225
On32974823010761110
CT,3432482301075196107
it3564482301071947
typically3636482301072871121140181222241260300
has3961482301074889122
these4108482301072876121154198
features:4332482301072367107134182208251285300
predominantly4657482301075077120170218292311359400448474493533
peripheral5216482301074994121140190238282304749630107276988
ground‑glass3161496301075076124172221271299350370410444478
opacities3665496301074899141182201229248292326
(GGOs)4018496301072478135196230252
with4296496301076585113162
or4484496301074976
without4586496301076685114162211260288
consolidations4901496301074087136169218238257306347375394442491524
or5452496301074875
crazy3047510301074168110148191
paving,3265510301075093133153202252268
with3560510301076585113162
a37495103010742
bibasilar3817510301075170120163197215234276302
predominance4146510301075078121172221296315364405454495538
[17–21]4712510101092670110152195238259
(Figs.499851030107246685134168185
352105103010744
and5281510301074190140
4).544851030107446680
Fig.425526801255687137164
1.608526801255477
Spectrum731528201073984122160188213259330
of1080528201074568
COVID-1911675282010748103147165222251288323
lung1509528201071864110155
changes1683528201073783128175220258289
in1991528201071965
patients2075528201074591117135172219244275
admitted2369528201074591162180206234271316
with2704528201076280106152
dyspnoea2875528201074582113157204249288333
on3227528201074592
oxygen.3338528201074581120165203250266
A36235282010748
normal3690528201074692118189234252
CXR3961528201074995138
(A)411852820107247194
can4231528201073882128
be4378528201074584
seen,4481528201073169107153169
as4669528201074575
well47635282010762100118136
as4918528201074676
the5013528201072672110
bilateral514252820107456482127153189215258276
interstitial543752820107196542553920107266389120146164190208253271
pattern714539201074591117145182207254
(B)98653920107236688
or1092539201074571
visible118153920107385685102148166204
infiltrates140353920107196587106124150176218244281312
(C).173353920107247094107
Images1858539201071990135180219250
reproduced2126539201072662108134178224270307343389
with2533539201076280106152
permission2703539201074584110181199228259276321367
from308853920107235094165
the3271539201072672110
archives3399539201074671107153171209246277
of3694539201074568
the3780539201072672111
Department3908539201075796142187213241313351397422
of4348539201074568
Diagnostic4434539201075776121166212257287313331369
Radiology,4821539201074388134152197216261307344357
University51965392010754100118156193218250267292332
Hospital4255502010754100130174192218261280
Bulovka,721550201074389107152190227271287
Prague,1024550201074368110156201239255
Czech1295550201074886123160206
Republic1517550201074482128174219237256293