681
PŘEHLEDOVÉ425202011151111167232285340403465523580
ČLÁNKY1031202011154107169233293349
/1405202011133
REVIEW1463202011157113173207263347
ARTICLES1835202011158120175208264317372423
Imaging4253230971986126171190235281
of7233230974367
COVID-1980732309747100144165219247284321
in11453230971863
critical1225323097366282109128165204224
care14663230973675102142
with16253230975979106151
a179332309738
focus18483230972468105150182
on20473230974489
chest21533230973681122154182
ultrasound2352323097446390117156188233278323369
6420220201114597
|343202011126
ANESTEZIOLOGIE4268043010753112155200245290342362425467527586607650
A10988043010753
INTENZIVNÍ1172804301071978123168227276296345405426
MEDICÍNA16198043010770114174195248268328382
/20468043010732
Anest21238043010753101145179208
intenziv235180430107186693136184221240281
Med.26528043010770114164180
2023;34(2):61-682852804301074487128172186230275299342364379423461484532576
/34738043010732
www.aimjournal.cz48358043010765133201214257275349367415463490539579598614654693
from4256230107244995167
Wuhan614623010774119165204250
in88762301071864
the97462301072874116
early111362301074382106124162
2020129862301074385124165
[30].1486621010926701141371620623010716
The165862301074290132
Czech181262301075289130169215
Society205062301074188128144186212253
of232662301074770
Radiology241862301074585133149196213260308347
has278762301074887119
advocated42576301074188128174213253278319367
for8067630107236994
the91476301072874117
use104476301074879122
of117976301074871
CT126376301075295
on137276301074895
admission;148076301074189160177208240256302349362
however,185676301074895158199238279304314
the218476301072874116
algorithm231476301074158106152177195221268339
concedes26677630107408513217121142590301074991123
to56290301072873
CT64990301075195
findings7589030107244288135152198246277
not104990301074895120
being118490301074992109155203
specific140190301073481124164180203221259
solely16749030107348098141158196
to188490301072873
the197190301072875117
COVID-192102903010751107150169225253290326
infection24429030107196587128168196213260306
[17].2763901010926671051302890903010716
In425104301071965
contrast,511104301074085132157182221253280295
due826104301074995137
to984104301072873
the1077104301072874117
increased1215104301071864103128169207239281330
volume1565104301074187104150222264
of1850104301074870
CT1941104301075194
examinations2056104301074482121193210256295320337383430461
during2538104301074995119137183230
the2789104301072874117
pandemic,425118301074989135182224295312350364
a8011183010741
number855118301074893164212254279
of1147118301074769
societal1229118301073379119135177202242259
guidelines1500118301074994111158200217233279321353
recommended1865118301072768107151223294336382429471519
against2397118301074088126143188219246
the2656118301072874116
use2784118301074879121
of425132301074870
CT511132301075194
as621132301074172
a7091323010741
screening76613230107337297138181227244290338
tool1119132301072873120138
[18–21].127313210109266710715319323425315221323010716
A15531323010753
widespread1622132301076582129172204251276317356403
use2041132301074879121
of2178132301074870
CT2264132301075194
in2374132301071965
every2454132301074483124149190
patient2660132301075090115132174220245
with425146301076582109155
severe595146301073476115156181222
COVID-198321463010751107150169225253290326
has1173146301074887118
been1306146301075093136183
disregarded150314630107496697121163211250274321363411
by1929146301075087
several2031146301073476115157181221238
national2284146301074887113130176223262279
and2578146301074187134
international272714630107196590131156425160301074887112129176223261279
radiology717160301072766114131177195241290328
societies.1059160301073380119136178204221263295310
The1382160301074290132
Radiologic1528160301074585132149195213260308325363
Society1905160301074188128144186212253
of2172160301074870
North22551603010758104129159205
America,24731603010753125167192210248288302
the2788160301072874117
Canadian425174301075191137176224241279325
Society766174301074188128144186212253
of1035174301074870
Thoracic1120174301074290137162202240257296
Radiology,1431174301074585133149196213260308347357
and1803174301074187135
the1953174301072874117
Canadian2085174301075191137176224241279325
Association2426174301075386117164203220259284301347394
of2835174301074871
Radiologists425188301074584131148193211257305321352378411
have849188301074786123164
advocated1026188301074088126172210250275315362
against1401188301074188126143188219246
routine1659188301072772117143160206247
CT1919188301075194
in2026188301071864
every2102188301074482123147188
respiratory230318830107266798145162186226250295320360
insufficiency26761883010719649514016218720442520230107405799145184225
due667202301074995137
to822202301072872
unspecific912202301074894125173216255272294312351
findings128020230107244288136152198246277
and1575202301074187134
lack172720230107195897133
of1877202301074870
sensitivity1965202301073476122154170196213253270296337
in2320202301071965
the2402202301072875117
first25372023010723416698125
482680202301074488
hrs.2785202301074973106120
Instead,42521630107196596124164203250264
the708216301072875117
diagnostic844216301074966105152198245277304321360
effort122321630107446591137162191
should1433216301073480127173190238
be1690216301075093
channelled1802216301074086125172218260278294336385
towards2206216301072873136175200246277
appropriate2503216301074188137162207255280298336362402
sputum425230301073482129155202274
testing722230301072869102129146193241
and986230301074188136
CT1145230301075195
should1263230301073480127174192239
be1525230301075094
limited1642230301071936108125152193242
to1907230301072873
diagnosing2003230301074966105153200247279296342390
complications2416230301074186159207225242281321346364410458489
such425244301073479118164
as607244301074173
lung699244301071964110158
abscesses876244301074188120159200231263305337
or1232244301074873
empyemas,13242443010743115163201242314353384399
or1741244301074873
in1833244301071965
cases1917244301074079111153185
where21212443010765112154179220
CT2360244301075194
imaging2473244301071991129177194240288
can2779244301074080126
change425258301074086125172219261
the702258301072875117
clinical83525830107405774120137175215232
management10832583010774113159198246288360402449474
of1573258301074870
the1659258301072874117
patient1792258301074989114131173220245
[18–20].205325810109266710715319323726023102583010716
In565272301071965
summary,642272301073479150221259284324334
the989272301072773115
pandemic1117272301074989135182224295311349
era1479272301074468107
should1599272301073379125171188235
not1847272301074794119
change1979272301073985124170217258
the2250272301072874116
attitude237827230107416694111137183230272
of2663272301074769
a27452723010740
critical27982723010740648242528630107284583123140
care584286301074080104145
physician748286301075097133166182220237276322
to1089286301072872
chest1180286301074086129161188
CT1387286301075194
in1500286301071965
a15842863010740
patient1643286301075090115132174220245
with1907286301076583109155
respiratory2081286301072768100147164189229254299324365
insufficiency.246528630107196596141164189207246262304351389430440
Alleged42530030107526884125172213260
changes697300301073984122166213254284
in993300301071963
therapy1068300301072873114138176222259
based1339300301074987118159206
on1556300301074793
the1661300301072772113
calculated178630030107397894132176192230254294341
percentage2139300301074890114150189234258297343384
of2535300301074768
diseased261530030107486494135172203244291
lung425314301071963109155
parenchyma592314301074988112152197235280316388426
on1030314301074793
radiology1135314301072665111128173190235283320
methods14673143010773115140185231278308
are1787314301074165105
not1904314301074793118
supported2034314301073377124171217242270310357
by2403314301074986
any2501314301074085121
relevant263431430107266783125163201247271
clinical42532830107405774120137175215232
data.679328301074987113152167
Moreover,8683283010770116141183230268310334344
in1234328301071965
daily1321328301074987104121159
practice,1502328301075075115153182199237278291
we18153283010764106
have1943328301074887125166
seen2131328301073476119165
multiple23183283010774119137163180227245287
patients2627328301075090115132174220245278
with425342301076582109155
a6003423010741
rather66034230107276692138181205
poor885342301074997144169
correlation1074342301074085110135176194232258275321368
between1461342301075093119185227270316
their1796342301072875117134158
radiology1974342301072766114131177195241290328
imaging2322342301071990129177194240287
findings262934230107234187135152198245276
and425356301074187135
clinical57335630107405774120137175215232
status818356301073461101126172203
(Figs.103535630107246379127158173
212213563010744
and1278356301074187135
5).142635630107446577
Detection15163563010758101127168207236253299346
of1875356301074870
viral195935630107405882122139
load,2112356301071965105153166
i.e.22923563010719337588
of2393356301074870
a24773563010741
living25313563010719367592139186
virus,273035630107415983130161175
implies425370301071990137154171212244
infectiousness,68237030107186485126165194210256302333378420452483497
the1192370301072773115
need1320370301074890132180
for151337030107236893
virostatic161937030107405882127158185224249266304
therapy,1936370301072773115140179226263273
and2222370301074086133
is2368370301071949
not2430370301074894119
correlated2562370301074084109134175192230255295343
to425384301072873
findings51438430107234187135152198246276
on807384301074794
chest917384301074187129161188
imaging1121384301071991130177194240288
[31].142538410109267011012915503843010716
Physicians565398301074591127160176214231270316347
should927398301073379126172190237
avoid1179398301074078124141189
extremes1382398301074482111136177249291323
supported1720398301073378126174222247276317365
by2100398301074987
an2202398301074187
inappropriate2303398301071965104152200225271319344362400425466
use2784398301074879121
of425412301074870
CT.512412301075295104
An634412301075299
example750412301074481121193240258300
is1068412301071849
denying1135412301074991137174192238285
treatment143841230107275294132157229272318343
to1798412301072873
someone1888412301073481153195242289332
with2237412301076582109155
excessive2409412301074482119160192224240279321
lung2747412301071965111158
involvement425426301071965103149167207249321364411436
on884426301074895
CT1002426301075295
and1120426301074188136
with1279426301076583109156
more14584263010774121147188
than1669426301072875114161
seven1853426301073476116157204
days2080426301074988126158
of2261426301074871
clinical235542630107405774120137176216234
findings,261142630107244289137154200248280294
which4254403010765111128166211
has649440301074887118
been779440301075092135181
part973440301074988113142
of1127440301074870
some1209440301073480152194
guidelines1416440301074893110157199216232278320351
[32].178044010109256911113219094403010716
Coronavirus1937440301075196121165212250288305329376406
mutations23564403010773119145184209226271318349
(Beta,2717440301072467109135174188
Delta)4254543010758101119145184204
replicate650454301072668115133150188228253294
often964454301074870100141187
beyond1171454301075093131177224271
101463454301074481
days,1565454301074988125157171
especially1756454301074476123166206222261278295333
in2109454301071965
an2195454301074187
immunocompromised2302454301071991162208254301340385457505530576425468301077491121164212
population654468301075097145192209248273290336383
where10544683010765112154179220
half1291468301074887104126
of1434468301074870
the1521468301072874116
patients1654468301075090115132174220245279
may19494683010774113150
still21164683010733617895111
be2244468301075093
antigen2354468301074187112129176218265
positive2636468301074997128145171188227269
[33,425482101092670112129
34].5714821010946911136814823010716
Therefore,714482301074290133157198220266291332345
parenchymal1077482301075089114155201240286323396435452
changes1547482301074086125171219261293
may18584823010773112149
also202548230107415889136
resolve2178482301072768100146164203245
slowly244148230107335096159177215
and,2674482301074187135149
in2840482301071965
many4254963010774113159196
patients,637496301074989115132174220245278292
may9454963010774113150
persist1111496301075093118150166197225
regardless1352496301072667116155179225243285317348
of1716496301074870
clinical180249630107415874120137176215232
resolution2050496301072768100147165210236253300347
of2413496301074870
the2499496301072874116
disease.263249630107496596139177209251264
Chest3047587015377147203254303
ultrasound3366587015372110157215275326389458529596
CUS3047763010751104142
has320176301074886117
demonstrated333076301074991161207254284311335374398437483
its38247630107194475
usefulness391076301074777118138184200244285315346
during426676301074993116132177223
the449976301072873114
pandemic462376301075088132178219289305342
when4975763010765110151196
evaluating518176301074481119135179216240256300346
patients304790301075089113129170216240272
at333690301074165
the341890301072873115
bedside355090301075092139169185231273
for38409030107236892
the394990301072874115
evolution408190301074482126143188213230275321
of441990301074869
the450590301072873115
disease46379030107496595136173204246
and489990301074187133
the504990301072874115
efficacy51819030107446589107144183221260
of545890301074869
treatment304710430107285395133159232275321346
initiated341510430107196683109126164190231279
for371610430107247196
COVID-1938341043010752108153172230259297334
pneumonia.4192104301075099142189263311359377416432
The4647104301074392136
ultrasound480710430107496693119160193241288336385
machine52161043010775115155203220268311
has3047118301074887119
become3184118301075093132177249292
widely3494118301076583130172190228
available3740118301074179119136153191239257299
in4057118301071965
intensive414111830107196590130177208224264305
care4464118301074180105146
units4628118301074894111137170
and4817118301074187134
is4970118301071950
easier5038118301074482113130172196
to5253118301072872
clean534411830107405799138184
and3047132301074187135
disinfect319613230107496596113159180222262290
than3500132301072874113159
other3673132301074874120162187
radiographic3874132301072666114131177225250290337384401439
imaging4327132301071991130177194240288
methods.46291323010773116142188235283314329
This4972132301074290107138
reduces5123132301072768116162201241273
the5410132301072874117
potential3047146301075097123163210235252290307
of3375146301074770
complicated3465146301074085157205223239278317343383432
transport391714630107285392139170217265290319
to4256146301072873
the4349146301072874117
CT4486146301075194
suite460014630107347996122163
for478314630107247095
imaging4898146301071990129177194240287
indicated5206146301071864112129167207232273321
for304716030107247198
establishing3168160301074578106147197215233265312330377427
the3618160301072977121
diagnosis3763160301075067107156204252285302334
of4121160301074972
COVID-19.42171603010753110155174232261299337349
Unless45901603010757105123166199232
other4846160301074975123167193
confounding5063160301074187135158205253301350368415464
factors3047174301072464103132177202235
are3305174301074165107
at3434174301074167
play3524174301075068107144
which36911743010765112129167214
can3928174301074080126
only4077174301074895112151
be4251174301074993
assessed4367174301074172104147179210253301
by4691174301075088
CT,4802174301075195103
CUS49281743010752106144
also509517430107415889136
reduces5254174301072768116162201242274
unnecessary3047188301074896143186226267300332373398440
infectious351118830107196688130170199217264311343
and3877188301074289137
radiation4038188301072767116133172198216263311
exposure4372188301074483132180213259284326
of4721188301074971
both4816188301075098124172
personnel5011188301075094119153200248295338356
and5390188301074289137
patients3047202301075090115132174220245278
[9,334220210109266882
23,3440202101094690107
35,3562202101094689105
36].368220210109469111337922023010716
CUS31872163010751105143
should3351216301073379126172189237
be3608216301075093
performed3722216301074992117142188213286328376
systematically4119216301073373105132173244283309326364404421438476
in4615216301071965
an4701216301074187
algorithmic4808216301074158106152177195221268339356395
way.52232163010765105142152
The5395216301074290132
comprehensive3047230301074085157205230271318360407438454493535
12-zone3600230301074480104135180227270
method38882303010774116142189236284
(64190230301072464
zones4273230301073682128171203
per4494230301075093118
hemithorax)4630230301074991163180206252299324364402424
of5073230301074870
examining5161230301074482121193210256273319366
Fig.425519701255687137164
5.605519701255479
The729521201074087125
course870521201073881127153184221
of1108521201074568
a11925212010745
severe1254521201073168107144170206
global1477521201074563108154200218
respiratory171252120107256293137156182224250294320359
failure208852120107236785103148174211
on2315521201074592
bedside2423521201074584130159176221260
X-ray269952120107446995138175
documents2890521201074591129174245283330355386
a32925212010746
poor3354521201074591137163
correlation3533521201073881107133170188233259277322369
between3918521201074584111175212251297
CXR4231521201074995138
lung4385521201071964111156
findings455752120107234288133151197242272
and4845521201074692137
disease499952120107456393130175205243
severity:5258521201073169107144170188214253270
A4255322010748
CXR494532201074894137
on652532201074591
Day7645322010756102139
29235322010742
after98553220107466897134160
cannulation1165532201073882128174219237283308326372418
of1604532201074568
VV-ECMO1692532201074592117158206274332
for204453220107236894
severe2158532201073169107144170207
hypoxia2385532201074782128173210228273
in2678532201071965
an2763532201074592
intubated287553220107196590135180226252289334
patient3229532201074692117135173220245
with3494532201076281106152
severe3667532201073168107144170206
COVID-1938945322010748103147165222251288323
ARDS;4237532201074992148186200
B44575322010743
CXR4521532201074894137
on4679532201074591
Day47915322010756102139
549515322010741
pre-extubation5013532201074571108135175214242287333378404422467514
on425543201074592
VV-ECMO;538543201074492117158206273332347
note906543201074792118154
the1081543201072672111
radiographic1213543201072568114132177223249291337383402439
worsening16735432010762107133164201248266312357
of2051543201074568
the2140543201072672110
bilateral227154320107466482128153190216258277
parenchymal2569543201074591116153200237283318390435453
opacities3043543201074591137174192218236274305
contrasting3369543201073881128153178221251277295341386
with3776543201076281106152
grossly3949543201074671115145175192229
improved4199543201071990135161205243280325
lung4546543201071863110155
mechanics47225432010771110147193238284302340371
allowing511454320107466482127190208254299
for543454320107236793
extubation;425554201073876105150195241267285330377391
C8325542010748
CXR896554201074994138
on1050554201074591
Day11575542010756102139
8,1312554201074259
the1387554201072672110
patient1513554201074591117135173219244
is1773554201071848
extubated1837554201073876104150195241267303349
on2201554201074592
an2309554201074591
oxygen2416554201074581121165204250
face2682554201072367104141
mask28385542010772117147183
and3036554201074692137
with3189554201076280106152
the3357554201072672110
ECMO3483554201074088156214
cannulae3713554201073781127173219237282320
removed,4049554201072663134179217254299315
i.e.43805542010719357389
not4484554201074792118
seen4618554201073168107153
on4787554201074591
X-ray.489455420107446995138175189
Overall5098554201075897134160203221239
gross5353554201074571115145175
improvement425565201071990135161205242279351389435461
is902565201071848
not966565201074691117
followed110056520107226786104149211249294
by1411565201074581
the1508565201072672110
bilateral163556520107456482127153189215258276
lung1927565201071964110155
findings209956520107234187133151197242272
on2387565201074591
X-ray,249556520107446895138174188
similar2699565201073148119137155200226
to2941565201072670
A30275652010749
(one3092565201072466113151
day3259565201074590127
after340356520107456897133159
admission)3578565201074591162180209240257302349370
Fig.3047250401255587136163
4.3225250401255380
COVID-1933512519010748102146165221250287323
on3688251901074591
CT3794251901074790
scans:3898251901073168112158188203
four4116251901072267113139
different426925190107456486112150176212259284
patients4568251901074490116134172219244275
with4858251901076180106151
various5024251901073781107125171216246
disease528525190107446393130175206243
severity:3047262901073170110149176196223263281
A33522629010749
oxygen3425262901074583124170210258
by3707262901074583
face3814262901072369108145
mask39832629010773119151188
(O24195262901072482122
mask);43412629010772119150187213227
B45922629010744
non-invasive4660262901074794142170191238277322354372412450
ventilation;5134262901073877125151171190237264283330378394
note3047273901074692118155
the3217273901072673111
asymmetry3343273901074576113185256295322348388
with3746273901076281107154
predominant3915273901074571108154200272290337382429455
right438527390107254490136162
lung4562273901071864111156
ground-glass4733273901074571116162209254282330349394425455
opacities;5203273901074591138175194220239278309324
C30472849010748
IPPV3110284901071962104148
and3273284901074592137
VV-ECMO,3425284901074593118159208276334350
acute3790284901074583128154191
fibrinous399628490107234388115133180225272302
organising4313284901074471115160207225255273319365
pneumonitis;4693284901074591130176248293340359385404433448
D51572849010755
IPPV5228284901071861103147
and5391284901074591137
VV-ECMO,3047295901074593119161209278337353
diffuse341829590107466588115162193231
alveolar3667295901074565104142188207253280
damage3965295901074591163209256295
A30873115012565
O237963848010962106
mask39213848010975119154197
NIV5048384801095981132
IPPV,3475488901092270117167181
VV-ECMO36754889010951105132178230303365
IPPV,4822487501092270117167181
VV-ECMO50224875010951105132178230303365
B43143115012557
C30874017012562
D42874017012566