pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2020-30-5-658-670pulmo-1398Research ArticleОБЗОРЫREVIEWВизуализация изменений в легких при коронавирусной инфекции (обзор литературы и собственные данные)Imaging of lung pathology in COVID-19 (literature review and own data)ТюринИ. Е.TyurinI. E.

Тюрин Игорь Евгеньевич – д. м. н., заведующий кафедрой рентгенологии и радиологии

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1тел.: (903) 758-46-52 

Doctor of Medicine, Professor, Head of the Department of X-Ray and Radiology

ul. Barrikadnaya 2/1, build. 1, Moscow, 123995tel.: (903) 758-46-52 

igortyurin@gmail.comСтрутынскаяА. Д.StrutynskayaA. D.

Струтынская Анастасия Дмитриевна – аспирант кафедры рентгенологии и радиологии

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1тел.: (909) 685-75-38 

Anastasia D. Strutynskayа – Postgraduate student

ul. Barrikadnaya 2/1, build. 1, Moscow, 123995tel.: (909) 685-75-38 

strutynskaya@yandex.ruФедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Federal Academy of Continued Medical Education, Healthcare Ministry of RussiaRussian Federation202026102020305658670Copyright © Тюрин И.Е., Струтынская А.Д., 20202020Тюрин И.Е., Струтынская А.Д.Tyurin I.E., Strutynskaya A.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1398

Одним из главных проявлений новой коронавирусной инфекции (КВИ) является поражение легочной ткани, при этом для выявления изменений в легких и их дифференциальной диагностики с другими заболеваниями (преимущественно иными вирусными пневмониями) большую роль играют методы визуализации, в первую очередь – обзорная рентгенография и компьютерная томография. В начале заболевания в большинстве случаев определяется уплотнение легочной ткани по типу «матового стекла» или консолидации, симптом «булыжной мостовой». Данные изменения при динамическом исследовании могут уменьшиться в объеме с постепенным восстановлением воздушности легочной паренхимы или нарастанием консолидации и формированием типичной картины организующейся пневмонии. Они могут сохраняться и даже увеличиваться с нарастанием консолидации, появлением типичной картины или отдельных признаков организующейся пневмонии. Однако при высокой чувствительности методов лучевой диагностики на сегодняшний день их специфичность и прогностическая способность остаются не столь высокими. Осложнениями КВИ являются тромбоэмболия легочной артерии, развитие тромбозов легочных сосудов in situ, острая сердечная недостаточность с развитием кардиогенного отека легких, бактериальная суперинфекция, обострение или ухудшение хронического заболевания легких и последствия проводимой терапии (пневмоторакс, пневмомедиастинум, гематомы).

Novel coronavirus infection is predominantly manifests as lung tissue damage. Imaging methods, particularly, chest X-Ray and computed tomography, are of great importance for detecting pulmonary changes and differentiate them with other diseases (mainly other viral pneumonias). In the early disease stages the disease presents on CT with ground glass opacities, consolidations, crazy paving symptom. With time course, they can gradually decrease, evolve into organizing pneumonia or stay stable and even increase in volume with the spread of consolidation and formation of several signs of organizing pneumonia. Although radiological methods show high sensitivity in the detection of pulmonary changes, their specificity and prognostic ability are not so good today. Novel coronavirus infection can be complicated with pulmonary embolism, development thrombosis in situ in pulmonary small vessels, acute heart failure and subsequent development of cardiogenic pulmonary edema, bacterial superinfection, exacerbation or worsening of chronic lung disease and several iatrogenic issues (pneumothorax, pneumomediastinum, hematomas).

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The authors declare that there are no conflicts of interest present.