RADIOLOGY, from Pediatrics Team COVID-19/MIS-C



PDF - RADIOLOGY, from Pediatrics Team COVID-19/MIS-C

Review key facts, bulleted text, essential images and current references.

RADIOLOGY from Pediatrics Team

by Michael R. Aquino, MD, MHSc

Frontal radiograph in a 14-year-old patient with shortness of breath & fever demonstrates hazy & patchy bilateral pulmonary opacities.
Axial CECT in the same patient shows bilateral lower lung zone-predominant ground-glass & consolidative densities . The patient tested positive for COVID-19 on nasopharyngeal RT-PCR. Other features seen in pediatric cases of COVID-19 include bronchial wall thickening & the halo sign (not shown).
Axial CECT from a 17 year old demonstrates bilateral symmetric lower lung zone-predominant ground-glass & patchy densities. Bronchial wall thickening is also noted.
Axial T1 C+ FS MR in 9 year old with left-sided weakness shows a right cerebral lesion with cortical enhancement & hemorrhagic necrosis (confirmed on T2 & SWI with minimal precontrast T1 shortening) due to COVID-19-associated vasculitis & infarction.
Short-axis T2 STIR cardiac MR in a 16 year old with 10 days of fever & abdominal pain shows high signal intensity of the left ventricular (LV) myocardium vs. skeletal muscle (ratio of 2.5, with > 1.9 being abnormal), consistent with edema. COVID-19 IgG was positive, consistent with MIS-C.
Axial CECT in the same patient shows diffuse pancreatic thickening & homogeneous enhancement with surrounding edema, consistent with acute interstitial edematous pancreatitis in MIS-C.
Axial CECT of a 15 year old with pain demonstrates inflammatory stranding at the right lower quadrant & multiple prominent lymph nodes , some with low density. The appendix was normal (not shown).
Frontal radiograph in the same patient shows diffuse interstitial opacities compatible with pulmonary edema. Echocardiography showed LV dysfunction & ↓ LVEF. Inflammatory markers were elevated, & COVID-19 RT-PCR test was positive. The patient was diagnosed with MIS-C.
Coronal CECT in a 10 year old with right lower quadrant pain, fever, rash, & conjunctivitis shows multiple enlarged lymph nodes & fluid-filled bowel .
Transverse US in the same patient shows distal ileal wall thickening & hyperechogenicity with adjacent fat induration . Serology was positive for COVID-19 exposure. Decreased systolic LV function & coronary artery ectasia were seen on echocardiography. The patient met the criteria for MIS-C & also had elevated inflammatory markers.
Axial CECT from an 18-year-old patient with fever & cough shows bilateral ground-glass densities at the lower lobes. A nasopharyngeal swab RT-PCR test for COVID-19 was positive. Pulmonary nodules, pleural effusions, & cavitation are atypical for COVID-19 & should prompt consideration of other diagnoses.

Contact us now

The site is updated with the latest information and continues to be enhanced to provide healthcare professionals an optimal experience. Want to stay informed when new information is added? Sign up to receive alerts.