A
Figure 1.
CT exam results indicate patient is positive for COVID-19. Images acquired on GE Revolution™ A EVO 128-slice CT.
B
Figure 1.
CT exam results indicate patient is positive for COVID-19. Images acquired on GE Revolution™ A EVO 128-slice CT.
C
Figure 1.
CT exam results indicate patient is positive for COVID-19. Images acquired on GE Revolution™ A EVO 128-slice CT.
A
Figure 2.
Patient is referred for a brain and venography MR exam on SIGNA™ Explorer by neurologists because of severe headache and neck pain. Results indicate thrombosis. (A, B) Non-contrast 2D TOF SPGR, 5:13 min.
B
Figure 2.
Patient is referred for a brain and venography MR exam on SIGNA™ Explorer by neurologists because of severe headache and neck pain. Results indicate thrombosis. (A, B) Non-contrast 2D TOF SPGR, 5:13 min.
A
Figure 3.
T2 frFSE and T2 FLAIR images from initial SIGNA™ Explorer exam depict evidence of thrombosis (circles). (A) Axial T2 frFSE, 1:38 min.; (B) coronal T2 frFSE, 1:16 min.; and (C) axial T2 FLAIR, 2:16 min.
B
Figure 3.
T2 frFSE and T2 FLAIR images from initial SIGNA™ Explorer exam depict evidence of thrombosis (circles). (A) Axial T2 frFSE, 1:38 min.; (B) coronal T2 frFSE, 1:16 min.; and (C) axial T2 FLAIR, 2:16 min.
C
Figure 3.
T2 frFSE and T2 FLAIR images from initial SIGNA™ Explorer exam depict evidence of thrombosis (circles). (A) Axial T2 frFSE, 1:38 min.; (B) coronal T2 frFSE, 1:16 min.; and (C) axial T2 FLAIR, 2:16 min.
A
Figure 4.
Follow-up brain and venography exam on SIGNA™ Pioneer depicts non-thrombosis after treatment. (A, B) Non-contrast 3D Inhance.
B
Figure 4.
Follow-up brain and venography exam on SIGNA™ Pioneer depicts non-thrombosis after treatment. (A, B) Non-contrast 3D Inhance.
A
Figure 5.
(A) Before and (B) after images of patient with thrombosis resulting from COVID-19. (A) Sagittal 3D Cube on SIGNA™ Explorer, 4:21 min. (B) Sagittal 3D Cube PROMO, 6:50 min. on SIGNA™ Pioneer.
B
Figure 5.
(A) Before and (B) after images of patient with thrombosis resulting from COVID-19. (A) Sagittal 3D Cube on SIGNA™ Explorer, 4:21 min. (B) Sagittal 3D Cube PROMO, 6:50 min. on SIGNA™ Pioneer.
1. Ellul MA, Benjamin L, Singh B, et al. Neurological associations of COVID-19. (2020) The Lancet Neurology, 19(9):767-783.
2. Ross W Paterson, Rachel L Brown, Laura Benjamin, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings, Brain, July 2020, https://doi.org/10.1093/brain/awaa240.
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Banu Topçu Çakir MD, FESC, FACC, MSCMR
Ankara City Hospital
Ankara, Turkey
Semih Aydin RT
Ankara City Hospital
Ankara, Turkey
SPOTLIGHT
Imaging COVID-19 patients with neurological symptoms
Imaging COVID-19 patients with neurological symptoms
by Banu Topçu Çakir MD, FESC, FACC, MSCMR, Ministry of Health Associate Professor and radiologist, and Semih Aydin RT, ATL Site Supervisor and radiographer, Ministry of Health, Ankara City Hospital, Ankara, Turkey
Introduction
Although COVID-19 is primarily considered a respiratory disease, there are increasing reports of neurological effects that in some cases may be the first manifestation of the disease. Several reports of patients with COVID-19-related neurological disorders included encephalitis, Guillain-Barré syndrome, anosmia and ageusia, inflammatory CNS syndromes and acute cerebrovascular disease1,2.
Banu Topçu Çakir
MD, FESC, FACC, MSCMR, Ministry of Health Associate Professor and radiologist
Ankara City Hospital, Ankara, Turkey
Semih Aydin
RT, ATL Site Supervisor and radiographer, Ministry of Health
Ankara City Hospital, Ankara, Turkey
Patient history
A 34-year-old male complaining of sore throat, headache, fever, dry cough, tiredness, difficulty breathing, chest pain and brain pain/pressure. Patient underwent thorax CT and PCR test, both positive for COVID-19.
Due to the complaint of severe headache and neck pain and pressure, the patient was referred by the neurology department for a brain and venography MR.
Technique
A non-contrast 2D TOF SPGR and fast T2 FRFSE and T2 FLAIR performed on a SIGNA™ Explorer 1.5T confirmed the presence of thrombosis. Patient was treated with anticoagulants. After the patient recovered from COVID-19 (negative PCR test), a follow up brain and venography MR was requested. Due to his recovery from COVID-19, the patient was evaluated on a SIGNA™ Pioneer 3.0T system at our non-pandemic section of the hospital campus. Non-contrast 3D Inhance along with fast acquisitions of T2 frFSE and T2 FLAIR were utilized.
Results
The follow-up brain and venography demonstrated the patient returned to normal (non-thrombosis) after anticoagulation therapy.
Discussion
Thrombotic events may be seen in patients positive for COVID-19. Therefore, radiologists should be careful to review venous sinus thrombosis while evaluating brain images in patients with neurological symptoms.
A
B
C
Figure 1.
CT exam results indicate patient is positive for COVID-19. Images acquired on GE Revolution™ A EVO 128-slice CT.
A
B
Figure 2.
Patient is referred for a brain and venography MR exam on SIGNA™ Explorer by neurologists because of severe headache and neck pain. Results indicate thrombosis. (A, B) Non-contrast 2D TOF SPGR, 5:13 min.
A
B
C
Figure 3.
T2 frFSE and T2 FLAIR images from initial SIGNA™ Explorer exam depict evidence of thrombosis (circles). (A) Axial T2 frFSE, 1:38 min.; (B) coronal T2 frFSE, 1:16 min.; and (C) axial T2 FLAIR, 2:16 min.
A
B
Figure 4.
Follow-up brain and venography exam on SIGNA™ Pioneer depicts non-thrombosis after treatment. (A, B) Non-contrast 3D Inhance.
A
B
Figure 5.
(A) Before and (B) after images of patient with thrombosis resulting from COVID-19. (A) Sagittal 3D Cube on SIGNA™ Explorer, 4:21 min. (B) Sagittal 3D Cube PROMO, 6:50 min. on SIGNA™ Pioneer.
