Table 2.
CT protocol in suspected COVID-19 related cardiovascular injury.
| CT scan | Indication | Parameters | Information | Severity cut-off value |
|---|---|---|---|---|
| Non-contrast scan | -Pneumonia assessment -Coronary artery calcium |
Standard Large FOV for pneumonia evaluation Cardiac FOV prospective ECG-gated scan at 75% of the R-R interval |
- Pneumonia severity - Coronary artery calcium - Total thoracic calcium - Main pulmonary artery diameter/Hypertension - Epicardial adipose tissue attenuation - Liver steatosis - Myosteatosis |
>50% lung volumea1., 27. >400 AUa[25] ≥1068 cca[10] ≥31 mma[27] ≥−96.3 HUa[11] ≤−40 HUb[49] <34.3 (F) and <38.5 (M) HUb[50] |
| Angiographic scan | -Pulmonary embolism - CAD -Triple-rule out |
Chest FOV, Single energy or DECT, standard parameters Cardiac FOV. Retrospective gating with automatic tube current modulation (100% in 60–80% or 40–80% for HR <65 bpm or >65 bpm with 4% current in other phases). 80 kVp for BMI < 20; 100 kVp for BMI ≥ 20 and <30; 120 kVp for BMI ≥ 30 Same for CAD protocol but chest FOV |
- Pulmonary artery embolism - Oligoemia - RV dysfunction - Obstructive CAD - Wall motion abnormalities - Obstructive CAD - Pulmonary artery embolism - Acute aortic injury |
Presence Presence RV/LV diameter ratio > 0.9a[26] IVC reflux [26] ≥50% [69] presence ≥50%b[69] Presence Presence |
| Late contrast enhancement | Myocardial tissue characterization | Cardiac FOV. Single energy: 80KV, p prospective ECG-gating at 75% of the R-R interval 5–10 minute post contrast |
Myocardial scar Extracellular volume fraction |
Presence ≥27%b53., 54. |
Abbreviation: CAD: coronary artery disease, FOV: field-of-view; LV: left ventricle, RV: right ventricle, IVC: inferior vena cava.
a
Cut-off values associated with increased mortality in COVID-19 setting.
b
Cut-off values derived from population studies or other clinical settings.