COVID-19 geçirmiş hastaların beyin yapılarındaki değişimlerin manyetik rezonans görüntüleme (MRG) ile değerlendirilmesi
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Şiddetli Akut Solunum Yolu Sendromu Koronavirüsü 2'nin (SARS-CoV-2) neden olduğu Koronavirüs Hastalığı 2019 (COVID-19), devam eden bir viral pandemidir ve tüm dünyaya yayılmıştır. Hastalarda görülen solunum semptomlarının yanı sıra nörolojik semptomlardaki artış zamanla dikkat çekmiş ve beyin üzerinde bıraktığı etkiler araştırılmıştır. Çalışmamız; COVİD-19 tanısı almış hastaların manyetik rezonans görüntülerini (MRG) inceleyerek beyin yapılarındaki hacimsel değişikliklerin varlığının araştırılmasını amaçlamaktadır. Çalışmaya 67 post-covid (31 kadın, 36 erkek, yaş ort=46,2±13,8 yıl) hasta dahil edildi. Bireylerin demografik bilgileri alınarak, COVID-19 geçirdiği tarihten MR çekimine kadarki geçen süreleri, hastalık sürecinde görülen semptomlar, devam eden semptom varlığı, hastaneye yatma durumu, aşı durumu sorgulandı. Hastalara, 1.5T sisteminde 3D T1 (FFE) ağırlıklı tarama yapıldı. Beyin parselasyonu için volBrain çevrimiçi web arayüzü kullanılarak intracranial kavite ve beyin yapıların hacimleri ölçüldü. Hastaların, COVID-19 geçirdikten MR çekildikleri zamana kadarki geçen süreleri ortalama 5,2 ± 2,8 aydı. En sık görülen semptomların tat kaybı (%64,2), koku kaybı (%64,2) ve baş ağrısı (%61,2) olduğu kaydedildi. Beyin yapılarının hacimlerinin çoğunlukla erkeklerde kadınlara göre büyük olduğu ancak aynı yapıların intracranial cavite içinde kapladığı alanlar kıyaslandığında ise telencephalon, substantia grisea, cerebrum, nuc. caudatus, putamen, talamus ve nuc. accumbens hacimlerinin kadınlarda fazla olduğu gözlemlendi. Cinsiyete ve lateralizasyona göre atrofiye gidiş bakıldığında anlamlı bir farklılık görülmedi. En sık amigdala'da (%26,9) atrofi olduğu ve telencephalon, cerebrum (sağ), talamus (sağ), globus pallidus (total-sağ-sol), hippocampus (sağ) ve amigdala'da (total-sağ-sol) atrofiye gidiş anlamlıyken beyin omurilik sıvısında (BOS) hipertrofi varlığı anlamlı bulundu (p<0,05). Kronik hastalığı olan bireylerde (n=27, %40,3) telencephalon, substantia alba, cerebrum (total-sağ) ve cerebellum'da (sağ) atrofi, BOS'ta hipertrofi'nin anlamlı düzeyde arttığı saptandı (p<0,05). Sonuç olarak, COVID-19 geçirmiş bireylerin beyin yapılarında atrofiye gidiş olduğu kaydedildi. Oluşabilecek komplikasyonları önceden belirleme, klinisyenlere tanı ve tedavi aşamalarında yardımcı olabilme ve yapılacak sonraki çalışmalara yol gösterme açısından çalışmamızın etkili olacağı kanaatindeyiz.
Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an ongoing viral pandemic and has spread worldwide. In addition to respiratory symptoms seen in patients, the increase in neurological symptoms attracted attention over time and the effects on the brain were investigated. Our work; It aims to investigate the presence of volumetric changes in brain structures by examining magnetic resonance images (MRI) of patients diagnosed with COVID-19. 67 post-covid (31 female, 36 male, mean age=46.2±13.8 years) patients were included in the study. By taking the demographic information of the individuals, the duration from the date of COVID-19 to the MRI scan, the symptoms seen during the disease process, the presence of ongoing symptoms, hospitalization status, and vaccination status were questioned. Patients underwent 3D T1 (FFE) weighted scanning on the 1.5T system. For brain parcellation, the volumes of the intracranial cavity and brain structures were measured using the volBrain online web interface. The mean time of patients from COVID-19 to the time they had an MRI was 5.2 ± 2.8 months. It was noted that the most common symptoms in individuals were loss of taste (64.2%), loss of smell (64.2%) and headache (61.2%). It was observed that the volumes of the brain structures were mostly larger in males than females, but when the areas covered by the same structures in the intracranial cavity were compared, the volumes of the telencephalon, substantia grisea, cerebrum, nuc. caudatus, putamen, thalamus and nuc. accumbens were higher in women. There was no significant difference in the course of atrophy according to gender and lateralization. The atrophy was most common in the amygdala (26.9%), and the telencephalon, cerebrum (right), thalamus (right), globus pallidus (total-right-left), hippocampus (right) and amygdala (total-right-left) progression to atrophy was significant, while the presence of hypertrophy in cerebrospinal fluid (CSF) was significant (p<0,05). In individuals with chronic disease (n=27, 40.3%), atrophy in the telencephalon, substantia alba, cerebrum (total-right) and cerebellum (right), and hypertrophy in the CSF were found to be significantly increased (p<0,05). As a result, it has been noted that there are volumetric changes in the brain structures of individuals who have had COVID-19. We believe that our study will be effective in terms of predicting the complications that may occur, helping clinicians in the diagnosis and treatment stages, and guiding future studies.
Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an ongoing viral pandemic and has spread worldwide. In addition to respiratory symptoms seen in patients, the increase in neurological symptoms attracted attention over time and the effects on the brain were investigated. Our work; It aims to investigate the presence of volumetric changes in brain structures by examining magnetic resonance images (MRI) of patients diagnosed with COVID-19. 67 post-covid (31 female, 36 male, mean age=46.2±13.8 years) patients were included in the study. By taking the demographic information of the individuals, the duration from the date of COVID-19 to the MRI scan, the symptoms seen during the disease process, the presence of ongoing symptoms, hospitalization status, and vaccination status were questioned. Patients underwent 3D T1 (FFE) weighted scanning on the 1.5T system. For brain parcellation, the volumes of the intracranial cavity and brain structures were measured using the volBrain online web interface. The mean time of patients from COVID-19 to the time they had an MRI was 5.2 ± 2.8 months. It was noted that the most common symptoms in individuals were loss of taste (64.2%), loss of smell (64.2%) and headache (61.2%). It was observed that the volumes of the brain structures were mostly larger in males than females, but when the areas covered by the same structures in the intracranial cavity were compared, the volumes of the telencephalon, substantia grisea, cerebrum, nuc. caudatus, putamen, thalamus and nuc. accumbens were higher in women. There was no significant difference in the course of atrophy according to gender and lateralization. The atrophy was most common in the amygdala (26.9%), and the telencephalon, cerebrum (right), thalamus (right), globus pallidus (total-right-left), hippocampus (right) and amygdala (total-right-left) progression to atrophy was significant, while the presence of hypertrophy in cerebrospinal fluid (CSF) was significant (p<0,05). In individuals with chronic disease (n=27, 40.3%), atrophy in the telencephalon, substantia alba, cerebrum (total-right) and cerebellum (right), and hypertrophy in the CSF were found to be significantly increased (p<0,05). As a result, it has been noted that there are volumetric changes in the brain structures of individuals who have had COVID-19. We believe that our study will be effective in terms of predicting the complications that may occur, helping clinicians in the diagnosis and treatment stages, and guiding future studies.
Açıklama
Anahtar Kelimeler
Fizyoterapi ve Rehabilitasyon, Physiotherapy and Rehabilitation
