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BACKGROUND: Lung imaging, next to a polymerase chain reaction (PCR) test, is a key diagnostic tool in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The degree of abnormalities correlates with clinical outcome. Imaging of the lungs using chest radiography (CXR) at the peak of a pandemic is considered a basic diagnostic tool at the triage stage. The CXR images are less characteristic than computed tomography (CT) and should be interpreted with a combination of clinical findings. OBJECTIVES: Comparison of the usefulness of 2 CXR severity scores to evaluate the presence/severity of inflammation in the course of COVID-19 and the possibility of a non-radiologist to interpret the image independently. MATERIAL AND METHODS: Retrospective analysis of the medical records of 152 consecutive patients (aged 19-96, 73 men), infected with SARS-CoV-2, confirmed using real-time PCR (RT-PCR). Five-point and twelve-point CXR severity scoring systems were used (independently by a radiologist and a referring physician) to assess the severity of inflammation. RESULTS: In 77 of 152 cases, the CXR revealed features of inflammation. Bilateral abnormalities were found in 48/77 (62.3%) cases. Statistically, the lower lobes were involved more often than the upper ones (p < 0.001) and the left lobe more often than the right one (p < 0.001). The intensity of the abnormalities using both scales correlated with the persistence of symptoms (p = 0.0133 and p = 0.0403). A positive and statistically significant correlation was found between both scales and dyspnea, decreased oxygen saturation, elevated C-reactive protein (CRP), ferritin, D-dimer, lactate dehydrogenase, and alanine aminotransferase activity. The interobserver agreement analysis did not show a statistically significant difference in the CXR severity score using the five-point (B = 0.8345, kappa = 0.82; p = 0.1480) or the twelve-point scale (B = 0.8219, kappa = 0.77; p = 0.0502). CONCLUSIONS: The CXR severity score is a useful tool to assess the inflammation in the initial diagnosis of coronavirus disease 2019 (COVID-19). Quantifying lung abnormalities accurately may be performed by a referring physician. Both CXR severity scales correlate well with clinical parameters.

BACKGROUND Cerebrovascular disease is an important cause of epilepsy. The incidence may significantly vary (from 2.3% to 43%). Post-stroke seizures occur within 2 weeks of stroke onset (as early-onset seizures) or 2 weeks after a stroke (as late-onset seizures). OBJECTIVES To retrospectively evaluate and differentiate predictive factors for post-stroke seizures. MATERIAL AND METHODS We retrospectively analyzed the medical histories of 164 adult patients diagnosed with post-stroke seizures but no epilepsy recognized prior to the stroke who were hospitalized at the Neurology Clinic of Wroclaw Medical University between 2012 and 2018. The seizures were classified according to the criteria of the International League Against Epilepsy (ILAE) from 2017. The relevant demographic data, type of stroke (ischemic/hemorrhagic), time of occurrence of seizures in relation to the type of stroke, score on the modified Rankin Scale, presence of cardiovascular risk factors, electroencephalography (EEG) recording, and antiepileptic treatment (AED) were collected. In the case of ischemic stroke (IS), the size of the stroke lesion was rated on the ASPECTS scale. RESULTS The study involved 164 patients (average age = 68.83 years), including 86 men (average age = 66.2 years). In 20 out of 164 patients, the seizures were associated with hemorrhagic stroke (HS); in 144 out of 164 patients, the post-stroke epilepsy was associated with IS. Generalized tonic-clonic seizures occurred in 101 out of 164 patients, focal aware seizures occurred in 19 out of 164 patients and focal impaired-awareness seizures occurred in 44 out of 164 patients. CONCLUSIONS Our study has confirmed that generalized seizures occur mostly after an IS and are late complications of it. Early-onset seizures occur mostly after HS associated with severe disability. Seizures are more likely to happen due to the cortical location of the stroke. There is a shift from generalized to focal seizures with an increase in the extent of IS as evaluated using the ASPECTS scale.

Dual energy CT (DECT) was conceived at the very beginning of the computed tomography era. However the first DECT scanner was developed in 2006. Nowadays there are three different types of DECT available: dual-source CT with 80(100) kVp and 140 kVp tubes (Siemens Medical Solution); dual-layer multi-detector scanner with acquisition 120 or 140kVp (Philips Healthcare); CT unit with one rapid kVp switching source and new detector based on gemstone scintillator materials (GE Healthcare). This article describes the physical background and principles of DECT imaging as well as applications of this innovative method in routine clinical practice (renal stone differentiation, pulmonary perfusion, neuroradiology and metallic implant imaging). The particular applications are illustrated by cases from author's material.