ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2023-14-4-73-81ldt-941Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHОценка выраженности легочного фиброза по данным аутопсии у реконвалесцентов COVID-19: сопоставление с данными количественной КТ легких в острой фазе заболеванияAssessment of pulmonary fibrosis severity at autopsy in patients after COVID-19: comparison with quantitative CT scan data in the acute phase of the diseasehttps://orcid.org/0009-0002-6560-6671ЗахароваА. В.ZakharovaA. V.

Захарова Анна Валерьевна — ассистент кафедры медицинской биофизики; врач-рентгенолог отдела лучевой диагностики

194100, Санкт-Петербург, Литовская ул., д. 2

194354, Санкт-Петербург

Anna V. Zakharova — Assistant Professor of the Department of Medical Biophysics; Radiologist, Department of Radiology Diagnostics

194100, St. Petersburg, Litovskaya Str. 2

194354, St. Petersburg, Uchebny lane, 5

ellin-ave@yandex.ruhttps://orcid.org/0000-0001-8045-1220ГвоздецкийА. Н.GvozdetskiyA. N.

Гвоздецкий Антон Николаевич — кандидат медицинских наук, ассистент кафедры психиатрии

191015, Санкт-Петербург, Кирочная ул., д. 41

Anton N. Gvozdetskiy — Cand. of Sci. (Med.), Assistant Professor of the Department of Psychiatry

191015, St. Petersburg, Kirochnaya Str, 41

comisora@yandex.ruhttps://orcid.org/0000-0001-5912-4663АлексеевД. А.AlekseevD. A.

Алексеев Дмитрий Александрович — кандидат медицинских наук, заведующий отделением — врач-патологоанатом Выборгского межрайонного централизованного патологоанатомического отделения

194354, Санкт-Петербург

Dmitry A. Alekseev — Cand. of Sci. (Med.), Head of the department — pathologist of the Vyborg Interdistrict Centralized Pathoanatomical Department

194354, St. Petersburg

dm_alekseev@bk.ruhttps://orcid.org/0000-0002-1110-066XПоздняковА. В.PozdnyakovA. V.

Александр Владимирович Поздняков — д-р мед. наук, профессор, заведующий отделением лучевой диагностики

194100, Санкт-Петербург, Литовская ул., д. 2

Alexander V. Pozdnyakov — Dr. of Sci. (Med.), Professor, Head of the Department of Radiology Diagnostic

194100, St. Petersburg, Litovskaya Str, 2

pozdnyakovalex@yandex.ruСанкт-Петербургский государственный педиатрический медицинский университет; Городская многопрофильная больница № 2РоссияSt. Petersburg State Pediatric Medical University; City Multidisciplinary Hospital No. 2Russian FederationСеверо-Западный государственный медицинский университет имени И. И. МечниковаРоссияNorth-Western State Medical University named after I. I. MechnikovRussian FederationГородское патологоанатомическое бюроРоссияCity pathology departmentRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSt. Petersburg State Pediatric Medical UniversityRussian Federation2023180120241447381Copyright © Захарова А.В., Гвоздецкий А.Н., Алексеев Д.А., Поздняков А.В., 20242024Захарова А.В., Гвоздецкий А.Н., Алексеев Д.А., Поздняков А.В.Zakharova A.V., Gvozdetskiy A.N., Alekseev D.A., Pozdnyakov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/941

ВВЕДЕНИЕ: После пандемии COVID-19 появляется все больше доказательств того, что у многих реконвалесцентов COVID-19 выявляются фиброзные изменения легочной ткани, сопровождающиеся функциональными нарушениями легких. Объективных данных о гистопатогенезе подобных изменений по-прежнему недостаточно. Для полной оценки последствий этих клинических проявлений требуются проспективные исследования.ЦЕЛЬ: Оценка возможностей цифровой обработки гистологических препаратов легочной ткани и их сопоставление с данными количественной КТ легких пациентов в острой фазе COVID-19.МАТЕРИАЛЫ И МЕТОДЫ: В исследование были включены данные пациентов-реконвалесцентов COVID-19 (7 женщин и 3 мужчин в возрасте от 47 до 93 лет), умерших после острой фазы COVID-19 от внелегочных причин. В контрольную группу вошли данные 7 человек (5 женщин и 2 мужчин в возрасте от 35 до 93 лет), умерших вскоре после госпитализации от внелегочных причин (ОКС либо ОНМК), без каких-либо признаков заболеваний легких, в том числе по результатам аутопсии. Проводилась цифровая обработка полученных при аутопсии гистологических препаратов легочной ткани и их сопоставление с результатами количественной полуавтоматической обработки данных СКТ. Статистика. Использовалась бета-регрессия (библиотека mgcv). Модель характеризовалась коэффициентом псевдодетерминации R2. Ассоциация признавалась статистически значимой при p<0,05.РЕЗУЛЬТАТЫ: Продемонстрирована достоверная зависимость выраженности фиброзных изменений в гистологических образцах от результатов количественного анализа КТ-изображений пациентов в остром периоде COVID-19.ОБСУЖДЕНИЕ: Экстраполяция данных аутопсийного исследования легких через количественную оценку КТ является одним из способов предварительной диагностики и определения групп пациентов, которым требуется специфическое лечение пост-COVID-19 легочного фиброза.ЗАКЛЮЧЕНИЕ: Компьютеризированная цифровая обработка гистологических изображений позволила корректно сопоставить данные гистопатологического исследования с КТ-картиной при COVID-19, что потенциально может иметь прогностическое значение в поиске более эффективных стратегий лечения.

INTRODUCTION: After the COVID-19 pandemic, there is increasing evidence that many patients show fibrous changes in lung tissue accompanied by functional lung disorders. Objective data on the histopathogenesis of such changes is still insufficient. Prospective studies are required to fully assess the consequences of these clinical manifestations.OBJECTIVE: Evaluation of the capabilities of digital processing of histological preparations of lung tissue and their comparison with quantitative CT data of lung patients in the acute phase of COVID-19.MATERIALS AND METHODS: The study included data from patients after COVID-19 (7 women and 3 men aged 47 to 93 years) who died after the acute phase of COVID-19 from extrapulmonary causes. The control group included data from 7 people (5 women and 2 men aged 35 to 93 years) who died shortly after hospitalization from extrapulmonary causes (myocardial infarction or acute cerebral stroke), with no signs of lung diseases, including autopsy results. Digital processing of histological preparations of lung tissue obtained during autopsy was carried out, and their comparison with the results of quantitative semi-automatic processing of CT data.Statistics. Beta regression (mgcv library) was used. The model was characterized by a pseudodetermination coefficient R2. The association was considered statistically significant at p<0.05.RESULTS: A reliable dependence of the severity of fibrous changes in histological samples on the results of quantitative analysis of CT images of patients in the acute period of COVID-19 was demonstrated.DISCUSSION: Extrapolation of lung autopsy data through quantitative CT assessment is one of the ways to pre-diagnose and identify groups of patients who require specific treatment of post-COVID-19 pulmonary fibrosis.CONCLUSION. Computerized digital processing of histological images made it possible to correctly compare the histopathological examination data with the CT picture in COVID-19, which could potentially have a prognostic value in the search for more effective treatment strategies.

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The authors declare that there are no conflicts of interest present.