Introduction

Chest radiology provides an opportunity to better understand the diagnostic characteristics of e-cigarette or vaping product use associated lung injury (EVALI). This systematic review aimed to summarize the radiological findings associated with EVALI reported in the literature.

Methods

This systematic review was conducted in accordance with PRISMA guidelines. Electronic searches of MEDLINE®, CINAHL, Embase® and CENTRAL were conducted in February 2020. Included were all English-language studies reporting radiological findings of EVALI. Data was synthesized using descriptive statistics.

Results

Thirty studies comprising 184 participants were included. Mean patient age was 24.5 years old. The majority (n = 141, 76.6%) of included patients were male. The most common radiological features reported on chest x-ray were bilateral infiltrates (n = 64, 41.3%) and ground glass opacities (n = 17, 11.0%), and on chest CT were bilateral infiltrates (n = 62, 36.9%), bilateral ground glass opacities (n = 56, 33.3%), subpleural sparing (n = 29, 17.3%), pleural effusions (n = 14, 8.3%), and centrilobular nodularity (n = 13, 7.7%). Of patients with follow-up data reported (n = 81), only 28.4% (n = 23) had complete resolution of symptoms or radiological findings.

Conclusion

Chest radiology is the cornerstone of diagnosis and monitoring of EVALI. A wide variety of radiological findings highlight the need for standardisation of terminology in the radiological descriptions of EVALI. Common findings included bilateral infiltrates and ground glass opacities. Higher quality evidence is warranted to help develop evidenced-based guidelines for the diagnosis and management of EVALI.

中文翻译：

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电子烟或电子烟产品使用相关肺损伤的放射学发现：系统评价

介绍

胸部放射学为更好地了解电子烟或电子烟产品使用相关肺损伤 (EVALI) 的诊断特征提供了机会。本系统综述旨在总结文献中报道的与 EVALI 相关的放射学发现。

方法

本系统评价是根据 PRISMA 指南进行的。2020 年 2 月对 MEDLINE®、CINAHL、Embase® 和 CENTRAL 进行了电子搜索。包括所有报告 EVALI 放射学结果的英语研究。使用描述性统计合成数据。

结果

包括 184 名参与者的 30 项研究被纳入。平均患者年龄为 24.5 岁。大多数 ( n  = 141, 76.6%) 纳入的患者是男性。胸部 X 线报告最常见的放射学特征是双侧浸润 ( n  = 64, 41.3%) 和磨玻璃影 ( n  = 17, 11.0%)，胸部 CT 显示双侧浸润 ( n  = 62, 36.9%) 、双侧磨玻璃影 ( n  = 56, 33.3%)、胸膜下保留 ( n  = 29, 17.3%)、胸腔积液 ( n  = 14, 8.3%) 和小叶中心结节 ( n  = 13, 7.7%)。在报告了随访数据的患者 ( n  = 81) 中，只有 28.4% ( n = 23) 症状或放射学发现完全消失。

结论

胸部放射学是 EVALI 诊断和监测的基石。各种各样的放射学发现突出了 EVALI 放射学描述中术语标准化的必要性。常见的发现包括双侧浸润和毛玻璃样混浊。需要更高质量的证据来帮助制定基于证据的 EVALI 诊断和管理指南。