Criteria and Diagnostic Significance of Density Maps for Acute Lung Injury in Patients of the Intensive Care Unit According to Computed Tomography of the Chest

Objective. To determine the criteria and diagnostic significance of density maps for acute lung injury (ALI) in patients of the intensive care unit according to computed tomography (CT) of the chest. Materials and Methods. 93 patients aged 44–85 years were examined in the Clinical Hospital No. 1, Smolensk from 2022 to 2024, men — 52 (55.9 %), women — 41 (44.1 %). Patients were admitted to the intensive care unit, 87 (95.6 %) of them were transferred to the other hospital departments corresponding to the nosological forms of the diseases; 81 (93.1 %) patients remained under follow up period during two years (inpatient and/or outpatient stages of treatment). All patients of the main group underwent CT of the chest, with additional assessment of lung tissue density maps, on a 64-slice GE Revolution EVO computed tomography scan, in the control group – in 19 (45.2 %) cases. Statistical analysis of the results included descriptive statistics, comparison samples of nonparametric criteria. Results. In our study with a summation quantitative criterion of lung tissue density maps of more than 14 %, we watched damage to all life support systems: kidney damage more often occurs with a density criterion from 14 to 25 %, then goes damage of central nervous system; in case of density criterion more than 26 % — kidneys and liver damage. In the monitoring in the intensive care unit in 57 patients, the summation quantitative criterion of density maps ranged from 14 to 25 %. In the follow up period of the presented group of patients, a high correlation was noted with negative clinical and laboratory dynamics in the form of shortness of breath, cyanosis, tachypnea, a decrease in partial oxygen pressure in arterial blood and the development of ALI (r = 0.978). The summation quantitative criterion of lung tissue density maps made it possible to predict the most likely changes from other life support systems upon admission (AUROC 0.912; CI 0.881–0.919) and follow up period (AUROC 0.902; CI 0.868–0.907). Conclusions There was a high correlation between negative clinical and laboratory dynamics and the development of ALI with a summation quantitative criterion of lung tissue density maps according to CT from 14 to 25 % (r = 0.978), as well as the progression of ALI at 26 % (r = 0.985). The summation quantitative criterion of lung tissue density maps based on CT allows predicting changes from other life support systems upon admission (AUROC 0.912; CI 0.881–0.919) and follow up period (AUROC 0.902; CI 0.868 – 0.907). The inclusion in the algorithm of management of patients in the intensive care unit of the assessment of lung tissue density maps in CT of the chest helps to reduce mortality and the risk of developing the syndrome of the consequences of intensive therapy.