The patient tested positive the next day, and later remembered mild upper respiratory tract infection symptoms a few weeks prior. These findings were urgently communicated to the ordering otorhinolaryngologist with a recommendation for SARS-CoV-2 testing. The consolidation was hyperintense on T2/STIR sequences and avidly enhanced on T1-weighted fast multiplanar spoiled gradient-echo sequences. MR imaging of the neck was ordered, which showed no aerodigestive tract mass or cervical lymphadenopathy ( Fig 1) however, slices through the lung apices showed bilateral, peripheral consolidation with rounded morphology, consistent with high confidence features of COVID-19 pneumonia ( Fig 2). Findings of physical examination, throat swab for Streptococcus pyogenes, and nasopharyngolaryngoscopy were negative. He presented as an outpatient to his otorhinolaryngologist with chronic intermittent throat/neck and ear pain, excessive sputum production, and a history of prior tonsillectomy. We, therefore, report the following case of incidentally detected COVID-19 in a 43-year-old man undergoing MR imaging of the neck. To date, there is a scarcity of reporting on the MR imaging appearance of the coronavirus disease, 2 which is not surprising given the overall reduced MR imaging volume and strict infection control measures taken during the lockdown. Similarly, as MR imaging outpatient volumes continue to return to normal levels as the country reopens, larger numbers of potentially infected-but-asymptomatic or paucisymptomatic patients will be coming to the radiology clinics each day, providing new opportunities for incidental detection of COVID-19 on routine MR neuroimaging. It is emphasized that neuroradiologists should be familiar with the imaging appearance of common thoracic and abdominal diseases that can be detected on neuroimaging studies and they should always carefully scrutinize the image “corners” or “blind-spots” to minimize perceptual diagnostic errors, the significance of which has never been more important. In this article, the authors reported a cohort of 17 patients who presented to the emergency department with either trauma or stroke-like symptoms and underwent neuroimaging evaluation revealing incidental thoracic findings on a CTA of the neck or CT of the cervical/thoracic spine, suspicious for viral pneumonia, triggering testing for Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) with an eventual diagnosis of coronavirus disease 2019 (COVID-19). We read with great interest the recently published article by Jain et al 1 in the July 2020 issue of the American Journal of Neuroradiology.
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