SARS-CoV-2 is a novel coronavirus isolated in the respiratory tract of patients with infection of unknown causes on December 31, 2019, in Wuhan, Hubei, China [1,2,3], and consequently, it has spread globally, becoming a pandemic. In Europe, this infection had a high prevalence and a high infection rate in Northern Italy, even if the causes are currently undefined. It belongs to the family of Coronaviridae that includes viruses that cause diseases ranging from the common cold to severe respiratory syndromes (SARS) and the Middle East respiratory syndrome (MERS).
The most common COVID-19 symptoms are fever (37.5-38 °C), dry cough, dyspnea, myalgia, syncope, and fatigue [4,5,6]. Some studies reported gastrointestinal involvement (intestinal ischemia, cholecystitis), acute cardiac, kidney injury [6, 7], and neurological manifestations (dizziness, headache, hypogeusia, and hyposmia) . The most severe patients had a sudden development of ARDS (acute respiratory distress syndrome white lung at chest RX) ischemic or hemorrhagic stroke, loss of consciousness .
Many subjects, however, may be initially or throughout the infection completely asymptomatic and they are above all the contributors to propagate infection in the population. So far, the possibility of contracting COVID-19 infection is considered most likely in patients with fever and/or respiratory tract symptoms who have had close contact with a suspected or confirmed affected patient RT-PCR and next-generation sequencing have been used for the definitive diagnosis of this new coronavirus , according to the indication of WHO.
The RT-PCR test for COVID-19 is well known for its high specificity; however, it has a low sensitivity (60-70%) [9, 10] as well as a great variability related to the moment of performing the swabs (prodromal phase or full-blown phase) and area analyzed (nasopharyngeal swab is more reliable than oropharyngeal). Besides, the constant growth in number of swabs to be analyzed had as a consequence the delay of results.
Therefore, a further technique with higher accuracy needs to be implemented to improve the management of patients admitted to hospitals during the pandemic. Radiologists can help in this task by identifying and characterizing the pulmonary involvement of COVID-19 . CT typically shows bilateral ground-glass opacities (GGOs), with a predominantly peripheral, subpleural location [12,13,14]; intralobular reticulations can be seen superimposed on the ground-glass opacities, resulting in a crazy-paving pattern which is usually associated with a more severe stage of the disease. In the high prevalence region, the radiologists could help to individuate incidental thoracic alterations, too, especially in asymptomatic patients.
This article reports the case of accidental diagnosis of the first finding of COVID-19 by WB-MR of a patient with MM. The patient had no respiratory symptoms at the time of the examination and 1 month earlier had a negative chest X-ray.