Top

Published in:

01-10-2020 | Coronavirus | Chest

Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia

Authors: Fangfang Fu, Jianghua Lou, Deyan Xi, Yan Bai, Gongbao Ma, Bin Zhao, Dong Liu, Guofeng Bao, Zhidan Lei, Meiyun Wang

Published in: European Radiology | Issue 10/2020

Abstract

Objective

To retrospectively analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia.

Methods

From January 9, 2020, to February 26, 2020, totally 56 laboratory-confirmed patients with COVID-19 underwent chest CT. For 40 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared.

Results

Forty patients (83.6%) had two or more opacities in the lung. Eighteen (32.7%) patients had only ground-glass opacities; twenty-nine patients (52.7%) had ground-glass and consolidative opacities; and eight patients (14.5%) had only consolidation. A total of 43 patients (78.2%) showed two or more lobes involved. The opacities tended to be both in peripheral and central (30/55, 54.5%) or purely peripheral distribution (25/55, 45.5%). Fifty patients (90.9%) had the lower lobe involved. The first follow-up CT scans showed that twelve patients (30%) had improvement, 26 (65%) patients had mild-moderate progression, and two patients (5%) had severe progression with “white lungs.” The second follow-up CT showed that 22 patients (71%) showed improvement compared with the first follow-up CT, four patients (12.9%) had aggravated progression, and five patients (16.1%) showed unchanged radiographic appearance.

Conclusions

The common CT features of COVID-19 pneumonia are multiple lung opacities, multiple types of the opacity (ground-glass, ground-glass and consolidation, and consolidation alone), and multiple lobes especially the lower lobe involved. Follow-up CT could demonstrate the rapid progression of COVID-19 pneumonia (either in aggravation or absorption).

Key Points

• The predominant CT features of COVID-19 pneumonia are multiple ground-glass opacities with or without consolidation and, with both lungs, multiple lobes and especially the lower lobe affected.

• CT plays a crucial role in early diagnosis and assessment of COVID-19 pneumonia progression.

• CT findings of COVID-19 pneumonia may not be consistent with the clinical symptoms or the initial RT-PCR test results.

World Health Organization (2020) Novel coronavirus -China. World Health Organization, Geneva Available via https://wwwwhoint/csr/don/12-january-2020-novel-coronavirus-china/en/. Accessed 13 Jan 2020

Hui DS, I Azhar E, Madani TA et al (2020) The continuing 2019- nCoV epidemic threat of novel coronaviruses to global health-the latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis 91:264–266. https://doi.org/10.1016/j.ijid.2020.01.009CrossRefPubMedPubMedCentral

Huang CL, Wang YM, Li XW et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395:497–506. https://doi.org/10.1016/S0140-6736(20)30183-5CrossRefPubMedPubMedCentral

Zhu N, Zhang DY, Wang WL et al (2020) A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382:727–733. https://doi.org/10.1056/NEJMoa2001017CrossRefPubMedPubMedCentral

General Office of National Health Committee. Office of State Administration of Traditional Chinese Medicine (2020) Notice on the issuance of a programme for the diagnosis and treatment of novel coronavirus (2019-nCoV) infected pneumonia (trial version 6). Available via http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2/files/b218cfeb1bc54639af227f922bf6b817.pdf. Accessed 18 Feb 2020

World Health Organization (2020) Novel coronavirus (COVID-19) situation report-37. World Health Organization, Geneva Available via https://wwwwhoint/docs/default-source/coronaviruse/situation-reports/20200226-sitrep-37-covid-19pdf?sfvrsn=2146841e_2. Accessed 26 Feb 2020

Wong KT, Antonio GE, Hui DS et al (2003) Severe acute respiratory syndrome: radiographic appearances and pattern of progression in 138 patients. Radiology 228:401–406. https://doi.org/10.1148/radiol.2282030593CrossRefPubMed

Franquet T (2011) Imaging of pulmonary viral pneumonia. Radiology 260:18–39. https://doi.org/10.1148/radiol.11092149CrossRefPubMed

Koo HJ, Lim S, Choe J, Choi SH, Sung H, Do KH (2018) Radiographic and CT features of viral pneumonia. Radiographics 38:719–739. https://doi.org/10.1148/rg.2018170048CrossRefPubMed

10.

Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722. https://doi.org/10.1148/radiol.2462070712CrossRefPubMed

11.

Chan JF, Yuan S, Kok KH, et al (2020) A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 395:514–523. https://doi.org/10.1016/S0140-6736(20)30154-9

12.

Chung M, Bernheim A, Mei XY et al (2020) CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 295:202–207. https://doi.org/10.1148/radiol.2020200230CrossRefPubMed

13.

Silva CI, Churg A, Müller NL (2007) Hypersensitivity pneumonitis: spectrum of high-resolutions CT and pathologic findings. AJR Am J Roentgenol 188:334–344. https://doi.org/10.2214/AJR.05.1826CrossRefPubMed

14.

Pan YY, Guan HX (2020) Imaging changes in patients with COVID-19. Eur Radiol. https://doi.org/10.1007/s00330-020-06713-z

15.

Ooi GC, Khong PL, Müller NL et al (2004) Severe acute respiratory syndrome: temporal lung changes at thin-section CT in 30 patients. Radiology 230:836–844. https://doi.org/10.1148/radiol.2303030853CrossRefPubMed

16.

Müller NL, Ooi GC, Khong PL, Zhou LJ, Tsang KW, Nicolaou S (2004) High-resolution CT findings of severe acute respiratory syndrome at presentation and after admission. AJR Am J Roentgenol 182:39–44. https://doi.org/10.2214/ajr.182.1.1820039CrossRefPubMed

17.

Das KM, Lee EY, Enani MA et al (2015) CT correlation with outcomes in 15 patients with acute Middle East respiratory syndrome coronavirus. AJR Am J Roentgenol 204:736–742. https://doi.org/10.2214/AJR.14.13671CrossRefPubMed

18.

Das KM, Lee EY, Al Jawder SE et al (2015) Acute Middle East respiratory syndrome coronavirus: temporal lung changes observed on the chest radiographs of 55 patients. AJR Am J Roentgenol 205:W267–W274. https://doi.org/10.2214/AJR.15.14445CrossRefPubMed

19.

Kanne JP (2020) Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: key points for the radiologist. Radiology 295:16–17. https://doi.org/10.1148/radiol.2020200241CrossRefPubMed

Title: Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia
Authors: Fangfang Fu
Jianghua Lou
Deyan Xi
Yan Bai
Gongbao Ma
Bin Zhao
Dong Liu
Guofeng Bao
Zhidan Lei
Meiyun Wang
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Coronavirus
Computed Tomography
Computed Tomography
Pneumonia
COVID-19
Published in: European Radiology / Issue 10/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06920-8

At a glance: The STEP trials

Springer Medicine

Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia

Abstract

Objective

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 10/2020

Hepatobiliary MR contrast agent uptake as a predictive biomarker of aggressive features on pathology and reduced recurrence-free survival in resectable hepatocellular carcinoma: comparison with dual-tracer 18F-FDG and 18F-FCH PET/CT

Research in abdominal imaging – current status and trends at ECR 2020

Comparison of chest CT findings between COVID-19 pneumonia and other types of viral pneumonia: a two-center retrospective study

Speed of sound ultrasound: comparison with proton density fat fraction assessed with Dixon MRI for fat content quantification of the lower extremity

Prediction of HCC microvascular invasion with gadobenate-enhanced MRI: correlation with pathology

Solving the preoperative breast MRI conundrum: design and protocol of the MIPA study