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Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China.
Eur Radiol. 2020 Oct; 30(10):5446-5454.ER

Abstract

OBJECTIVES

To investigate CT images of 100 confirmed COVID-19 pneumonia patients to describe the lesion distribution, CT signs, and evolution during different courses.

METHODS

A retrospective study of 100 COVID-19 pneumonia patients without ARDS was performed, and CT scans were reviewed. A COVID-19 pneumonia course diagram was drawn. Mann-Whitney U test was used to compare the lesion distribution and CT scores, χ2 test was used to compare the CT findings between different stages.

RESULTS

A total of 272 CT scans from 100 patients (mean age, 52.3 years ± 13.1) were investigated. Four patients with lung abnormalities on CT first showed negative RT-PCR result and turned positive afterwards. One hundred sixty-nine (62.1%) showed predominantly peripheral distribution. The CT scores of the upper zone (3.4 ± 3.6) were significantly lower than those of the middle (5.0 ± 3.9) and lower (4.8 ± 3.6) zones (p < 0.001). The CT scores of the anterior zones (4.9 ± 4.7) were significantly lower than those of the posterior zones (8.4 ± 6.2) (p < 0.001). In the early rapid progressive stage (1~7 days), ground glass opacity (GGO) plus reticular pattern (58.1%), GGO plus consolidation (43.0%), and GGO (41.9%) were all common. In the advanced stage (8~14 days), GGO plus consolidation (79.8%) and repairing CT signs (subpleural line, bronchus distortion, and fibrotic strips) showed a significant increase (p < 0.05). In the absorption stage, GGO plus consolidation (9.1%) sharply decreased (p < 0.05).

CONCLUSION

CT imaging of COVID-19 pneumonia showed a predominantly peripheral, middle and lower, and posterior distribution. The early rapid progressive stage is 1~7 days from symptom onset, the advanced stage with peak levels of abnormalities on CT is 8~14 days, and the abnormalities started to improve after 14 days.

KEY POINTS

• The course of COVID-19 pneumonia consists of three stages: 1~7 days is the early rapid progressive stage, 8~14 days is the advanced stage, and after 14 days, the abnormalities started to decrease. • In the early rapid progressive stage, GGO plus a reticular pattern, GGO plus consolidation, and GGO were all common signs; in the advanced stage, signs of progression and absorption coexisted; lung abnormalities showed an asynchronous process with parts with absorption and parts progressing. • Lung abnormalities mainly showed predominantly peripheral, middle, and lower distribution.

Authors+Show Affiliations

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Jiefang Road, Qiaokou District, Wuhan, Hubei, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Jiefang Road, Qiaokou District, Wuhan, Hubei, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Jiefang Road, Qiaokou District, Wuhan, Hubei, China. wangyujin8303@163.com.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Jiefang Road, Qiaokou District, Wuhan, Hubei, China. xialiming2018@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32367418

Citation

Zhou, Shuchang, et al. "Imaging Features and Evolution On CT in 100 COVID-19 Pneumonia Patients in Wuhan, China." European Radiology, vol. 30, no. 10, 2020, pp. 5446-5454.
Zhou S, Zhu T, Wang Y, et al. Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China. Eur Radiol. 2020;30(10):5446-5454.
Zhou, S., Zhu, T., Wang, Y., & Xia, L. (2020). Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China. European Radiology, 30(10), 5446-5454. https://doi.org/10.1007/s00330-020-06879-6
Zhou S, et al. Imaging Features and Evolution On CT in 100 COVID-19 Pneumonia Patients in Wuhan, China. Eur Radiol. 2020;30(10):5446-5454. PubMed PMID: 32367418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China. AU - Zhou,Shuchang, AU - Zhu,Tingting, AU - Wang,Yujing, AU - Xia,LiMing, Y1 - 2020/05/04/ PY - 2020/02/19/received PY - 2020/04/08/accepted PY - 2020/04/02/revised PY - 2020/5/6/pubmed PY - 2020/9/15/medline PY - 2020/5/6/entrez KW - Computed tomography KW - Coronavirus KW - Pneumonia SP - 5446 EP - 5454 JF - European radiology JO - Eur Radiol VL - 30 IS - 10 N2 - OBJECTIVES: To investigate CT images of 100 confirmed COVID-19 pneumonia patients to describe the lesion distribution, CT signs, and evolution during different courses. METHODS: A retrospective study of 100 COVID-19 pneumonia patients without ARDS was performed, and CT scans were reviewed. A COVID-19 pneumonia course diagram was drawn. Mann-Whitney U test was used to compare the lesion distribution and CT scores, χ2 test was used to compare the CT findings between different stages. RESULTS: A total of 272 CT scans from 100 patients (mean age, 52.3 years ± 13.1) were investigated. Four patients with lung abnormalities on CT first showed negative RT-PCR result and turned positive afterwards. One hundred sixty-nine (62.1%) showed predominantly peripheral distribution. The CT scores of the upper zone (3.4 ± 3.6) were significantly lower than those of the middle (5.0 ± 3.9) and lower (4.8 ± 3.6) zones (p < 0.001). The CT scores of the anterior zones (4.9 ± 4.7) were significantly lower than those of the posterior zones (8.4 ± 6.2) (p < 0.001). In the early rapid progressive stage (1~7 days), ground glass opacity (GGO) plus reticular pattern (58.1%), GGO plus consolidation (43.0%), and GGO (41.9%) were all common. In the advanced stage (8~14 days), GGO plus consolidation (79.8%) and repairing CT signs (subpleural line, bronchus distortion, and fibrotic strips) showed a significant increase (p < 0.05). In the absorption stage, GGO plus consolidation (9.1%) sharply decreased (p < 0.05). CONCLUSION: CT imaging of COVID-19 pneumonia showed a predominantly peripheral, middle and lower, and posterior distribution. The early rapid progressive stage is 1~7 days from symptom onset, the advanced stage with peak levels of abnormalities on CT is 8~14 days, and the abnormalities started to improve after 14 days. KEY POINTS: • The course of COVID-19 pneumonia consists of three stages: 1~7 days is the early rapid progressive stage, 8~14 days is the advanced stage, and after 14 days, the abnormalities started to decrease. • In the early rapid progressive stage, GGO plus a reticular pattern, GGO plus consolidation, and GGO were all common signs; in the advanced stage, signs of progression and absorption coexisted; lung abnormalities showed an asynchronous process with parts with absorption and parts progressing. • Lung abnormalities mainly showed predominantly peripheral, middle, and lower distribution. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32367418/Imaging_features_and_evolution_on_CT_in_100_COVID_19_pneumonia_patients_in_Wuhan_China_ L2 - https://dx.doi.org/10.1007/s00330-020-06879-6 DB - PRIME DP - Unbound Medicine ER -