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COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia.
Eur Radiol. 2020 Oct; 30(10):5463-5469.ER

Abstract

OBJECTIVES

To investigate the clinical and chest CT characteristics of COVID-19 pneumonia and explore the radiological differences between COVID-19 and influenza.

MATERIALS AND METHODS

A total of 122 patients (61 men and 61 women, 48 ± 15 years) confirmed with COVID-19 and 48 patients (23 men and 25 women, 47 ± 19 years) confirmed with influenza were enrolled in the study. Thin-section CT was performed. The clinical data and the chest CT findings were recorded.

RESULTS

The most common symptoms of COVID-19 were fever (74%) and cough (63%), and 102 patients (83%) had Wuhan contact. Pneumonia in 50 patients with COVID-19 (45%) distributed in the peripheral regions of the lung, while it showed mixed distribution in 26 patients (74%) with influenza (p = 0.022). The most common CT features of the COVID-19 group were pure ground-glass opacities (GGO, 36%), GGO with consolidation (51%), rounded opacities (35%), linear opacities (64%), bronchiolar wall thickening (49%), and interlobular septal thickening (66%). Compared with the influenza group, the COVID-19 group was more likely to have rounded opacities (35% vs. 17%, p = 0.048) and interlobular septal thickening (66% vs. 43%, p = 0.014), but less likely to have nodules (28% vs. 71%, p < 0.001), tree-in-bud sign (9% vs. 40%, p < 0.001), and pleural effusion (6% vs. 31%, p < 0.001).

CONCLUSIONS

There are significant differences in the CT manifestations of patients with COVID-19 and influenza. Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza.

KEY POINTS

• Typical CT features of COVID-19 include pure ground-glass opacities (GGO), GGO with consolidation, rounded opacities, bronchiolar wall thickening, interlobular septal thickening, and a peripheral distribution. • Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza.

Authors+Show Affiliations

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.Medical Imaging Center, Chongqing Three Gorges Central Hospital, Chongqing, 404100, China.Medical Imaging Center, Chongqing Three Gorges Central Hospital, Chongqing, 404100, China.Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. fajinlv@163.com.Department of Cardiology, Chongqing Three Gorges Central Hospital, Chongqing, 404100, China. xiaokh1@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32399710

Citation

Liu, Mengqi, et al. "COVID-19 Pneumonia: CT Findings of 122 Patients and Differentiation From Influenza Pneumonia." European Radiology, vol. 30, no. 10, 2020, pp. 5463-5469.
Liu M, Zeng W, Wen Y, et al. COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia. Eur Radiol. 2020;30(10):5463-5469.
Liu, M., Zeng, W., Wen, Y., Zheng, Y., Lv, F., & Xiao, K. (2020). COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia. European Radiology, 30(10), 5463-5469. https://doi.org/10.1007/s00330-020-06928-0
Liu M, et al. COVID-19 Pneumonia: CT Findings of 122 Patients and Differentiation From Influenza Pneumonia. Eur Radiol. 2020;30(10):5463-5469. PubMed PMID: 32399710.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia. AU - Liu,Mengqi, AU - Zeng,Wenbin, AU - Wen,Yun, AU - Zheng,Yineng, AU - Lv,Fajin, AU - Xiao,Kaihu, Y1 - 2020/05/12/ PY - 2020/02/20/received PY - 2020/04/28/accepted PY - 2020/04/09/revised PY - 2020/5/14/pubmed PY - 2020/9/15/medline PY - 2020/5/14/entrez KW - Coronavirus infections KW - Human KW - Influenza KW - Pneumonia, viral KW - Tomography, x-ray computed SP - 5463 EP - 5469 JF - European radiology JO - Eur Radiol VL - 30 IS - 10 N2 - OBJECTIVES: To investigate the clinical and chest CT characteristics of COVID-19 pneumonia and explore the radiological differences between COVID-19 and influenza. MATERIALS AND METHODS: A total of 122 patients (61 men and 61 women, 48 ± 15 years) confirmed with COVID-19 and 48 patients (23 men and 25 women, 47 ± 19 years) confirmed with influenza were enrolled in the study. Thin-section CT was performed. The clinical data and the chest CT findings were recorded. RESULTS: The most common symptoms of COVID-19 were fever (74%) and cough (63%), and 102 patients (83%) had Wuhan contact. Pneumonia in 50 patients with COVID-19 (45%) distributed in the peripheral regions of the lung, while it showed mixed distribution in 26 patients (74%) with influenza (p = 0.022). The most common CT features of the COVID-19 group were pure ground-glass opacities (GGO, 36%), GGO with consolidation (51%), rounded opacities (35%), linear opacities (64%), bronchiolar wall thickening (49%), and interlobular septal thickening (66%). Compared with the influenza group, the COVID-19 group was more likely to have rounded opacities (35% vs. 17%, p = 0.048) and interlobular septal thickening (66% vs. 43%, p = 0.014), but less likely to have nodules (28% vs. 71%, p < 0.001), tree-in-bud sign (9% vs. 40%, p < 0.001), and pleural effusion (6% vs. 31%, p < 0.001). CONCLUSIONS: There are significant differences in the CT manifestations of patients with COVID-19 and influenza. Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. KEY POINTS: • Typical CT features of COVID-19 include pure ground-glass opacities (GGO), GGO with consolidation, rounded opacities, bronchiolar wall thickening, interlobular septal thickening, and a peripheral distribution. • Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32399710/COVID_19_pneumonia:_CT_findings_of_122_patients_and_differentiation_from_influenza_pneumonia_ L2 - https://dx.doi.org/10.1007/s00330-020-06928-0 DB - PRIME DP - Unbound Medicine ER -