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Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia.
Eur Radiol. 2020 Oct; 30(10):5489-5498.ER

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.

Authors+Show Affiliations

Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.Department of Radiology, Taikang People's Hospital, Zhoukou, Henan, China.Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.Department of Radiology, Gongyi People's Hospital, Zhengzhou, Henan, China.Department of Radiology, Xincai People's Hospital, Zhumadian, Henan, China.Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.Department of Radiology, Yihe Hospital in Zhengzhou, Zhengzhou, Henan, China.Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China. mywang@ha.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32435925

Citation

Fu, Fangfang, et al. "Chest Computed Tomography Findings of Coronavirus Disease 2019 (COVID-19) Pneumonia." European Radiology, vol. 30, no. 10, 2020, pp. 5489-5498.
Fu F, Lou J, Xi D, et al. Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia. Eur Radiol. 2020;30(10):5489-5498.
Fu, F., Lou, J., Xi, D., Bai, Y., Ma, G., Zhao, B., Liu, D., Bao, G., Lei, Z., & Wang, M. (2020). Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia. European Radiology, 30(10), 5489-5498. https://doi.org/10.1007/s00330-020-06920-8
Fu F, et al. Chest Computed Tomography Findings of Coronavirus Disease 2019 (COVID-19) Pneumonia. Eur Radiol. 2020;30(10):5489-5498. PubMed PMID: 32435925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia. AU - Fu,Fangfang, AU - Lou,Jianghua, AU - Xi,Deyan, AU - Bai,Yan, AU - Ma,Gongbao, AU - Zhao,Bin, AU - Liu,Dong, AU - Bao,Guofeng, AU - Lei,Zhidan, AU - Wang,Meiyun, Y1 - 2020/05/20/ PY - 2020/03/12/received PY - 2020/04/24/accepted PY - 2020/04/08/revised PY - 2020/5/22/pubmed PY - 2020/9/15/medline PY - 2020/5/22/entrez KW - Coronavirus KW - Pneumonia KW - Thoracic diseases KW - Tomography, spiral computed SP - 5489 EP - 5498 JF - European radiology JO - Eur Radiol VL - 30 IS - 10 N2 - 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. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32435925/Chest_computed_tomography_findings_of_coronavirus_disease_2019__COVID_19__pneumonia_ L2 - https://dx.doi.org/10.1007/s00330-020-06920-8 DB - PRIME DP - Unbound Medicine ER -