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

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 C...

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Bibliographic Details
Published in:	European radiology Vol. 30; no. 10; pp. 5489 - 5498
Main Authors:	Fu, Fangfang, Lou, Jianghua, Xi, Deyan, Bai, Yan, Ma, Gongbao, Zhao, Bin, Liu, Dong, Bao, Guofeng, Lei, Zhidan, Wang, Meiyun
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2020 Springer Nature B.V
Subjects:	Adult Aged Betacoronavirus Chest Computed tomography Consolidation Coronaviridae Coronavirus Infections - diagnosis Coronaviruses COVID-19 Diagnostic Radiology Disease Progression Female Glass Humans Imaging Internal Medicine Interventional Radiology Lobes Lung - diagnostic imaging Lungs Male Medical imaging Medicine Medicine & Public Health Middle Aged Neuroradiology Opacity Pandemics Pneumonia Pneumonia, Viral - diagnosis Polymerase chain reaction Radiology Retrospective Studies SARS-CoV-2 Signs and symptoms Tomography Tomography, X-Ray Computed - methods Ultrasound Viral diseases Pneumonia Thoracic diseases Coronavirus Tomography, spiral computed
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0938-7994 1432-1084
DOI:	10.1007/s00330-020-06920-8