Chest Imaging Appearance of COVID-19 Infection

Abstract

Key Points:1. It is important for all radiologists to be aware of the imaging spectrum of the disease and contribute to effective surveillance and response measures.2. Ground-glass opacities and consolidation can demonstrate an organizing pneumonia pattern. Cavitation can also occur in areas of airspace disease.This copy is for personal use only. To order printed copies, contact reprints@rsna.org I n P r e s s Abstract:COVID-19 (previously known as novel coronavirus [2019-nCoV]), first reported in China, has now been declared a global health emergency by World Health Organization. As confirmed I n P r e s s Case 1:A 59-year-old female from Sichuan Provincial People's Hospital presented with fever and chills.She had no history of sick contacts in the family, but she referred a plane ride 5 days prior to onset of symptoms from London, U.K., to Chengdu, China. Chest radiograph (Fig 1a) and chest CT (Fig 1b,c) at presentation showed patchy right lower lobe ground-glass opacities. Follow-up chest CT images (Fig 1d, e) obtained 2 days later showed improvement of the ground-glass opacities, with development of subpleural curvilinear lines. Case 2:A 62-year-old female from Sichuan Provincial People's Hospital presented 7 days after contact with relative who had recently traveled from Wuhan, China. Symptoms at presentation included paroxysmal cough, productive sputum, and fever. Chest CT showed a small solitary nodular ground-glass opacity in the left upper lobe (Fig 2a), which progressed in 3 days to multifocal nodular and peripheral ground-glass opacities involving both upper lobes (Fig 2 b,c). Another follow-up CT done 5 days from presentation showed a new tiny cavity (Fig 2d) and increasing component of consolidation (Fig 2e) admixed with ground-glass opacities and crazy-paving pattern. Case 3:A 45-year-old female from Sichuan Provincial People's Hospital presented with fever, cough, and chest pain after recent travel to Japan. Her CT at presentation showed extensive peripheral

Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea

“…Interestingly, we observed a reversed halo sign in one patient (Fig. 3B), and a few similar cases have been reported in recent reports (19)(20)(21). The reversed halo sign was first regarded as specific for cryptogenic organizing pneumonia, and it can be seen in various infectious diseases, including angioinvasive pulmonary aspergillosis or mucormycosis, paracoccidioidomycosis, pneumocystis jiroveci pneumonia, and tuberculosis (22).…”

“…The reversed halo sign was first regarded as specific for cryptogenic organizing pneumonia, and it can be seen in various infectious diseases, including angioinvasive pulmonary aspergillosis or mucormycosis, paracoccidioidomycosis, pneumocystis jiroveci pneumonia, and tuberculosis (22). This sign might reflect an organizing pneumonia pattern in COVID-19 pneumonia (21).…”

Coronavirus Disease 2019 (COVID-19): A Perspective from China

“…Chung et al (41) found one patient with an initial normal chest CT that evolved into a new solitary, rounded peripheral GGO after three days. The reversed CT halo sign defined as a rounded area of ground glass surrounded by a complete or almost complete ring of consolidation can also be observed (16,49). Pleural effusion, lung cavitation, lymphadenopathy and calcification are rarely reported (40)(41)(42)(43)(44)(49)(50).…”

The Many Faces of COVID-19: Spectrum of Imaging Manifestations

“…This is reflected in the large number of case reports with very interesting aspects recently submitted to this journal. For example, Kong and Agarwal (10) report a series of three unrelated cases of COVID-19 pneumonia presenting with a spectrum of findings on chest radiograph and CT, varying from the commonly seen ground-glass opacities and consolidation, to patterns that include crazy paving and reversed halo, suggesting organizing pneumonia as the underlying mechanism of lung injury (11,12). In another report, Wu et al (13) show the temporal evolution on CT of a patient with COVID-19 infection, also presenting with radiologic findings resembling organizing pneumonia.…”