CT Manifestations of Two Cases of 2019 Novel Coronavirus (2019-nCoV)                    Pneumonia

Fang, Yicheng; Zhang, Huangqi; Xu, Yunyu; Xie, Jun; Pang, Peipei; Ji, Wenbin

doi:10.1148/radiol.2020200280

Cited by 226 publications

(197 citation statements)

References 6 publications

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“…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).…”

Section: Discussionsupporting

confidence: 85%

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

et al. 2020

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Objective: This study presents a preliminary report on the chest radiographic and computed tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) pneumonia in Korea. Materials and Methods: As part of a multi-institutional collaboration coordinated by the Korean Society of Thoracic Radiology, we collected nine patients with COVID-19 infections who had undergone chest radiography and CT scans. We analyzed the radiographic and CT findings of COVID-19 pneumonia at baseline. Fisher's exact test was used to compare CT findings depending on the shape of pulmonary lesions. Results: Three of the nine patients (33.3%) had parenchymal abnormalities detected by chest radiography, and most of the abnormalities were peripheral consolidations. Chest CT images showed bilateral involvement in eight of the nine patients, and a unilobar reversed halo sign in the other patient. In total, 77 pulmonary lesions were found, including patchy lesions (39%), large confluent lesions (13%), and small nodular lesions (48%). The peripheral and posterior lung fields were involved in 78% and 67% of the lesions, respectively. The lesions were typically ill-defined and were composed of mixed ground-glass opacities and consolidation or pure ground-glass opacities. Patchy to confluent lesions were primarily distributed in the lower lobes (p = 0.040) and along the pleura (p < 0.001), whereas nodular lesions were primarily distributed along the bronchovascular bundles (p = 0.006). Conclusion: COVID-19 pneumonia in Korea primarily manifested as pure to mixed ground-glass opacities with a patchy to confluent or nodular shape in the bilateral peripheral posterior lungs. A considerable proportion of patients with COVID-19 pneumonia had normal chest radiographs.

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Section: Discussionsupporting

confidence: 85%

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

et al. 2020

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“…From the recently published literature, the typical radiological imaging of COVID-19 pneumonia demonstrated clear destruction of the pulmonary parenchyma including interstitial inflammation and extensive consolidation, similar to the previously reported coronavirus infection (1,(9)(10)(11). However, some patients with COVID-19 pneumonia consistently demonstrated no hypoxemia or respiratory distress during the course of hospitalization.…”

Section: N P R E S S Introductionsupporting

confidence: 79%

Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19)

Pan¹,

Ye²,

Sun³

et al. 2020

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In patients recovering from COVID-19 infection, four stages of evolution on chest CT were identified: early stage (0-4 days); progressive stage (5-8 days); peak stage (10-13 days); and absorption stage (≥14 days). Key Results1. In patients who recovered from COVID-19 pneumonia, initial lung findings on chest CT were small subpleural ground glass opacities (GGO) that grew larger with crazy-paving pattern and consolidation.2. Lung involvement increased to consolidation up to two weeks after disease onset.3. After two weeks, the lesions were gradually absorbed leaving extensive GGO and subpleural parenchymal bands.This copy is for personal use only. To order printed copies, contact reprints@rsna.org I n P r e s s Abstract:Background: Chest CT is used to assess the severity of lung involvement in COVID-19 pneumonia. Purpose:To determine the change in chest CT findings associated with COVID-19 pneumonia from initial diagnosis until patient recovery. Materials and Methods:This retrospective review included patients with RT-PCR confirmed COVID-19 infection presenting between 12 January 2020 to 6 February 2020. Patients with severe respiratory distress and/ or oxygen requirement at any time during the disease course were excluded.Repeat Chest CT was obtained at approximately 4 day intervals. The total CT score was the sum of lung involvement (5 lobes, score 1-5 for each lobe, range, 0 none, 25 maximum) was determined.Results: Twenty one patients (6 males and 15 females, age 25-63 years) with confirmed COVID-19 pneumonia were evaluated. These patients underwent a total of 82 pulmonary CT scans with a mean interval of 4±1 days (range: 1-8 days). All patients were discharged after a mean hospitalized period of 17±4 days (range: 11-26 days). Maximum lung involved peaked at approximately 10 days (with the calculated total CT score of 6) from the onset of initial symptoms (R2=0.25), p<0.001). Based on quartiles of patients from day 0 to day 26 involvement, 4 stages of lung CT were defined: Stage 1 (0-4 days): ground glass opacities (GGO) in 18/24 (75%) patients with the total CT score of 2±2; (2) Stage-2 (5-8d days): increased crazy-paving pattern 9/17 patients (53%) with a increase in total CT score (6±4, p=0.002); (3) Stage-3 (9-13days): consolidation 19/21 (91%) patients with the peak of total CT score (7±4) ; (4) Stage-4 (≥14 days): gradual resolution of consolidation 15/20 (75%) patients with a decreased total CT score (6±4) without crazy-paving pattern. Conclusion:In patients recovering from COVID-19 pneumonia (without severe respiratory distress during the disease course), lung abnormalities on chest CT showed greatest severity approximately 10 days after initial onset of symptoms.

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“…9 Crazy-paving pattern was also detected in some cases. 10,13 Pure consolidation without GGO is less common. 10 These lesions usually involve bilateral lungs.…”

Section: Discussionmentioning

confidence: 99%

“…10 As the NCP progresses, increasing size and density of these GGOs or crazy paving pattern were reported. 9,10,13,15 On the contrary, the GGOs will decrease in size and the consolidations, if present, will decrease in density when patients gradually recover. 9,15,16 Fibrotic change may be left as a sequela after recovery as was seen in patients recovering from SARS.…”

Section: Discussionmentioning

confidence: 99%