Radiographic and CT Features of Viral Pneumonia

Abstract

Viruses are the most common causes of respiratory infection. The imaging findings of viral pneumonia are diverse and overlap with those of other nonviral infectious and inflammatory conditions. However, identification of the underlying viral pathogens may not always be easy. There are a number of indicators for identifying viral pathogens on the basis of imaging patterns, which are associated with the pathogenesis of viral infections. Viruses in the same viral family share a similar pathogenesis of pneumonia, and the imaging patterns have distinguishable characteristics. Although not all cases manifest with typical patterns, most typical imaging patterns of viral pneumonia can be classified according to viral families. Although a definite diagnosis cannot be achieved on the basis of imaging features alone, recognition of viral pneumonia patterns may aid in differentiating viral pathogens, thus reducing the use of antibiotics. Recently, new viruses associated with recent outbreaks including human metapneumovirus, severe acute respiratory syndrome coronavirus, and Middle East respiratory syndrome coronavirus have been discovered. The imaging findings of these emerging pathogens have been described in a few recent studies. This review focuses on the radiographic and computed tomographic patterns of viral pneumonia caused by different pathogens, including new pathogens. Clinical characteristics that could affect imaging, such as patient age and immune status, seasonal variation and community outbreaks, and pathogenesis, are also discussed. The first goal of this review is to indicate that there are imaging features that should raise the possibility of viral infections. Second, to help radiologists differentiate viral infections, viruses in the same viridae that have similar pathogenesis and can have similar imaging characteristics are shown. By considering both the clinical and radiologic characteristics, radiologists can suggest the diagnosis of viral pneumonia. RSNA, 2018.

High-resolution computed tomography manifestations of COVID-19 infections in patients of different ages

“…In the chest HRCT manifestations patients in this study, patchy GGO and consolidation were common features. Similar manifestations were also present in severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) infections, as shown in previous studies [8][9] . In this study, the lesions of patients were mainly located in the lower lobe of the right lung.…”

Human metapneumovirus infection: Diagnostic impact of radiologic imaging

“…In a recent review for radiologic imaging of viral agents that may cause pneumonia, the general radiologic findings of hMPV infections were followed as bilateral centrilobular nodules, GGO, and multilobar infiltrations; however, there was no information about nodular consolidation. In addition, they noted that the radiologic findings of hMPV infections were most commonly reported in patients with hematologic malignancy, but there were limited data on immunocompetent patients . Similar radiologic findings in hMPV infection among immunocompromised patients have been reported in different studies .…”

“…Radiologic findings of hMPV infection have not been reported to be different from other viral pathogens in studies with high sample sizes; however, it has been reported that studies including radiologic findings of hMPV infections were commonly done among immunocompromised hosts …”

Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children

“…Nevertheless, it was difficult to distinguish if the consolidation was associated with COVID-19 pneumonia, since the consolidation and pleural effusion were also common in pure RSV infection. 27 The contact history and clinical symptoms of fever or cough may be helpful for the surveillance.…”