CT imaging features of 34 patients infected with COVID-19

Clin Imaging. 2020 Dec:68:226-231. doi: 10.1016/j.clinimag.2020.05.016. Epub 2020 May 16.

Abstract

Objective: To retrospectively analyze the CT findings in patients infected with Coronavirus disease 2019 (COVID-19).

Materials and methods: The thirty-four cases, 15 females and 19 males, with an age ranging from 7 to 88 years old, confirmed by real-time reverse-transcriptase-polymerase chain reaction (RT-PCR), were used for our study. All thin-section CT scans of the lungs were performed in all of patients. The clinical, laboratory and CT imaging were available to evaluate in all patients.

Results: The patients present with fever (85.29%, n = 29), cough (67.65%, n = 23), fatigue or myalgia (26.47%, n = 9), and pharyngalgia (8.82%, n = 3). The 4 patients (11.76%) with no symptoms were identified during screening for close contacts, who had typical CT findings. On initial CT scans, the bilateral lung involved was shown in 24 cases (70.59%), while 29 (82.35%) cases were distributed in peripheral. The pure ground glass opacity (GGO) was shown in 18 cases (52.94%), the GGO with consolidation was in 12 cases (35.29%), and full consolidation only in 3 cases. The lesion with air bronchogram was seen in 14 (41.18%) cases, with enlarged blood vessel in 17 (50.00%) cases, with crazy-paving pattern in 8 (23.53%) cases, with fine reticular pattern in 4 (11.77%) cases, and with intralesional vacuole sign in 6 (17.65%) cases. The pleural effusion was seen in one patient. Follow-up imaging in 19 patients during the study time window demonstrated mild, moderate or severe progression of disease, as manifested by increasing extent and density of lung opacities.

Conclusions: The bilateral GGO with air bronchogram, enlarged blood vessel, fine reticular pattern, and peripheral distribution are the early CT findings of COVID-19. The crazy-paving pattern and intralesional vacuole sign are the features of progressive stage.

Keywords: COVID-19; CT; Consolidation; Crazy-paving pattern; Ground glass opacity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • Blood Vessels / pathology
  • COVID-19
  • Child
  • Coronavirus
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / pathology*
  • Coronavirus Infections / virology
  • Cough / etiology
  • Female
  • Humans
  • Hypertrophy
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Lung / virology
  • Male
  • Middle Aged
  • Pandemics
  • Pleural Effusion / etiology
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / pathology*
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods
  • Young Adult