Coronavirus disease 2019: initial chest CT findings
Tóm tắt
To systematically analyze CT findings during the early and progressive stages of natural course of coronavirus disease 2019 and also to explore possible changes in pulmonary parenchymal abnormalities during these two stages. We retrospectively reviewed the initial chest CT data of 62 confirmed coronavirus disease 2019 patients (34 men, 28 women; age range 20–91 years old) who did not receive any antiviral treatment between January 21 and February 4, 2020, in Chongqing, China. Patients were assigned to the early-stage group (onset of symptoms within 4 days) or progressive-stage group (onset of symptoms within 4–7 days) for analysis. CT characteristics and the distribution, size, and CT score of pulmonary parenchymal abnormalities were assessed. In our study, the major characteristic of coronavirus disease 2019 was ground-glass opacity (61.3%), followed by ground-glass opacity with consolidation (35.5%), rounded opacities (25.8%), a crazy-paving pattern (25.8%), and an air bronchogram (22.6%). No patient presented cavitation, a reticular pattern, or bronchial wall thickening. The CT scores of the progressive-stage group were significantly greater than those of the early-stage group (p = 0.004). Multiple ground-glass opacities with consolidations in the periphery of the lungs were the primary CT characteristic of coronavirus disease 2019. CT score can be used to evaluate the severity of the disease. If these typical alterations are found, then the differential diagnosis of coronavirus disease 2019 must be considered. • Multiple GGOs with consolidations in the periphery of the lungs were the primary CT characteristic of COVID-19. • The halo sign may be a special CT feature in the early-stage COVID-19 patients. • Significantly increased CT score may indicate the aggravation of COVID-19 in the progressive stage.
Tài liệu tham khảo
Holshue ML, DeBolt C, Lindquist S et al (2020) First case of 2019 novel coronavirus in the United States. N Engl J Med 382(10):929–936
World Health Organization (2020) Statement on novel coronavirus in Thailand. World Health Organization, Geneva Available via https://www.who.int/news-room/detail/13-01-2020-who-statement-on-novel-coronavirus-in-thailand. Accessed 12 Jan 2020
World Health Organization (2020) WHO confirms first cases of novel coronavirus (2019-nCoV) in the Eastern Mediterranean Region. World Health Organization, Geneva Available via http://www.emro.who.int/media/news/who-confirms-first-cases-of-novel-coronavirus-2019-ncov-in-the-eastern-mediterranean-region.html. Accessed 29 Jan 2020
World Health Organization (2020) Readiness is the key to detect, combat spread of the new coronavirus. World Health Organization, Geneva Available via https://www.who.int/southeastasia/news/detail/27-01-2020-readiness-is-the-key-to-detect-combat-spread-of-the-new-coronavirus. Accessed 27 Jan 2020
Lei J, Li J, Li X, Qi X (2020) CT imaging of the 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology. https://doi.org/10.1148/radiol.2020200236:200236
Chen N, Zhou M, Dong X et al (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395(10223):507–513
Huang C, Wang Y, Li X et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395(10223):497–506
Yin Y, Wunderink RG (2018) MERS, SARS and other coronaviruses as causes of pneumonia. Respirology 23:130–137
World Health Organization (2020) Global surveillance for human infection with coronavirus disease (COVID-19). World Health Organization, Geneva Available via https://www.who.int/publications-detail/global-surveillance-for-human-infection-with-novel-coronavirus-(2019-ncov). Accessed 27 Feb 2020
Chan JF, Yuan S, Kok KH et al (2020) A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 395(10223):514–523
Li Q, Guan X, Wu P et al (2020) Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. https://doi.org/10.1056/NEJMoa2001316
People's Medical Publishing House; Committee of the Infectious Diseases Radiology Group of Chinese Society of Radiology; Committee of the Infectious Diseases Radiology Section of Chinese Medical Doctor Association; Infectious Disease Imaging Group, Infectious Disease Branch, Chinese Research Hospital Association; Imaging Committee of Chinese Association for the Prevention and Treatment of STD AIDS Infection (Infectious Disease); Infectious Diseases Group, General Radiological Equipment Committee, China Association of Medical Equipment; Beijing Imaging Diagnosis and Treatment Technology Innovation Alliance, Li HJ, Xu HB (2020) Guideline for imaging diagnosis of novel coronavirus (2019-nCoV) infected pneumonia (1st edition 2020). New Medicine 30:22–34
Wormanns D, Hamer OW (2015) Glossary of terms for thoracic imaging--German version of the Fleischner Society recommendations. Rofo 187(8):638–661
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722
Ooi GC, Khong PL, Müller NL et al (2004) Severe acute respiratory syndrome: temporal lung changes at thin-section CT in 30 patients. Radiology 230:836–844
Chang YC, Yu CJ, Chang SC et al (2005) Pulmonary sequelae in convalescent patients after severe acute respiratory syndrome: evaluation with thin-section CT. Radiology 236:1067–1075
Zhou P, Yang XL, Wang XG et al (2020) A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. https://doi.org/10.1038/s41586-020-2012-7
Lu R, Zhao X, Li J et al (2020) Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 395(10224):565–574
Koo HJ, Lim S, Choe J, Choi SH, Sung H, Do KH (2018) Radiographic and CT features of viral pneumonia. Radiographics 38:719–739
Wong KT, Antonio GE, Hui DS et al (2003) Thin-section CT of severe acute respiratory syndrome: evaluation of 73 patients exposed to or with the disease. Radiology 228:395–400
Das KM, Lee EY, Enani MA et al (2015) CT correlation with outcomes in 15 patients with acute Middle East respiratory syndrome coronavirus. AJR Am J Roentgenol 204:736–742
Ajlan AM, Ahyad RA, Jamjoom LG, Alharthy A, Madani TA (2014) Middle East respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. AJR Am J Roentgenol 203:782–787
Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E (2020) A novel coronavirus emerging in China - key questions for impact assessment. N Engl J Med 382(8):692–694
Grinblat L, Shulman H, Glickman A, Matukas L, Paul N (2003) Severe acute respiratory syndrome: radiographic review of 40 probable cases in Toronto, Canada. Radiology 228:802–809