Fu Fangfang, Lou Jianghua, Xi Deyan, Bai Yan, Ma Gongbao, Zhao Bin, Liu Dong, Bao Guofeng, Lei Zhidan, Wang Meiyun
Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
Department of Radiology, Taikang People's Hospital, Zhoukou, Henan, China.
Eur Radiol. 2020 Oct;30(10):5489-5498. doi: 10.1007/s00330-020-06920-8. Epub 2020 May 20.
To retrospectively analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia.
From January 9, 2020, to February 26, 2020, totally 56 laboratory-confirmed patients with COVID-19 underwent chest CT. For 40 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared.
Forty patients (83.6%) had two or more opacities in the lung. Eighteen (32.7%) patients had only ground-glass opacities; twenty-nine patients (52.7%) had ground-glass and consolidative opacities; and eight patients (14.5%) had only consolidation. A total of 43 patients (78.2%) showed two or more lobes involved. The opacities tended to be both in peripheral and central (30/55, 54.5%) or purely peripheral distribution (25/55, 45.5%). Fifty patients (90.9%) had the lower lobe involved. The first follow-up CT scans showed that twelve patients (30%) had improvement, 26 (65%) patients had mild-moderate progression, and two patients (5%) had severe progression with "white lungs." The second follow-up CT showed that 22 patients (71%) showed improvement compared with the first follow-up CT, four patients (12.9%) had aggravated progression, and five patients (16.1%) showed unchanged radiographic appearance.
The common CT features of COVID-19 pneumonia are multiple lung opacities, multiple types of the opacity (ground-glass, ground-glass and consolidation, and consolidation alone), and multiple lobes especially the lower lobe involved. Follow-up CT could demonstrate the rapid progression of COVID-19 pneumonia (either in aggravation or absorption).
• The predominant CT features of COVID-19 pneumonia are multiple ground-glass opacities with or without consolidation and, with both lungs, multiple lobes and especially the lower lobe affected. • CT plays a crucial role in early diagnosis and assessment of COVID-19 pneumonia progression. • CT findings of COVID-19 pneumonia may not be consistent with the clinical symptoms or the initial RT-PCR test results.
回顾性分析2019冠状病毒病（COVID-19）肺炎患者的胸部计算机断层扫描（CT）特征。
2020年1月9日至2020年2月26日，共有56例实验室确诊的COVID-19患者接受了胸部CT检查。其中40例患者进行了CT随访扫描。对CT图像评估了肺部混浊影的数量、类型和分布以及受累肺叶。此外，对初次CT扫描和随访CT扫描进行了比较。
40例患者（83.6%）肺部有两个或更多混浊影。18例（32.7%）患者仅有磨玻璃影；29例（52.7%）患者有磨玻璃影和实变影；8例（14.5%）患者仅有实变影。共有43例患者（78.2%）显示两个或更多肺叶受累。混浊影倾向于外周和中央均有（30/55，54.5%）或单纯外周分布（25/55，45.5%）。50例患者（90.9%）下叶受累。首次随访CT扫描显示，12例患者（30%）病情改善，26例（65%）患者有轻至中度进展，2例（5%）患者病情严重进展出现“白肺”。第二次随访CT显示，与首次随访CT相比，22例患者（71%）病情改善，4例（12.9%）患者病情加重，5例（16.1%）患者影像学表现无变化。
COVID-19肺炎的常见CT特征为肺部多发混浊影、多种类型的混浊影（磨玻璃影、磨玻璃影与实变影、单纯实变影）、多个肺叶受累尤其是下叶。随访CT可显示COVID-19肺炎的快速进展（加重或吸收）。
• COVID-19肺炎的主要CT特征为多发磨玻璃影伴或不伴实变影，双肺、多个肺叶尤其是下叶受累。• CT在COVID-19肺炎的早期诊断和病情进展评估中起关键作用。• COVID-19肺炎的CT表现可能与临床症状或初始逆转录聚合酶链反应（RT-PCR）检测结果不一致。
