Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India.
Department of Cardiology, Sri Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Eur Radiol. 2020 Nov;30(11):6129-6138. doi: 10.1007/s00330-020-06975-7. Epub 2020 May 30.
The objective of this systematic review was to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature.
We performed a systematic literature search from the PubMed, Google Scholar, Embase, and WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients.
A total of 45 studies comprising 4410 patients were included. Ground glass opacities (GGO), in isolation (50.2%) or coexisting with consolidations (44.2%), were the most common lesions. Distribution of GGOs was most commonly bilateral, peripheral/subpleural, and posterior with predilection for lower lobes. Common ancillary findings included pulmonary vascular enlargement (64%), intralobular septal thickening (60%), adjacent pleural thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving, bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in early follow-up period generally showed an increase in size, number, and density of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy paving, peaking at 10-11 days, before gradually resolving or persisting as patchy fibrosis. While younger adults more commonly had GGOs, extensive/multilobar involvement with consolidations was prevalent in the older population and those with severe disease.
This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance. It is pertinent to be familiar with the various imaging findings to positively impact the management of these patients.
• Ground glass opacities (GGOs), whether isolated or coexisting with consolidations, in bilateral and subpleural distribution, are the most prevalent chest CT findings in adult COVID-19 patients. • Follow-up CT shows a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before gradually resolving or persisting as patchy fibrosis. • Younger people tend to have more GGOs. Older or sicker people tend to have more extensive involvement with consolidations.
本系统评价旨在通过综合回顾已发表文献，评估成人 COVID-19 患者胸部 CT 的关键影像学表现。
我们从 PubMed、Google Scholar、Embase 和世界卫生组织数据库中进行了系统文献检索，以查找提及成人 COVID-19 患者胸部 CT 影像学发现的研究。
共纳入 45 项研究，共计 4410 例患者。磨玻璃影（GGO），无论是孤立存在（50.2%）还是与实变共存（44.2%），是最常见的病变。GGO 的分布最常见为双侧、外周/胸膜下和后背部，以下肺叶多见。常见的辅助发现包括肺血管增大（64%）、小叶间隔增厚（60%）、相邻胸膜增厚（41.7%）、空气支气管征（41.2%）、胸膜下线、铺路石征、支气管扭曲、支气管扩张和小叶间隔增厚。早期随访 CT 通常显示 GGO 数量、大小和密度增加，进展为 GGO 合并实变的混杂区和铺路石征，在第 10-11 天达到高峰，然后逐渐消退或持续存在为斑片状纤维化。年轻患者更常见 GGO，而老年患者和重症患者则更常见广泛/多叶累及实变。
本综述描述了 COVID-19 患者的诊断、分层和随访的影像学特征。最常见的 CT 表现为双侧、外周/胸膜下、后背部 GGO 伴或不伴实变，以下肺叶为主。熟悉各种影像学表现对于积极管理这些患者至关重要。
磨玻璃影（GGOs），无论是孤立存在还是与实变共存，在双侧和胸膜下分布，是成人 COVID-19 患者胸部 CT 最常见的发现。
随访 CT 显示 GGO 进展为混合模式，在第 10-11 天达到高峰，然后逐渐消退或持续存在为斑片状纤维化。
年轻患者倾向于出现更多的 GGOs。年龄较大或病情较重的患者更倾向于出现广泛的实变累及。
