Department of Radiology, Hospital de Sant Pau. Universidad Autónoma de Barcelona, Barcelona, Spain.
Department of Radiology and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Br J Radiol. 2020 Aug;93(1112):20200515. doi: 10.1259/bjr.20200515. Epub 2020 Jul 6.
During the first two decades of the 21st century, there have been three coronavirus infection outbreaks raising global health concerns by severe acute respiratory syndrome coronavirus (SARS-CoV), the Middle East respiratory syndrome coronavirus (MERS-CoV), and the SARS-CoV-2. Although the reported imaging findings of coronavirus infection are variable and non-specific, the most common initial chest radiograph (CXR) and CT findings are ground-glass opacities and consolidation with peripheral predominance and eventually spread to involve both lungs as the disease progresses. These findings can be explained by the immune pathogenesis of coronavirus infection causing diffuse alveolar damage. Although it is insensitive in mild or early coronavirus infection, the CXR remains as the first-line and the most commonly used imaging modality. That is because it is rapid and easily accessible and helpful for monitoring patient progress during treatment. CT is more sensitive to detect early parenchymal lung abnormalities and disease progression, and can provide an alternative diagnosis. In this pictorial review, various coronavirus infection cases are presented to provide imaging spectrums of coronavirus infection and present differences in imaging among them or from other viral infections, and to discuss the role of imaging in viral infection outbreaks.
在 21 世纪的头二十年里,有三种冠状病毒感染爆发引起了全球健康关注,分别是严重急性呼吸综合征冠状病毒(SARS-CoV)、中东呼吸综合征冠状病毒(MERS-CoV)和 SARS-CoV-2。尽管冠状病毒感染的报告影像学表现多种多样且无特异性,但最常见的初始胸部 X 线摄影(CXR)和 CT 表现为磨玻璃影和实变影,以周边为主,随着疾病的进展逐渐累及双肺。这些发现可以用冠状病毒感染引起的免疫发病机制来解释,导致弥漫性肺泡损伤。虽然在轻度或早期冠状病毒感染中不敏感,但 CXR 仍然是一线和最常用的影像学检查方法。这是因为它快速、易于获得,有助于在治疗过程中监测患者的病情进展。CT 对检测早期肺实质异常和疾病进展更敏感,并能提供替代诊断。在这篇影像学综述中,展示了各种冠状病毒感染的病例,提供了冠状病毒感染的影像学谱,并介绍了它们之间或与其他病毒感染之间的影像学差异,并讨论了影像学在病毒感染爆发中的作用。