Department of Radiology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Pathology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Br J Radiol. 2020 Sep 1;93(1113):20200538. doi: 10.1259/bjr.20200538. Epub 2020 Aug 6.
COVID-19 pneumonia is a newly recognized lung infection. Initially, CT imaging was demonstrated to be one of the most sensitive tests for the detection of infection. Currently, with broader availability of polymerase chain reaction for disease diagnosis, CT is mainly used for the identification of complications and other defined clinical indications in hospitalized patients. Nonetheless, radiologists are interpreting lung imaging in unsuspected patients as well as in suspected patients with imaging obtained to rule out other relevant clinical indications. The knowledge of pathological findings is also crucial for imagers to better interpret various imaging findings. Identification of the imaging findings that are commonly seen with the disease is important to diagnose and suggest confirmatory testing in unsuspected cases. Proper precautionary measures will be important in such unsuspected patients to prevent further spread. In addition to understanding the imaging findings for the diagnosis of the disease, it is important to understand the growing set of tools provided by artificial intelligence. The goal of this review is to highlight common imaging findings using illustrative examples, describe the evolution of disease over time, discuss differences in imaging appearance of adult and pediatric patients and review the available literature on quantitative CT for COVID-19. We briefly address the known pathological findings of the COVID-19 lung disease that may help better understand the imaging appearance, and we provide a demonstration of novel display methodologies and artificial intelligence applications serving to support clinical observations.
新型冠状病毒肺炎是一种新出现的肺部感染。最初,CT 成像被证明是检测感染的最敏感检查方法之一。目前,随着聚合酶链反应在疾病诊断中的广泛应用,CT 主要用于识别住院患者的并发症和其他明确的临床指征。尽管如此,放射科医生仍在对疑似患者和为排除其他相关临床指征而进行影像学检查的疑似患者进行肺部影像学检查。了解病理发现对于影像医生更好地解读各种影像学发现也很重要。识别与该疾病常见的影像学表现对于在疑似病例中进行诊断和建议进行确认性检查非常重要。在这些疑似患者中,采取适当的预防措施对于防止进一步传播非常重要。除了了解用于诊断该疾病的影像学表现外,了解人工智能提供的一系列新工具也很重要。本文的目的是通过举例说明来突出常见的影像学表现,描述疾病随时间的演变,讨论成人和儿科患者影像学表现的差异,并综述关于 COVID-19 的定量 CT 的现有文献。我们简要介绍了已知的 COVID-19 肺部疾病的病理发现,这可能有助于更好地理解影像学表现,并展示了用于支持临床观察的新的显示方法和人工智能应用。