Caruso Damiano, Polidori Tiziano, Guido Gisella, Nicolai Matteo, Bracci Benedetta, Cremona Antonio, Zerunian Marta, Polici Michela, Pucciarelli Francesco, Rucci Carlotta, Dominicis Chiara De, Girolamo Marco Di, Argento Giuseppe, Sergi Daniela, Laghi Andrea
Department of Surgical and Medical Sciences and Translational Medicine, "Sapienza"-University of Rome, Sant'Andrea University Hospital, AOU Sant'Andrea, Rome 00189, Italy.
World J Clin Cases. 2020 Aug 6;8(15):3177-3187. doi: 10.12998/wjcc.v8.i15.3177.
In December 2019 a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 was identified and the disease associated was named coronavirus disease 2019 (COVID-19). Fever, cough, myalgia, fatigue associated to dyspnea represent most common clinical symptoms of the disease. The reference standard for diagnosis of severe acute respiratory syndrome coronavirus 2 infection is real time reverse-transcription polymerase chain reaction test applied on respiratory tract specimens. Despite of lower specificity, chest computed tomography (CT), as reported in manifold scientific studies, showed high sensitivity, therefore it may help in the early detection, management and follow-up of COVID-19 pneumonia. Patients affected by COVID-19 pneumonia usually showed on chest CT some typical features, such as: Bilateral ground glass opacities characterized by multilobe involvement with posterior and peripheral distribution; parenchymal consolidations with or without air bronchogram; interlobular septal thickening; crazy paving pattern, represented by interlobular and intralobular septal thickening surrounded by ground-glass opacities; subsegmental pulmonary vessels enlargement (> 3 mm). Halo sign, reversed halo sign, cavitation and pleural or pericardial effusion represent some of atypical findings of COVID-19 pneumonia. On the other hand lymphadenopathy's and bronchiectasis' frequency is unclear, indeed conflicting data emerged in literature. Radiologists play a key role in recognition of high suspicious findings of COVID-19 on chest CT, both typical and atypical ones. Thus, the aim of this review is to illustrate typical and atypical CT findings of COVID-19.
2019年12月,一种名为严重急性呼吸综合征冠状病毒2的新型冠状病毒被发现,与之相关的疾病被命名为冠状病毒病2019(COVID-19)。发热、咳嗽、肌痛、伴有呼吸困难的疲劳是该疾病最常见的临床症状。诊断严重急性呼吸综合征冠状病毒2感染的参考标准是对呼吸道标本进行实时逆转录聚合酶链反应检测。尽管特异性较低,但正如众多科学研究所报道的,胸部计算机断层扫描(CT)显示出高敏感性,因此它可能有助于COVID-19肺炎的早期检测、管理和随访。COVID-19肺炎患者的胸部CT通常表现出一些典型特征,如:双侧磨玻璃影,多累及多个肺叶,呈后部和周边分布;实变,有或无空气支气管征;小叶间隔增厚;碎石路征,表现为小叶内和小叶间隔增厚,周围有磨玻璃影;亚段肺血管增粗(>3mm)。晕征、反晕征、空洞形成以及胸腔或心包积液是COVID-19肺炎的一些非典型表现。另一方面,淋巴结肿大和支气管扩张的发生率尚不清楚,实际上文献中出现了相互矛盾的数据。放射科医生在识别胸部CT上COVID-19的高度可疑表现(包括典型和非典型表现)方面起着关键作用。因此,本综述的目的是阐述COVID-19的典型和非典型CT表现。