Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China

Abstract

Objectives: The purpose of this study was to observe the imaging characteristics of the novel coronavirus pneumonia.

Methods: Sixty-three confirmed patients were enrolled from December 30, 2019 to January 31, 2020. High-resolution CT (HRCT) of the chest was performed. The number of affected lobes, ground glass nodules (GGO), patchy/punctate ground glass opacities, patchy consolidation, fibrous stripes and irregular solid nodules in each patient's chest CT image were recorded. Additionally, we performed imaging follow-up of these patients.

Results: CT images of 63 confirmed patients were collected. M/F ratio: 33/30. The mean age was 44.9 ± 15.2 years. The mean number of affected lobes was 3.3 ± 1.8. Nineteen (30.2%) patients had one affected lobe, five (7.9%) patients had two affected lobes, four (6.3%) patients had three affected lobes, seven (11.1%) patients had four affected lobes while 28 (44.4%) patients had 5 affected lobes. Fifty-four (85.7%) patients had patchy/punctate ground glass opacities, 14 (22.2%) patients had GGO, 12 (19.0%) patients had patchy consolidation, 11 (17.5%) patients had fibrous stripes and 8 (12.7%) patients had irregular solid nodules. Fifty-four (85.7%) patients progressed, including single GGO increased, enlarged and consolidated; fibrous stripe enlarged, while solid nodules increased and enlarged.

Conclusions: Imaging changes in novel viral pneumonia are rapid. The manifestations of the novel coronavirus pneumonia are diverse. Imaging changes of typical viral pneumonia and some specific imaging features were observed. Therefore, we need to strengthen the recognition of image changes to help clinicians to diagnose quickly and accurately.

Key points: • High-resolution CT (HRCT) of the chest is critical for early detection, evaluation of disease severity and follow-up of patients with the novel coronavirus pneumonia. • The manifestations of the novel coronavirus pneumonia are diverse and change rapidly. • Radiologists should be aware of the various features of the disease and temporal changes.

Keywords: Coronavirus infections; Lung diseases; Pneumonia, viral; Thorax; Tomography, x-ray computed.

Fig. 1

Various lesions of the included patients. The red arrows and boxes indicated the abnormalities. a, b: GGO; c, d: patchy/punctate ground glass opacities; e, f: patchy consolidation; g: fibrous stripes; h: irregular solid nodules

Fig. 2

Follow up of the new coronavirus pneumonia. a1–d1 are the images of the patients’ first consultation, and a2–d2 are the images of the patients’ re-examination. a1, a2 showed single GGO in one lobe progressed to ground glass patches and consolidation in multi-lobes; b1, b2 showed fibrous stripe in right lower lung progressed to strip; c1, c2 showed solid nodules in right upper lung enlarged; d1 and d2 indicated that the density of solid nodules decreases and the range increases, like “melting sugar”