The characteristics and clinical value of chest CT images of novel coronavirus pneumonia

Abstract

Aim: To investigate the characteristics and clinical value of chest computed tomography (CT) images of novel coronavirus pneumonia (NCP).

Materials and methods: Clinical data and CT images of 80 cases of NCP were collected. The clinical manifestations and laboratory test results of the patients were analysed. The lesions in each lung segment of the patient's chest CT images were characterised. Lesions were scored according to length and diffusivity.

Results: The main clinical manifestations were fever, dry cough, fatigue, a little white sputum, or diarrhoea. A total of 1,702 scored lesions were found in the first chest CT images of 80 patients. The lesions were located mainly in the subpleural area of the lungs (92.4%). Most of the lesions were ground-glass opacity, and subsequent fusions could increase in range and spread mainly in the subpleural area. Pulmonary consolidation accounted for 44.1% of all of the lesions. Of the 80 cases, 76 patients (95%) had bilateral lung disease, four (5%) patients had unilateral lung disease, and eight (10%) patients had cord shadow.

Conclusion: The chest CT of NCP patients is characterised by the onset of bilateral ground-glass lesions located in the subpleural area of the lung, and progressive lesions that result in consolidation with no migratory lesions. Pleural effusions and mediastinal lymphadenopathy are rare. As patients can have inflammatory changes in the lungs alongside a negative early nucleic acid test, chest CT, in combination with epidemiological and laboratory tests, is a useful examination to evaluate the disease and curative effect.

Figure 1

First time CT distribution of lung segment lesions in 80 patients. AnRU:Anterior of Right Upper Lobe; ApRU:Apical of Right Upper Lobe; PRU:Apical of Right Upper Lobe; MRM:Medial of Right Middle Lobe; LRM:Lateral of Right Middle Lobe; SRL:Superior of Right Lower Lobe; MRL:Medial basal of Right Lower Lobe; ARL:Anterior basal of Right Lower Lobe; LRL:Lateral basal of Right Lower Lobe; PRL:Posterior basal of Right Lower Lobe; AnLU:Anterior of Left Upper Lobe; ApLU:Apical posterior of Left Upper Lobe; SlLU:Superior lingula of Left Upper Lobe; IlLU: Inferior lingula of Left Upper Lobe; SLL: Superior of Left Lower Lobe; MaLL: Medial anterior basal of Left Lower Lobe; LLL: Lateral basal of Left Lower Lobe; PLL: Posterior basal of Left Lower Lobe.

Figure 2

Male, 56 years old, with fever and cough for 3 days. a) multiple ground glass opacities in lungs, scattered (arrows), and the texture of the inner lungs are clear. b) Follow-up CT obtained 5 days after the onset of symptoms. The density of lung lesions increased, partly fused into patches (arrows), and part of the ground glass showed consolidation.

Figure 3

Male, 30 years old, with fever, cough, and white phlegm for 2 days. a) the ground glass opacity was accompanied by a thickening of the interlobular septum, showing “Crazy paving stone” sign in the subpleural of the right lung upper lobe (arrow). b) Figure 3b is partial enlarged view of the lesion of Figure 3a.

Figure 4

Male, 52 years old, with fever for 7 days. a), b) and c) were three-dimensional reconstructed images of chest CT examination. The lesions were mostly located in the subpleural area and stopped at the interpleural with clear margin (arrows).

Figure 5

Male, 27 years old, with fever and fatigue for 5 days. a) chest CT obtained 5 days after the onset of symptoms. CT images shows consolidation of the right lobe and lower lobe of the lung. The lesions were close to the pleura. b). Follow-up CT obtained on 13 days after the onset of symptoms. The lesions were absorbed and the range was reduced. Lesions in the lower lobe of the left lung were absorbed from the center and showed a “reverse halo sign” (arrow).