Imaging Features of Coronavirus disease 2019 (COVID-19): Evaluation on Thin-Section CT

Abstract

Rationale and objectives: To retrospectively analyze the chest imaging findings in patients with coronavirus disease 2019 (COVID-19) on thin-section CT.

Materials and methods: Fifty-three patients with confirmed COVID-19 infection underwent thin-section CT examination. Two chest radiologists independently evaluated the imaging in terms of distribution, ground-glass opacity (GGO), consolidation, air bronchogram, stripe, enlarged mediastinal lymph node, and pleural effusion.

Results: Fourty-seven cases (88.7%) had findings of COVID-19 infection, and the other six (11.3%) were normal. Among the 47 cases, 78.7% involved both lungs, and 93.6% had peripheral infiltrates distributed along the subpleural area. All cases showed GGO, 59.6% of which were round and 40.4% patchy. Other imaging features included "crazy-paving pattern" (89.4%), consolidation (63.8%), and air bronchogram (76.6%). Air bronchograms were observed within GGO (61.7%) and consolidation (70.3%). Neither enlarged mediastinal lymph nodes nor pleural effusion were present. Thirty-three patients (62.3%) were followed an average interval of 6.2 ± 2.9 days. The lesions increased in 75.8% and resorbed in 24.2% of patients.

Conclusion: COVID-19 showed the pulmonary lesions in patients infected with COVID-19 were predominantly distributed peripherally in the subpleural area.

Keywords: Coronavirus; Lung; Multidetector computed tomography; Pneumonia.

Figure 1

Male, 59-year-old, COVID-19. (a,b) Round GGO involve the bilateral lungs, distribute along the subpleural area. Air bronchogram appear on the background of GGO. (c,d) Follow-up imaging of 5 days later. The disease makes a progress, which shows consolidation obviously increase in the range, and a few of GGO remain. COVID-19, Coronavirus disease 2019; GGO, ground-glass opacity.

Figure 2

Male, 42-year-old, COVID-19. (a) The round GGO involve the bilateral lower lobes, distribute along the peribronchovascular bundle and subpleural area. A few of consolidation appear in the center of the GGO. (b) Follow-up imaging of 7 days later. The range of the lesions remain unchanged. The attenuation of GGO decrease, and only a few of consolidation remain. COVID-19, Coronavirus disease 2019; GGO, ground-glass opacity.

Figure 3

Female, 64-year-old, COVID-19. (a) The patchy GGO and consolidation diffusely involve the bilateral lungs. Air bronchogram appear on the background of GGO and consolidation. The crazy-paving pattern appear in the right middle lobe. (b) Follow-up imaging of 13 days later. All of consolidation and most of GGO are resorbed. Stripes appear. COVID-19, Coronavirus disease 2019; GGO, ground-glass opacity.

Figure 4

Male, 50-year-old, COVID-19. (a) The stripes involve the bilateral lungs, and distribute along the subpleural area. GGO appear the margin of the stripes. Patchy GGO and crazy-paving pattern distribute along the subpleural area of the left lower lobe. (b) Follow-up imaging of 7 days later. The stripe and consolidation obviously increase. The GGO in the left lower lobe is replaced by consolidation. (c) Follow-up imaging of 12 days later. The most of stripe, GGO, and consolidation are obviously resorbed. A few of stripe and GGO remain. COVID-19, Coronavirus disease 2019; GGO, ground-glass opacity.

Figure 5

Female, 29-year-old, COVID-19. (a) The initial CT shows the normal lungs. (b) Follow-up imaging of 4 days later. Round GGO and consolidation manifest in the left lower lobe, and locate in the subpleural area. COVID-19, Coronavirus disease 2019; GGO, ground-glass opacity.