Pulmonary High-Resolution Computed Tomography (HRCT) Findings of Patients with Early-Stage Coronavirus Disease 2019 (COVID-19) in Hangzhou, China

Abstract

BACKGROUND The aim of this study was to investigate the imaging manifestations of early-stage coronavirus disease 2019 (COVID-19) and to provide imaging basis for early detection of suspected cases and stratified intervention. MATERIAL AND METHODS From 20 January 2020 to 2 February 2020, 6 patients diagnosed with COVID-19, including 1 male and 5 females, were retrospectively reviewed in Zhejiang Hospital. These cases were clinically assessed and classified as common COVID-19. All patients underwent thoracic high-resolution computed tomography (HRCT) within 2 days after the onset of symptoms, and their images were viewed by 2 radiologists who were blind to their clinical records. RESULTS CT images of 6 confirmed patients were collected. Two of the 6 patients (33.3%) had bilateral lung involvements and 4 (66.7%) had single-lung involvement. Two cases (33.3%) had a single lesion, 2 cases (33.3%) had 2 lesions, and 2 cases (33.3%) had multiple lesions. There were 2 cases (33.3%) with focal subpleural distribution and 1 case (16.7%) along the bronchial vascular bundle. Five cases (83.3%) had ground-glass opacities, 4 cases (66.7%) had ground-glass nodules, 1 case (16.7%) had thickened lobular septum, 2 cases (33.3%) had thickened bronchial wall, 2 cases (33.3%) had halo sign,1 case (16.7%) had crazy-paving sign, and 1 case (16.7%) had tree-in-bud sign. CONCLUSIONS The imaging manifestations of early-stage COVID-19 are relatively mild, and the imaging findings of some patients are not typical, which can easily lead to missed diagnoses. Thus, suspected cases need to be closely monitored, and epidemiological history and clinical laboratory examination should also be considered during diagnosis.

Figure 1

(A, B) Shows the HRCT images of a 53-year-old female with fever for 5 days. Ground-glass opacity around bronchial trees can be seen in the left lower lobe with tree-in-bud sign. (C) Shows the HRCT image of a 52-year-old female with fever (highest temperature 38°C). Ground-glass opacity with thickened lobular septum can be seen in left upper lobe. (D) Shows the HRCT image of a 30-year-old female with shortness of breath and cough. Ground-glass nodule can be seen in the peri-pleural region of left lower lobe.