Chest Imaging Appearance of COVID-19 Infection

Abstract

Coronavirus disease 2019 (COVID-19) (previously known as novel coronavirus [2019-nCoV]), first reported in China, has now been declared a global health emergency by the World Health Organization. As confirmed cases are being reported in several countries from all over the world, it becomes important for all radiologists to be aware of the imaging spectrum of the disease and contribute to effective surveillance and response measures. © RSNA, 2020 See editorial by Kay and Abbara in this issue.

Figure 1a:

(a) Chest radiograph in a patient with COVID-19 infection demonstrates right infrahilar airspace opacities. (b) Axial and (c) sagittal chest CT images demonstrate peripheral right lower lobe ground-glass opacities. Follow-up (d) axial and (e) sagittal chest CT images 2 days later show improvement in the extent of ground-glass opacities, with more subpleural curvilinear lines (arrows).

Figure 1b:

(a) Chest radiograph in a patient with COVID-19 infection demonstrates right infrahilar airspace opacities. (b) Axial and (c) sagittal chest CT images demonstrate peripheral right lower lobe ground-glass opacities. Follow-up (d) axial and (e) sagittal chest CT images 2 days later show improvement in the extent of ground-glass opacities, with more subpleural curvilinear lines (arrows).

Figure 1c:

(a) Chest radiograph in a patient with COVID-19 infection demonstrates right infrahilar airspace opacities. (b) Axial and (c) sagittal chest CT images demonstrate peripheral right lower lobe ground-glass opacities. Follow-up (d) axial and (e) sagittal chest CT images 2 days later show improvement in the extent of ground-glass opacities, with more subpleural curvilinear lines (arrows).

Figure 1d:

(a) Chest radiograph in a patient with COVID-19 infection demonstrates right infrahilar airspace opacities. (b) Axial and (c) sagittal chest CT images demonstrate peripheral right lower lobe ground-glass opacities. Follow-up (d) axial and (e) sagittal chest CT images 2 days later show improvement in the extent of ground-glass opacities, with more subpleural curvilinear lines (arrows).

Figure 1e:

(a) Chest radiograph in a patient with COVID-19 infection demonstrates right infrahilar airspace opacities. (b) Axial and (c) sagittal chest CT images demonstrate peripheral right lower lobe ground-glass opacities. Follow-up (d) axial and (e) sagittal chest CT images 2 days later show improvement in the extent of ground-glass opacities, with more subpleural curvilinear lines (arrows).

Figure 2a:

(a) Axial chest CT image at presentation shows a small solitary nodular ground-glass opacity in left upper lobe (arrow). (b, c) Note the progression of airspace disease 3 days later, with new foci of ground-glass opacities (black arrows, b, c), as well as developing consolidation (white arrow). Additionally, there is higher peripheral attenuation with ground-glass opacities more centrally representing the reversed halo sign (curved arrows, c). (d, e) Further increase in extent of ground glass changes with new cavity in right lung (arrow, d) as well as new areas of consolidation (arrow, e) are seen on CT images 5 days after presentation.

Figure 2b:

(a) Axial chest CT image at presentation shows a small solitary nodular ground-glass opacity in left upper lobe (arrow). (b, c) Note the progression of airspace disease 3 days later, with new foci of ground-glass opacities (black arrows, b, c), as well as developing consolidation (white arrow). Additionally, there is higher peripheral attenuation with ground-glass opacities more centrally representing the reversed halo sign (curved arrows, c). (d, e) Further increase in extent of ground glass changes with new cavity in right lung (arrow, d) as well as new areas of consolidation (arrow, e) are seen on CT images 5 days after presentation.

Figure 2c:

(a) Axial chest CT image at presentation shows a small solitary nodular ground-glass opacity in left upper lobe (arrow). (b, c) Note the progression of airspace disease 3 days later, with new foci of ground-glass opacities (black arrows, b, c), as well as developing consolidation (white arrow). Additionally, there is higher peripheral attenuation with ground-glass opacities more centrally representing the reversed halo sign (curved arrows, c). (d, e) Further increase in extent of ground glass changes with new cavity in right lung (arrow, d) as well as new areas of consolidation (arrow, e) are seen on CT images 5 days after presentation.

Figure 2d:

(a) Axial chest CT image at presentation shows a small solitary nodular ground-glass opacity in left upper lobe (arrow). (b, c) Note the progression of airspace disease 3 days later, with new foci of ground-glass opacities (black arrows, b, c), as well as developing consolidation (white arrow). Additionally, there is higher peripheral attenuation with ground-glass opacities more centrally representing the reversed halo sign (curved arrows, c). (d, e) Further increase in extent of ground glass changes with new cavity in right lung (arrow, d) as well as new areas of consolidation (arrow, e) are seen on CT images 5 days after presentation.

Figure 2e:

(a) Axial chest CT image at presentation shows a small solitary nodular ground-glass opacity in left upper lobe (arrow). (b, c) Note the progression of airspace disease 3 days later, with new foci of ground-glass opacities (black arrows, b, c), as well as developing consolidation (white arrow). Additionally, there is higher peripheral attenuation with ground-glass opacities more centrally representing the reversed halo sign (curved arrows, c). (d, e) Further increase in extent of ground glass changes with new cavity in right lung (arrow, d) as well as new areas of consolidation (arrow, e) are seen on CT images 5 days after presentation.

Figure 3a:

(a) Note the peripheral predominant airspace opacities with a reversed halo pattern in the left upper lobe (arrow). (b, c) Organizing changes with increasing attenuation are noted on follow-up CT images.

Figure 3b:

(a) Note the peripheral predominant airspace opacities with a reversed halo pattern in the left upper lobe (arrow). (b, c) Organizing changes with increasing attenuation are noted on follow-up CT images.

Figure 3c:

(a) Note the peripheral predominant airspace opacities with a reversed halo pattern in the left upper lobe (arrow). (b, c) Organizing changes with increasing attenuation are noted on follow-up CT images.