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Review
. 2021 Jun 14;18(12):6434.
doi: 10.3390/ijerph18126434.

Role of Chest Imaging in Viral Lung Diseases

Diletta Cozzi  1   2 , Eleonora Bicci  1 , Alessandra Bindi  1 , Edoardo Cavigli  1 , Ginevra Danti  1 , Michele Galluzzo  3 , Vincenza Granata  2   4 , Silvia Pradella  1   2 , Margherita Trinci  3 , Vittorio Miele  1
Affiliations
Review

Role of Chest Imaging in Viral Lung Diseases

Diletta Cozzi et al. Int J Environ Res Public Health. .

Abstract

The infection caused by novel beta-coronavirus (SARS-CoV-2) was officially declared a pandemic by the World Health Organization in March 2020. However, in the last 20 years, this has not been the only viral infection to cause respiratory tract infections leading to hundreds of thousands of deaths worldwide, referring in particular to severe acute respiratory syndrome (SARS), influenza H1N1 and Middle East respiratory syndrome (MERS). Although in this pandemic period SARS-CoV-2 infection should be the first diagnosis to exclude, many other viruses can cause pulmonary manifestations and have to be recognized. Through the description of the main radiological patterns, radiologists can suggest the diagnosis of viral pneumonia, also combining information from clinical and laboratory data.

Keywords: COVID-19; computed tomography; coronavirus; differential diagnosis; viral pneumonia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chest radiograph in COVID-19 pneumonia. Three cases of supine chest X-ray with subpleural consolidations (arrows), in (A,B) with bilateral involvement, and in (C) with main involvement of the right lung.
Figure 2
Figure 2
HRCT (High resolution computed tomography) in COVID-19 pneumonia. Diffuse ground-glass opacities involving both lungs (A) and with peri-lobular pattern (B) in the acute phase of the infection. (C,D) show two cases of sub-acute interstitial pneumonia, with decrease in ground-glass opacities and the presence of subpleural focal consolidations and thickening of the interlobular/intralobular interstitium.
Figure 3
Figure 3
Influenza A. Figures in (A–C) show a case of influenza A with an interstitial pattern very similar to COVID-19: ground-glass opacities are mainly subpleural and bilateral, with a peri-lobular pattern of distribution. Figure (D) is a supine chest radiograph of the same patient, with diffuse interstitial involvement.
Figure 4
Figure 4
H1N1 interstitial pneumonia. These images (A–D) show a case of H1N1 related-pneumonia complicated in acute respiratory distress syndrome (ARDS), with diffuse and bilateral ground-glass opacities and traction bronchiectasis/bronchiolectasis.
Figure 5
Figure 5
Adenovirus pneumonia and Swyer–James syndrome. Figure in (A) shows a case of acute adenovirus pneumonia, with typical multifocal and lobar ground-glass opacities, similar to bacterial pneumonia. Images in (B,C) show a case of long-term complication, a unilateral hyperlucent lung (Swyer–James–MacLeod syndrome).
Figure 6
Figure 6
Herpes virus pneumonia. A case of HSV (Herpes virus) (A–C) pneumonia with bilateral ground-glass opacities with patchy distribution, mainly in both upper lobes.
Figure 7
Figure 7
Varicella. A case of acute varicella pneumonia (A) with focal nodular consolidations (arrows) and its chronic form with small, tiny calcifications, well-visible in Maximum Intensity Projection (MIP) reconstruction (B).
Figure 8
Figure 8
Cytomegalovirus pneumonia. Images in (A–C) show a case of mild parenchymal involvement on CMV pneumonia. Figures (D,E) show a patient with diffuse ground-glass opacities with a crazy-paving appearance, visible also in the chest radiograph (F).
Figure 9
Figure 9
Epstein–Barr virus (EBV) pneumonia. A case of EBV pneumonia showing mediastinal lymphadenopathies (arrows in (A,C)) associated with focal, lobular ground-glass opacities in both lungs (B,D).
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