2019 novel coronavirus (COVID-19) pneumonia: CT manifestations and pattern of evolution in 110 patients in Jiangxi, Chin
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2019 novel coronavirus (COVID-19) pneumonia: CT manifestations and pattern of evolution in 110 patients in Jiangxi, China Jie Zhan 1,2 & Haijun Li 1,2 & Honghui Yu 1,2 & Xiaochen Liu 3 & Xianjun Zeng 1,2 & Dechang Peng 1,2
&
Wei Zhang 4
Received: 29 April 2020 / Revised: 9 August 2020 / Accepted: 18 August 2020 # European Society of Radiology 2020
Abstract Objectives To elucidate the CT manifestations and patterns of evolution in patients with COVID-19 pneumonia. Methods This is a retrospective review of CT scans of 110 patients. All 110 patients had initial and second CT scans, 60 of 110 patients had three serial CT scans, and 17 of 60 patients had four serial CT scans. Numerous characteristics of pulmonary and extrapulmonary abnormalities and recognizable patterns of evolution were evaluated. Results Of the 110 initial CT scans, ground-glass opacities without consolidation (65.4%) were more common than a consolidation or mixed pattern. The most common findings were subpleural involvement (77.2%), multifocal involvement (80.7%), and bilateral involvement (67.3%). Three serial CT scans of 60 patients showed four patterns of CT evolution: type 1 showing relatively high CT scores on initial CT (averaged 4 days after symptom onset), with mild progression and improvement on follow-up CT scans (25%); type 2 with progression of CT findings from initial CT to first follow-up CT (averaged 9 days after symptom onset) with subsequent improvement on second follow-up CT (averaged 13 days after symptom onset, 61.7%); type 3 with no CT changes (5.0%); and type 4 pattern was similar to type 2 but with a more prolonged course and more severe CT findings (8.3%). Conclusions Predominant findings at initial CT scans were bilateral multifocal subpleural GGO. The most commonly shown evolution pattern was type 2: progression of disease with increased extent and density of opacities on first follow-up CT followed by improvement on second follow-up CT. Key Points • Predominant findings at initial CT in patients with COVID-19 infection are bilateral multifocal subpleural ground-glass opacities. • Ill-defined patchy or nodular opacities were most commonly observed on CT scans with the right lower lobe most commonly involved. • The most commonly shown evolution pattern on chest CT was type 2: progression of CT findings from initial CT to first followup CT with subsequent improvement on second follow-up CT. Keywords Coronavirus . Infections . COVID-19 . Pneumonia . Tomography, X-ray
Abbreviations COVID-19 Coronavirus disease 2019 CT Computed tomography GGO Ground-glass opacities
Introduction In December 2019, a series of respiratory disease cases of unknown etiology were reported in Wuhan, Hubei, China
Jie Zhan and Haijun Li contributed equally to this work. * Dechang Peng [email protected]
2
Jiangxi Province Medical Imaging Research Institute, Nanchang 330006, China
* Wei Zhang [email protected]
3
Department of Radiology, University of Toledo Medical Center, 3000 Arlington Ave, Toledo, OH, USA
4
Department of Res
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