COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia
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COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia Mengqi Liu 1 & Wenbin Zeng 2 & Yun Wen 2 & Yineng Zheng 1 & Fajin Lv 1 & Kaihu Xiao 3 Received: 20 February 2020 / Revised: 9 April 2020 / Accepted: 28 April 2020 # European Society of Radiology 2020
Abstract Objectives To investigate the clinical and chest CT characteristics of COVID-19 pneumonia and explore the radiological differences between COVID-19 and influenza. Materials and methods A total of 122 patients (61 men and 61 women, 48 ± 15 years) confirmed with COVID-19 and 48 patients (23 men and 25 women, 47 ± 19 years) confirmed with influenza were enrolled in the study. Thin-section CT was performed. The clinical data and the chest CT findings were recorded. Results The most common symptoms of COVID-19 were fever (74%) and cough (63%), and 102 patients (83%) had Wuhan contact. Pneumonia in 50 patients with COVID-19 (45%) distributed in the peripheral regions of the lung, while it showed mixed distribution in 26 patients (74%) with influenza (p = 0.022). The most common CT features of the COVID-19 group were pure ground-glass opacities (GGO, 36%), GGO with consolidation (51%), rounded opacities (35%), linear opacities (64%), bronchiolar wall thickening (49%), and interlobular septal thickening (66%). Compared with the influenza group, the COVID-19 group was more likely to have rounded opacities (35% vs. 17%, p = 0.048) and interlobular septal thickening (66% vs. 43%, p = 0.014), but less likely to have nodules (28% vs. 71%, p < 0.001), tree-in-bud sign (9% vs. 40%, p < 0.001), and pleural effusion (6% vs. 31%, p < 0.001). Conclusions There are significant differences in the CT manifestations of patients with COVID-19 and influenza. Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. Key Points • Typical CT features of COVID-19 include pure ground-glass opacities (GGO), GGO with consolidation, rounded opacities, bronchiolar wall thickening, interlobular septal thickening, and a peripheral distribution. • Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. Keywords Coronavirus infections . Tomography, x-ray computed . Pneumonia, viral . Influenza . Human
* Fajin Lv [email protected] * Kaihu Xiao [email protected] 1
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
2
Medical Imaging Center, Chongqing Three Gorges Central Hospital, Chongqing 404100, China
3
Department of Cardiology, Chongqing Three Gorges Central Hospital, Chongqing 404100, China
Abbreviations GGO Ground-glass opacities RT-PCR Reverse transcriptase polymerase chain reaction SARS Severe acute respiratory syndrome
Introduction In December 2019, an outbreak of COVID-19
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