Chest computed tomography findings of COVID-19 pneumonia: pictorial essay with literature review
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PICTORIAL ESSAY
Chest computed tomography findings of COVID‑19 pneumonia: pictorial essay with literature review Michaela Cellina1 · Marcello Orsi1 · Carlo Valenti Pittino2 · Tahereh Toluian2 · Giancarlo Oliva1 Received: 12 April 2020 / Accepted: 19 June 2020 © Japan Radiological Society 2020
Abstract Available information on chest Computed Tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) is constantly evolving. Ground glass opacities and consolidation with bilateral and peripheral distribution were reported as the most common CT findings, but also less typical features could be identified. All radiologists should be aware of the imaging spectrum of the COVID-19 pneumonia and imaging changes in the course of the disease. Our aim is to display the chest CT findings at first assessment and follow-up through a pictorial essay, to help in the recognition of these features for an accurate diagnosis. Keywords Pneumonia · Viral · Coronavirus · COVID-19 · Severe acute respiratory syndrome coronavirus 2 · Tomography · Spiral computed
Introduction In December 2019, the outbreak of an epidemical pneumonia, of initially unidentified origin occurred in Wuhan, Hubei Province, China [1]. Its cause was identified in a new virus, the “2019 novel coronavirus (2019-nCoV)” or “severe acute respiratory syndrome (SARS)-CoV-2”, which was subsequently named coronavirus disease (COVID-19) [2]. On January 30, 2020, the World Health Organization (WHO) declared a global public health emergency; on March 11, 2020, the pandemic declaration was made [3]. As of May 5, 2020, a total of 3,435,894 confirmed cases and 239,604 deaths have been reported [4]. Due to the current absence of specific therapies and vaccines for this infection, the detection of the disease at an Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11604-020-01010-7) contains supplementary material, which is available to authorized users. * Michaela Cellina michaela.cellina@asst‑fbf‑sacco.it 1
Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121 Milan, Italy
Scuola Di Specializzazione in Radiodiagnostica, Università Degli Studi Di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
2
early stage, with the isolation of the infected subjects from the healthy population, is crucial. The diagnosis of COVID-19 is based on viral nucleic acid test, through the reverse transcription-polymerase chain reaction (RT-PCR) on throat swab, however, the results of this test are not immediately available and some patients can show false-negative results at the onset of the symptoms [5]. Chest X-Rays showed little diagnostic value in early stages [6], whereas chest Computed Tomography (CT) showed a high sensitivity for the diagnosis of COVID-19, particularly important in COVID-19 patients with falsenegative RT-PCR result, assuming a role for the CT as a primary tool for COVID-19 diagnosis in the epidemic areas [5, 7–9]. The 6th version
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