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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Influenza A (H1N1) pneumonia: an analysis of 63 cases by chest CT
Min Li1, Jian-bing Zhu, Guang-qiang Chen
1Department of Radiology, Fifth People's Hospital of Suzhou, Suzhou, Jiangsu 215000, China.
Background:
In early April 2009, cases of human infection with 2009 pandemic influenza A (H1N1) virus were identified in Mexico. The virus then spread rapidly to other regions of the world. From October 2009, sporadic imported cases of novel influenza A (H1N1) were continuously confirmed in Suzhou. The aim of the study was to review the chest CT findings in 63 patients with laboratory-confirmed novel swine-origin influenza A (H1N1) virus (S-OIV) infection.
Methods:
Chest CT examinations were collected from 63 S-OIV infected patients during their hospital stay. Three experienced radiologists inspected images to qualitatively and quantitatively characterize S-OIV induced image changes. CT scores of lesion severity were calculated based on the percentage of affected area to determine severity of infectious lesions. Patients were divided into two groups based on the leukocyte counts. Lesion patterns, local distributions, and quantitative measures were investigated and compared between the two groups.
Results:
Various degrees of bilateral multifocal lesions of ground-glass opacities were found with or without consolidations on the chest CT images. The lesions were both bronchocentric and centrilobular. Patients with elevated leukocyte counts had more extensive lesions, in terms of severity and affected area, than the patients with normal leukocyte counts. The lesion severity scores of patients in the elevated leukocyte group were significantly higher than those of the normal leukocyte group in terms of the entire lung area (P < 0.01), and upper (P < 0.05) and lower (P < 0.01) lobes as well. There were changes in the CT characteristics seen at follow-up as demonstrated by lesions absorption (P < 0.01), especially in the upper lobe of the lung (P < 0.01), but less so in the middle lobe/lingual and lower lobe of the lung (P > 0.05).
Conclusions:
The most common CT findings in S-OIV infection patients were bilateral multifocal distributed ground-glass opacities and consolidations. The lesions were located dominantly at bronchocentric and centrilobular areas. Lung lesions were more obviously absorbed in upper lobes between two examinations. The observations and analysis from this study provide information that may be useful in image understanding and patient management for future pandemic influenza.
Insights
Novel swine-origin influenza A (H1N1) virus infection in Suzhou presented with bilateral multifocal ground-glass opacities and consolidations on chest CT scans. Elevated leukocyte counts correlated with more severe lung lesions, which showed better absorption in upper lobes.
Area of Science:
- Radiology
- Infectious Diseases
- Pulmonology
Background:
- The 2009 pandemic influenza A (H1N1) virus rapidly spread globally after initial cases in Mexico.
- Sporadic imported cases of novel H1N1 were confirmed in Suzhou starting October 2009.
- This study focuses on chest CT findings in patients with confirmed swine-origin influenza A (H1N1) virus (S-OIV) infection.
Purpose of the Study:
- To review and characterize chest CT findings in 63 patients with laboratory-confirmed S-OIV infection.
- To investigate lesion patterns, distributions, and quantitative measures in S-OIV patients.
- To compare CT findings between patients with normal and elevated leukocyte counts.
Main Methods:
- Collected chest CT examinations from 63 S-OIV infected patients.
- Three radiologists qualitatively and quantitatively analyzed CT images for S-OIV-induced changes.
- Calculated CT scores for lesion severity and compared findings based on leukocyte counts.
Main Results:
- Bilateral multifocal ground-glass opacities and consolidations were common CT findings, predominantly bronchocentric and centrilobular.
- Patients with elevated leukocyte counts exhibited more extensive and severe lesions compared to those with normal counts.
- Lesion absorption was observed on follow-up CT, particularly in the upper lobes.
Conclusions:
- Bilateral multifocal ground-glass opacities and consolidations are characteristic CT findings of S-OIV infection.
- Leukocyte count is a useful indicator of lesion severity in S-OIV patients.
- Understanding these CT findings aids in image interpretation and patient management during influenza pandemics.
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