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Published on: December 19, 2020
Patterns of COVID-19 on computed tomography imaging
Insights
Computed tomography (CT) scans revealed that all early coronavirus disease 2019 (COVID-19) patients in Hong Kong presented with peripheral subpleural ground-glass opacities. These characteristic CT findings aid in identifying COVID-19 cases during outbreaks.
Area of Science:
- Radiology
- Infectious Diseases
- Pulmonology
Background:
- Hong Kong's designated tertiary referral center for infectious diseases managed the initial COVID-19 cases.
- Understanding early radiological manifestations is crucial for timely diagnosis and patient management.
Purpose of the Study:
- To elucidate the typical computed tomography (CT) findings in the earliest patients diagnosed with coronavirus disease 2019 (COVID-19) in Hong Kong.
- To correlate radiological patterns with confirmed COVID-19 diagnoses.
Main Methods:
- Retrospective review of CT scans from 19 confirmed COVID-19 patients admitted between January 22 and February 29, 2020.
- Analysis of high-resolution or conventional thoracic CT imaging features.
Main Results:
- All patients (100%) exhibited peripheral subpleural ground-glass opacities (GGO).
- Common findings included involvement of all lobes (84.2%), focal subsegmental consolidations (73.7%), and interlobular septal thickening (63.2%).
- Absence of mediastinal lymph node enlargement, centrilobular nodules, or pleural effusion was noted in all cases.
Conclusions:
- Consistent CT findings of peripheral subpleural GGO, without zonal predominance and in the absence of specific other features, are indicative of COVID-19.
- These radiological patterns are valuable for identifying COVID-19 and assessing patients during outbreaks.
Purpose:
As the designated tertiary referral centre for infectious diseases in Hong Kong, our hospital received the city's first group of patients diagnosed with coronavirus disease 2019 (COVID-19). Herein, we studied the earliest patients admitted to our centre in order to clarify the typical radiological findings, particularly computed tomography (CT) findings, associated with COVID-19.
Methods:
From 22 January 2020 to 29 February 2020, 19 patients with confirmed COVID-19 underwent high-resolution or conventional CT scans of the thorax in our centre. The CT imaging findings of these patients with confirmed COVID-19 in Hong Kong were reviewed in this study.
Results:
Ground-glass opacities (GGO) with peripheral subpleural distribution were found in all patients (100%). No specific zonal predominance was observed. All lobes were involved in 16 (84.2%) patients, focal subsegmental consolidations were observed in 14 (73.7%) patients, and interlobular septal thickening was present in 12 (63.2%) patients. No mediastinal lymph node enlargement, centrilobular nodule, or pleural effusion was detected in any of the patients. Other imaging features present in several patients include bronchial dilatation, bronchial wall thickening, and crazy-paving patterns.
Conclusions:
Peripheral subpleural GGO without zonal predominance in the absence of centrilobular nodule, pleural effusion, and lymph node enlargement were consistent findings in patients with confirmed COVID-19. The observed radiological patterns on CT scans can help identify COVID-19 and assess affected patients in the context of the ongoing outbreak.
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