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Updated: Dec 13, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Imaging of COVID-19 pneumonia in children
Figen Palabiyik1, Suna Ors Kokurcan2, Nevin Hatipoglu3
1Department of Pediatric Radiology, Health Science University, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Insights
Pediatric COVID-19 pneumonia imaging differs from adults. Chest X-rays are often sufficient for diagnosis in children, with CT scans reserved for specific clinical indications.
Area of Science:
- Pediatric Radiology
- Infectious Disease Imaging
- Respiratory Medicine
Background:
- Limited literature exists on pediatric COVID-19 pneumonia imaging findings and diagnostic contributions.
- Understanding differences from adult presentations is crucial for accurate diagnosis in children.
Purpose of the Study:
- To evaluate chest X-ray and chest CT findings in pediatric patients diagnosed with COVID-19 pneumonia.
- To identify characteristic imaging patterns specific to children.
Main Methods:
- Retrospective analysis of chest X-ray findings in 59 pediatric patients.
- Retrospective analysis of chest CT findings in 22 pediatric patients with confirmed COVID-19 pneumonia.
Main Results:
- Chest X-rays commonly showed unilateral, lower-lobe lung involvement in pediatric COVID-19 pneumonia.
- Chest CT revealed bilateral, multifocal involvement (55%) and ground-glass opacities (41%) as frequent findings.
- Lesions were often peripherally and centrally co-distributed (55%), with significant lower lobe involvement (69%).
Conclusions:
- Imaging findings of COVID-19 pneumonia in children can differ from adult presentations.
- Chest X-ray is recommended as the primary imaging modality in pediatric cases to minimize radiation exposure.
- Chest CT should be utilized selectively for further evaluation when radiographic findings are equivocal or clinical suspicion is high.
Objective:
Literature related to the imaging of COVID-19 pneumonia, its findings and contribution to diagnosis and its differences from adults are limited in pediatric patients. The aim of this study was to evaluate chest X-ray and chest CT findings in children with COVID-19 pneumonia.
Methods:
Chest X-ray findings of 59 pediatric patients and chest CT findings of 22 patients with a confirmed diagnosis of COVID-19 pneumonia were evaluated retrospectively.
Results:
COVID-19 pneumonia was most commonly observed unilaterally and in lower zones of lungs in chest X-ray examinations. Bilateral and multifocal involvement (55%) was the most observed involvement in the CT examinations, as well as, single lesion and single lobe (27%) involvement were also detected. Pure ground-glass appearance was observed in 41%, ground-glass appearance and consolidation together was in 36%. While peripheral and central co-distribution of the lesions (55%) were frequently observed, the involvement of the lower lobes (69%) was significant. In four cases,the coexistence of multiple rounded multifocal ground-glass appearance and rounded consolidation were observed.
Conclusion:
COVID-19 pneumonia imaging findings may differ in the pediatric population from adults. In diagnosis, chest X-ray should be preferred, CT should be requested if there is a pathologic finding on radiography that merits further evaluation and if clinically indicated.
Advances In Knowledge:
Radiological findings of COVID-19 observed in children may differ from adults. Chest X-ray should often be sufficient in children avoiding additional irradiation, chest CT needs only be done in cases of clinical necessity.
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