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Updated: Nov 11, 2025

Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
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Lethal COVID-19: Radiologic-Pathologic Correlation of the Lungs

Maurice Henkel1, Thomas Weikert1, Katharina Marston1

  • 1Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.).

Radiology. Cardiothoracic Imaging
|March 29, 2021
PubMed

Insights

This study correlated CT scans with autopsy findings in fatal COVID-19 cases. Key findings show ground-glass opacities and consolidation on CT correlate with diffuse alveolar damage and vascular changes in the lungs.

Area of Science:

  • Radiology
  • Pathology
  • Pulmonology

Background:

  • Coronavirus disease 2019 (COVID-19) is a severe respiratory illness.
  • Understanding the pathological basis of COVID-19 is crucial for patient management.
  • CT imaging is a primary tool for diagnosing and monitoring COVID-19 pneumonia.

Purpose of the Study:

  • To correlate computed tomography (CT) findings with postmortem histopathology in fatal COVID-19 cases.
  • To identify radiologic patterns associated with specific pathological changes in lethal COVID-19.
  • To elucidate the role of vascular alterations in COVID-19 pathogenesis.

Main Methods:

  • Retrospective analysis of 70 lung lobes from 14 patients deceased from COVID-19.
  • Correlation of antemortem CT scans with postmortem autopsy findings.
  • Lobewise comparison of radiologic and histopathologic observations graded by severity.

Main Results:

  • Ground-glass opacities (GGO) and consolidation were predominant CT findings.
  • Histopathology revealed diffuse alveolar damage, capillary congestion, and microthrombi in all cases.
  • CT findings of GGO and consolidation corresponded to diffuse alveolar damage, vascular congestion, and microthrombosis.

Conclusions:

  • CT findings, particularly GGO, significantly correlate with diffuse alveolar damage, capillary congestion, and microthrombosis.
  • Vascular alterations are confirmed as critical pathophysiologic drivers in fatal COVID-19.
  • This study highlights the importance of integrating CT imaging with pathology for understanding severe COVID-19.
Abstract

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