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Updated: Aug 23, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Do COVID-19 CT features vary between patients from within and outside mainland China? Findings from a meta-analysis
Nianzong Hou1,2, Lin Wang3, Mingzhe Li4
1Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, China.
Insights
Chest CT scans are valuable for diagnosing coronavirus disease 2019 (COVID-19). However, CT findings in China differ from those globally, requiring awareness of regional variations for accurate diagnosis.
Area of Science:
- Radiology
- Infectious Diseases
- Medical Imaging
Background:
- Chest computerized tomography (CT) is crucial for diagnosing coronavirus disease 2019 (COVID-19).
- Previous research has not systematically compared COVID-19 CT findings between mainland China and other regions.
- Understanding these differences is vital for accurate global diagnosis.
Approach:
- A systematic review and meta-analysis of studies published before April 15, 2022, was conducted.
- Studies were sourced from PubMed, Embase, and Cochrane Library, with quality assessed using QUADAS.
- Data were analyzed to compare diagnostic performance and imaging features between patients from mainland China and those outside.
Key Points:
- The diagnostic value of chest CT for COVID-19 is comparable globally (93% vs. 91%).
- Incidence rates of unilateral lung involvement, crazy-paving sign, mixed GGO and consolidations, air bronchogram, vascular engorgement, bronchial wall thickening, and septal thickening were higher in mainland China.
- Bilateral lung involvement, ground-glass opacities (GGO), consolidations, nodules, and pleural effusion were more common outside mainland China.
Conclusions:
- Chest CT findings for COVID-19 pneumonia exhibit significant regional variations.
- Radiologists and clinicians must be aware of diverse CT presentations across different geographical areas.
- Tailoring diagnostic interpretation to regional CT patterns improves COVID-19 detection accuracy.
Background:
Chest computerized tomography (CT) plays an important role in detecting patients with suspected coronavirus disease 2019 (COVID-19), however, there are no systematic summaries on whether the chest CT findings of patients within mainland China are applicable to those found in patients outside.
Methods:
Relevant studies were retrieved comprehensively by searching PubMed, Embase, and Cochrane Library databases before 15 April 2022. Quality assessment of diagnostic accuracy studies (QUADAS) was used to evaluate the quality of the included studies, which were divided into two groups according to whether they were in mainland China or outside. Data on diagnostic performance, unilateral or bilateral lung involvement, and typical chest CT imaging appearances were extracted, and then, meta-analyses were performed with R software to compare the CT features of COVID-19 pneumonia between patients from within and outside mainland China.
Results:
Of the 8,258 studies screened, 19 studies with 3,400 patients in mainland China and 14 studies with 554 outside mainland China were included. Overall, the risk of quality assessment and publication bias was low. The diagnostic value of chest CT is similar between patients from within and outside mainland China (93, 91%). The pooled incidence of unilateral lung involvement (15, 7%), the crazy-paving sign (31, 21%), mixed ground-glass opacities (GGO) and consolidations (51, 35%), air bronchogram (44, 25%), vascular engorgement (59, 33%), bronchial wall thickening (19, 12%), and septal thickening (39, 26%) in patients from mainland China were significantly higher than those from outside; however, the incidence rates of bilateral lung involvement (75, 84%), GGO (78, 87%), consolidations (45, 58%), nodules (12, 17%), and pleural effusion (9, 15%) were significantly lower.
Conclusion:
Considering that the chest CT features of patients in mainland China may not reflect those of the patients abroad, radiologists and clinicians should be familiar with various CT presentations suggestive of COVID-19 in different regions.
