Chest CT features of the novel coronavirus disease COVID-19

A new type of coronavirus 2019-nCoV is rapidly spreading worldwide and causes pneumonia, respiratory distress, thromboembolic events, and death. Chest computed tomography CT plays an essential role in the diagnosis of viral pneumonia, monitoring disease progression, determination of disease severity, and evaluating therapeutic efficacy. Chest CT can show important clues of 2019-nCoV disease also known as COVID-19 in patients with an appropriate clinic. Prompt diagnosis of COVID-19 is essential to prevent disease transmission and provides close clinical observation of patients with clinically severe disease. Therefore, radiologists and clinicians should be familiar with the CT imaging findings of COVID-19 pneumonia. Herein, we aimed to review the imaging findings of COVID-19 pneumonia and examine the critical points to be considered for imaging in cases with COVID-19 suspicion.

___

  • 1. Zhu N, Zhang D, Wang W, Li X, Yang B et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine 2020; 382(8): 727-733. doi: 10.1056/NEJMoa2001017
  • 2. World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report–96. Geneva, Switzerland: World Health Organization; 2020.
  • 3. Xu Z, Shi L, Wang Y, Zhang J, Huang L et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respiratory Medicine 2020; 8(4): 420-422.
  • 4. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S et al. COVID19-associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features. Radiology 2020: 201187. doi: 10.1148/ radiol.2020201187 [Epub ahead of print]
  • 5. Zhou F, Yu T, Du R, Fan G, Liu Y et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229): 1054-1062.
  • 6. Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP et al. The role of chest imaging in patient management during the COVID-19 pandemic: a multinational consensus statement from the Fleischner Society. Radiology 2020; 201365.
  • doi:10.1148/radiol.2020201365 [Epub ahead of print] 7. China National Health Commission. Diagnosis and Treatment of Pneumonitis Caused by New Coronavirus (trial version 7). Pekin, China: China NHC; 2020.
  • 8. World Health Organization. Country & Technical GuidanceCoronavirus Disease (COVID-19). Geneva, Switzerland: WHO; 2020.
  • 9. Xie X, Zhong Z, Zhao W, Zheng C, Wang F et al. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology 2020: 200343. doi: 10.1148/ radiol.2020200343 [Epub ahead of print]
  • 10. Fang Y, Zhang H, Xie J, Lin M, Ying L et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020: 200432. doi: 10.1148/radiol.2020200432 [Epub ahead of print]
  • 11. Chung M, Bernheim A, Mei X, Zhang N, Huang M et al. CT imaging features of 2019 novel coronavirus (2019- nCoV). Radiology 2020; 295(1): 202-207. doi: 10.1148/ radiol.2020200230
  • 12. Ufuk F. 3D CT of novel coronavirus (COVID-19) pneumonia. Radiology 2020: 201183. doi: 10.1148/radiol.2020201183 [Epub ahead of print]
  • 13. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology 2020: 200463. doi: 10.1148/radiol.2020200463 [Epub ahead of print]
  • 14. Wu J, Wu X, Zeng W, Guo D, Fang Z et al. Chest CT findings in patients with corona virus disease 2019 and its relationship with clinical features. Investigative Radiology 2020; 55(5): 257- 261. doi: 10.1097/RLI.0000000000000670
  • 15. Huang P, Liu T, Huang L, Liu H, Lei M et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 2020; 295(1): 22-23. doi: 10.1148/radiol.2020200330
  • 16. Yang W, Sirajuddin A, Zhang X, Liu G, Teng Z et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). European Radiology 2020. doi: 10.1007/s00330-020-06827-4 [Epub ahead of print]
  • 17. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008; 246: 697-722.
  • 18. Song F, Shi N, Shan F, Zhang Z, Shen J et al. Emerging 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology 2020; 295(1): 210-217.
  • 19. Pan Y, Guan H, Zhou S. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. European Radiology 2020. doi: 10.1007/s00330-020-06731-x [Epub ahead of print]
  • 20. Ng M, Lee EYP, Yang J, Yang F, Li X et al. Imaging profile of the COVID-19 infection: radiologic findings and literature review. Radiology: Cardiothoracic Imaging 2020; 2(1): e200034. doi: 10.1148/ryct.2020200034
  • 21. Pan F, Ye T, Sun P, Gui S, Liang B et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020: 200370. doi: 10.1148/radiol.2020200370 [Epub ahead of print]
  • 22. Han R, Huang L, Jiang H, Dong J, Peng H et al. Early clinical and CT manifestations of coronavirus disease 2019 (COVID-19) pneumonia. AJR American Journal of Roentgenology 2020: 1-6. doi: 10.2214/AJR.20.22961 [Epub ahead of print]
  • 23. Xu X, Yu C, Qu J, Zhang L, Jiang S et al. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. European Journal of Nuclear Medicine and Molecular Imaging 2020; 47(5): 1275-1280.
  • 24. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR American Journal of Roentgenology 2020; 214(5): 1072-1077.
  • 25. Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. AJR American Journal of Roentgenology 2020: 1-8. doi: 10.2214/AJR.20.22975 [Epub ahead of print]
  • 26. Xu YH, Dong JH, An WM, Lv XY, Yin XP et al. Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARS-CoV-2. Journal of Infection 2020; 80(4): 394-400. doi: 10.1016/j.jinf.2020.02.017
  • 27. Li Y, Xia L. Coronavirus disease 2019 (COVID-19): role of chest CT in diagnosis and management [published online ahead of print, 2020 March 4]. AJR American Journal of Roentgenology 2020; 1-7. doi:10.2214/AJR.20.22954
  • 28. Yang W, Cao Q, Qin L, Wang X, Cheng Z et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. Journal of Infection 2020; 80(4): 388-393. doi:10.1016/j.jinf.2020.02.016
  • 29. Ai T, Yang Z, Hou H, Zhan C, Chen C et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 Cases. Radiology 2020; 200642. doi:10.1148/radiol.2020200642 [Epub ahead of print]
  • 30. Li K, Wu J, Wu F, Guo D, Chen L et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Investigative Radiology 2020; 10.1097/ RLI.0000000000000672. doi:10.1097/RLI.0000000000000672 [Epub ahead of print]
  • 31. Xiong Y, Sun D, Liu Y, Fan Y, Zhao L et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Investigative Radiology 2020; 10.1097/RLI.0000000000000674. doi:10.1097/ RLI.0000000000000674 [Epub ahead of print]
  • 32. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020. doi:10.1148/ radiol.2020200823 [Epub ahead of print]
  • 33. Cheng Z, Lu Y, Cao Q, Qin L, Pan Z et al. Clinical features and chest CT manifestations of coronavirus disease 2019 (COVID-19) in a single-center study in Shanghai, China. AJR American Journal of Roentgenology 2020; 1-6. doi:10.2214/ AJR.20.22959 [Epub ahead of print]
  • 34. Shi H, Han X, Jiang N, Cao Y, Alwalid O et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infectious Diseases 2020; 20(4): 425-434. doi:10.1016/S1473-3099(20)30086-4
  • 35. Wang J, Xu Z, Wang J, Feng R, An Y et al. CT characteristics of patients infected with 2019 novel coronavirus: association with clinical type. Clinical Radiology 2020. doi:10.1016/j. crad.2020.04.001 [Epub ahead of print]
  • 36. Fan N, Fan W, Li Z, Shi M, Liang Y. Imaging characteristics of initial chest computed tomography and clinical manifestations of patients with COVID-19 pneumonia. Japanese Journal of Radiology 2020. doi:10.1007/s11604-020-00973-x [Epub ahead of print]
  • 37. Colombi D, Bodini FC, Petrini M, Maffi G, Morelli N et al. Wellaerated lung on admitting chest CT to predict adverse outcome in COVID-19. Radiology 2020. doi:10.1148/radiol.2020201433 [Epub ahead of print]
  • 38. Zhang R, Ouyang H, Fu L, Wang S, Han J et al. CT features of SARS-CoV-2 pneumonia according to clinical presentation: a retrospective analysis of 120 consecutive patients from Wuhan City. European Radiology 2020. doi:10.1007/s00330-020-06854- 1 [Epub ahead of print]
  • 39. Zhu T, Wang Y, Zhou S, Zhang N, Xia L. A comparative study of chest computed tomography features in young and older adults with corona virus disease (COVID-19). Journal of Thoracic Imaging 2020. doi:10.1097/RTI.0000000000000513 [Epub ahead of print]
  • 40. Wang K, Kang S, Tian R, Zhang X, Zhang X et al. Imaging manifestations and diagnostic value of chest CT of coronavirus disease 2019 (COVID-19) in the Xiaogan area. Clinical Radiology 2020; 75(5): 341-347. doi:10.1016/j.crad.2020.03.004
  • 41. Li K, Fang Y, Li W, Pan C, Qin P et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). European Radiology 2020. doi:10.1007/ s00330-020-06817-6 [Epub ahead of print]
  • 42. Guan CS, Lv ZB, Yan S, Du YN, Chen H et al. Imaging features of coronavirus disease 2019 (COVID-19): evaluation on thin-section CT. Academic Radiology 2020; 27(5): 609-613. doi:10.1016/j.acra.2020.03.002
  • 43. Liu KC, Xu P, Lv WF, Qiu XH, Yao JL et al. CT manifestations of coronavirus disease-2019: A retrospective analysis of 73 cases by disease severity. European Journal of Radiology 2020; 126: 108941. doi:10.1016/j.ejrad.2020.108941
  • 44. Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute pulmonary embolism associated with COVID-19 pneumonia detected by pulmonary CT angiography. Radiology 2020; 201544. doi:10.1148/radiol.2020201544 [Epub ahead of print]
  • 45. Oudkerk M, Büller HR, Kuijpers D, van Es N, Oudkerk SF et al. Diagnosis, prevention, and treatment of thromboembolic complications in COVID-19: report of the National Institute for Public Health of the Netherlands. Radiology 2020. doi:10.1148/ radiol.2020201629 [Epub ahead of print]
  • 46. Ajlan AM, Ahyad RA, Jamjoom LG, Alharthy A, Madani TA. Middle East respiratory syndrome coronavirus (MERSCoV) infection: chest CT findings. AJR American Journal of Roentgenology 2014; 203(4): 782-787. doi: 10.2214/AJR.14.130
  • 47. Leonard-Lorant I, Delabranche X, Severac F, Helms J, Pauzet C et al. Acute pulmonary embolism in COVID-19 patients on CT angiography and relationship to D-Dimer levels. Radiology 2020. doi:10.1148/radiol.2020201561 [Epub ahead of print]
  • 48. Rodrigues JCL, Hare SS, Edey A, Devaraj A, Jacob J et al. An update on COVID-19 for the radiologist - a British society of Thoracic imaging statement. Clinical Radiology 2020; 75(5): 323‐325. doi:10.1016/j.crad.2020.03.003
  • 49. Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH et al. Radiological society of north America Expert Consensus Statement on reporting chest CT findings related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiology: Cardiothoracic Imaging 2020; 2(2): e200152.
  • 50. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19) imaging reporting and data system (COVID-RADS) and common lexicon: a proposal based on the imaging data of 37 studies. European Radiology 2020. doi:10.1007/s00330-020-06863-0 [Epub ahead of print]
  • 51. Prokop M, van Everdingen W, van Rees Vellinga T, Quarles van Ufford J, Stöger L et al. CO-RADS - A categorical CT assessment scheme for patients with suspected COVID-19: definition and evaluation. Radiology 2020; 201473. doi:10.1148/radiol.2020201473 [Epub ahead of print]
  • 52. Qi X, Lei J, Yu Q, Xi Y, Wang Y et al. CT imaging of coronavirus disease 2019 (COVID-19): from the qualitative to quantitative. Annals of Translational Medicine 2020; 8(5): 256. doi:10.21037/atm.2020.02.91
  • 53. Bai HX, Wang R, Xiong Z, Hsieh B, Chang K et al. AI augmentation of radiologist performance in distinguishing COVID-19 from pneumonia of other etiology on chest CT. Radiology 2020. doi:10.1148/radiol.2020201491 [Epub ahead of print]
  • 54. Dangis A, Gieraerts C, De Bruecker Y, Janssen L, Valgaeren H et al. Accuracy and reproducibility of low-dose submillisievert chest CT for the diagnosis of COVID-19. Radiology: Cardiothoracic Imaging 2020; 2(2). doi: 10.1148/ ryct.2020200196 [Epub ahead of print]
  • 55. Mossa-Basha M, Meltzer CC, Kim DC, Tuite MJ, Kolli KP et al. Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel. Radiology 2020; 200988. doi: 10.1148/radiol.2020200988 [Epub ahead of print]
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Esra ÖRENLİLİ YAYLAGÜL, Celal ÜLGER

Efficacy of the population-based pilot colorectal cancer screening, Csongrád county, Hungary, 2015

Mariann RUTKA, Renata BOR, Tamas MOLNAR, Klaudia FARKAS, Daniella PIGNICZKI, Anna FABIAN, Mark GYŐRFFY, Anita BALINT, Agnes MILASSIN, Ferenc NAGY, Zoltan SZEPES, Monika SZÜCS, Laszlo TISZLAVICZ

Clinical characteristics and long-term outcome of Takayasu arteritis in Iran: a multicentre study

Aida MALEK MAHDAVI, Nadereh RASHTCHIZADEH, Hadise KAVANDI, Mehrzad HAJIALILO, Sousan KOLAHI, Mohammad Reza JAFARI NAKHJAVANI, Ali-asghar EBRAHIMI, Alireza KHABBAZI, Seyedmostafa SEYEDMARDANI, Mansour SALESI, Mohsen SOROUSH

Aıda Malek MAHDAVI, Nadereh RASHTCHIZADEH, Hadıseh KAVANDI, Mehrzad HAJIALILO, Sousan KOLAHI, Mohammad-reza NAKHJAVANI, Alı-asghar EBRAHIMI, Seyedmostafa SEYEDMARDANI, Mansour SALESI, Mohsen SOROUSH, Alıreza KHABBAZI

Gökçen KARTAL ÖZTÜRK, Aykut EŞKİ, Figen ÇELEBİ ÇELİK, Seçil CONKAR, Figen GÜLEN, Esen DEMİR, Ahmet KESKİNOĞLU

Dilek DÜLGER, Özgür ALBUZ

Which Bayley-III cut-off values should be used in different developmental levels?

Halil İbrahim YAKUT, Pelin ÇELİK, İclal AYRANCI SUCAKLI

Neuroprotective effects of quercetin on cerebral vasospasm following experimental subarachnoid haemorrhage in rats

Berrak GÜVEN, Şanser GÜL, Evren AYDOĞMUŞ, Burak BAHADIR, Çağatay BÜYÜKUYSAL

Gülçin BABAOĞLU, Banu KILIÇASLAN, Aysun Ankay YILBAŞ, Bilge ÇELEBİOĞLU

Betül Yavuz KELEŞ, Meltem VURAL, Burcu ÖNDER, Kadriye ÖNEŞ