The features and longitudinal changes on high-resolution computed tomography for patients with coronavirus disease 2019_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

DIAO Kaiyue ^# , HAN Peilun ^# , PANG Tong , HUANG Shan , LI Yuan , BAI Hongli ,  YANG Zhigang

Department of Radiology, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YANG Zhigang, Email: yangzg666@163.com

Keywords：

CT; Coronavirus disease 2019; Pneumonia

DOI：

10.7507/1671-6205.202003017

Video：

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Objective To investigate the high-resolution computed tomography (HRCT) signs of patients diagnosed with the coronavirus disease 2019 (COVID-19) and explore its evolution features during hospitalization.Methods From January 17, 2020 to February 26, 2020, HRCT images from 15 COVID-19 patients were analyzed. All the patients had positive nucleic acid test results of SARS-CoV-2. The imaging features of initial and follow-up of each patient were reviewed and graded based on the severity of lung lesions.Results Among the 15 COVID-19 patients, ground-glass opacity (GGO) was found in 14 cases. Six patients presented with consolidation and 3 with fibrosis. Five patients had multi-lobe involvement. Subpleural distribution pattern was present in 12 patients (80.0%) and peribronchovascular distribution pattern was present in 2 patients (13.3%). The severity score on HRCT images at the follow-up was significantly higher than that at the initial (4.6±3.4 vs. 3.5±2.5, P=0.018 2). Increase of random distribution pattern (5 cases) were also noted at the follow-up.Conclusions Chest HRCT of COVID-19 patients is characterized with GGO mainly distributed in subpleural areas and a rapid progression within a short time interval. HRCT could provide a sensitive monitor to observe disease progression for COVID-19 patients.

Citation： DIAO Kaiyue, HAN Peilun, PANG Tong, HUANG Shan, LI Yuan, BAI Hongli, YANG Zhigang. The features and longitudinal changes on high-resolution computed tomography for patients with coronavirus disease 2019. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(2): 166-171. doi: 10.7507/1671-6205.202003017 Copy

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1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J/OL]. Lancet, 2020, 395(10223): 497-506.
2. 國家衛生健康委員會, 國家中醫藥管理局. 國衛辦醫函〔2020〕103號關于印發新型冠狀病毒感染的肺炎診療方案(試行第六版)的通知[EB/OL]. 2020-02-18. http://www.nhc.gov.cn/xcs/zhengcwj/202002/8334a8326dd94d329df351d7da8aefc2/files/b218cfeb1bc54639af227f922bf6b817.pdf.
3. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of 2019 novel coronavirus infection in China[J/OL].2020-02-09. https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1.
4. Yang ZG, Sone S, Takashima S, et al. High-resolution CT analysis of small peripheral lung adenocarcinomas revealed on screening helical CT. Am J Roentgenol, 2001, 176(6): 1399-1407.
5. Antonio GE, Wong KT, Hui DS, et al. Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge: preliminary experience. Radiology, 2003, 228(3): 810-815.
6. Chung M, Bernheim A, Mei X, et al. CT Imaging features of 2019 novel coronavirus (2019-nCoV) [J/OL]. Radiology. 2020-02-04. https://pubs.rsna.org/doi/10.1148/radiol.2020200230.
7. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in coronavirus disease-19(COVID-19): relationship to duration of infection[J/OL]. Radiology. 2020-02-20https://pubs.rsna.org/doi/10.1148/radiol.2020200463.
8. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020, 323(11): 1061-1069.
9. Hui DS, Memish ZA, Zumla A. Severe acute respiratory syndrome vs. the Middle East respiratory syndrome. Curr Opin Pulm Med, 2014, 20(3): 233-241.
10. Liu WJ, Zhao M, Liu K, et al. T-cell immunity of SARS-CoV: Implications for vaccine development against MERS-CoV. Antiviral Res, 2017, 1: 82-92.
11. Karhade AV, Shah KC, Shah AA, et al. Neutrophil to lymphocyte ratio and mortality in spinal epidural abscess. Spine J, 2019, 19(7): 1180-1185.
12. Lee JH, Song S, Yoon SY, et al. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as diagnostic markers for pneumonia severity. Br J Biomed Sci, 2016, 73(3): 140-142.
13. Jia J, Zheng X, Chen Y, et al. Stage-dependent changes of preoperative neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in colorectal cancer. Tumour Biol, 2015, 36(12): 9319-9325.
14. Ketai L, Paul NS, Wong KT. Radiology of severe acute respiratory syndrome (SARS): the emerging pathologic-radiologic correlates of an emerging disease. J Thorac Imaging, 2006, 21(4): 276-283.
15. 馮元春, 楊志剛. 塵肺高分辨率 CT 表現特征及病理、生理學基礎. 生物醫學工程學雜志, 2010, 27(1): 219-221.
16. Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCRtesting in coronavirus disease 2019(COVID-19) in China: A reportof 1014 cases[J/OL]. Radiology, 2020-02-26. https://pubs.rsna.org/doi/10.1148/radiol.2020200642.
17. Liu JY, Liu Y, Xiang P, et al. Neutrophil-to-lymphocyte ratiopredicts severe illness patients with 2019 novel coronavirus in theearly stage[J/OL]. MedRxiv, 2020-02-12. https://www.medrxiv.org/content/10.1101/2020.02.10.20021584v1.
18. Wong KT, Antonio GE, Hui DS, et al. Severe acute respiratory syndrome: thin-section computed tomography features, temporal changes, and clinicoradiologic correlation during the convalescent period. J Comput Assist Tomogr, 2004, 28(6): 790-795.
19. Ajlan AM, Ahyad RA, Jamjoom LG, et al. Middle East respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. Am J Roentgenol, 2014, 203(4): 782-787.
20. Das KM, Lee EY, Al Jawder SE, et al. Acute Middle East respiratory syndrome coronavirus: temporal lung changes observed on the chest radiographs of 55 patients. Am J Roentgenol, 2015, 205(3): W267-W274.
21. Kanne JP. Chest CT findings in 2019 novel coronavirus (2019-ncov) infections from Wuhan, China: Key Points for the Radiologist[J/OL]. Radiology, 2020-02-04. https://pubs.rsna.org/doi/10.1148/radiol.2020200241.
22. Zhao W, Zhong Z, Xie XZ, et al. CT scans of patients with 2019 novel coronavirus (COVID-19) pneumonia[J/OL]. Theranostics, 2020. http://thno.org/toc/acceptms1.

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