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Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia

OBJECTIVES: To investigate the different CT characteristics which may distinguish influenza from 2019 coronavirus disease (COVID-19). METHODS: A total of 13 confirmed patients with COVID-19 were enrolled from January 16, 2020, to February 25, 2020. Furthermore, 92 CT scans of confirmed patients with...

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Autores principales: Wang, Hao, Wei, Ran, Rao, Guihua, Zhu, Jie, Song, Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175830/
https://www.ncbi.nlm.nih.gov/pubmed/32323011
http://dx.doi.org/10.1007/s00330-020-06880-z
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author Wang, Hao
Wei, Ran
Rao, Guihua
Zhu, Jie
Song, Bin
author_facet Wang, Hao
Wei, Ran
Rao, Guihua
Zhu, Jie
Song, Bin
author_sort Wang, Hao
collection PubMed
description OBJECTIVES: To investigate the different CT characteristics which may distinguish influenza from 2019 coronavirus disease (COVID-19). METHODS: A total of 13 confirmed patients with COVID-19 were enrolled from January 16, 2020, to February 25, 2020. Furthermore, 92 CT scans of confirmed patients with influenza pneumonia, including 76 with influenza A and 16 with influenza B, scanned between January 1, 2019, to February 25, 2020, were retrospectively reviewed. Pulmonary lesion distributions, number, attenuation, lobe predomination, margin, contour, ground-glass opacity involvement pattern, bronchial wall thickening, air bronchogram, tree-in-bud sign, interlobular septal thickening, intralobular septal thickening, and pleural effusion were evaluated in COVID-19 and influenza pneumonia cohorts. RESULTS: Peripheral and non-specific distributions in COVID-19 showed a markedly higher frequency compared with the influenza group (p < 0.05). Most lesions in COVID-19 showed balanced lobe localization, while in influenza pneumonia they were predominantly located in the inferior lobe (p < 0.05). COVID-19 presented a clear lesion margin and a shrinking contour compared with influenza pneumonia (p < 0.05). COVID-19 had a patchy or combination of GGO and consolidation opacities, while a cluster-like pattern and bronchial wall thickening were more frequently seen in influenza pneumonia (p < 0.05). The lesion number and attenuation, air bronchogram, tree-in-bud sign, interlobular septal thickening, and intralobular septal thickening were not significantly different between the two groups (all p > 0.05). CONCLUSIONS: Though viral pneumonias generally show similar imaging features, there are some characteristic CT findings which may help differentiating COVID-19 from influenza pneumonia. KEY POINTS: • CT can play an early warning role in the diagnosis of COVID-19 in the case of no epidemic exposure. • CT could be used for the differential diagnosis of influenza and COVID-19 with satisfactory accuracy. • COVID-19 had a patchy or combination of GGO and consolidation opacities with peripheral distribution and balanced lobe predomination.
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spelling pubmed-71758302020-04-22 Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia Wang, Hao Wei, Ran Rao, Guihua Zhu, Jie Song, Bin Eur Radiol Chest OBJECTIVES: To investigate the different CT characteristics which may distinguish influenza from 2019 coronavirus disease (COVID-19). METHODS: A total of 13 confirmed patients with COVID-19 were enrolled from January 16, 2020, to February 25, 2020. Furthermore, 92 CT scans of confirmed patients with influenza pneumonia, including 76 with influenza A and 16 with influenza B, scanned between January 1, 2019, to February 25, 2020, were retrospectively reviewed. Pulmonary lesion distributions, number, attenuation, lobe predomination, margin, contour, ground-glass opacity involvement pattern, bronchial wall thickening, air bronchogram, tree-in-bud sign, interlobular septal thickening, intralobular septal thickening, and pleural effusion were evaluated in COVID-19 and influenza pneumonia cohorts. RESULTS: Peripheral and non-specific distributions in COVID-19 showed a markedly higher frequency compared with the influenza group (p < 0.05). Most lesions in COVID-19 showed balanced lobe localization, while in influenza pneumonia they were predominantly located in the inferior lobe (p < 0.05). COVID-19 presented a clear lesion margin and a shrinking contour compared with influenza pneumonia (p < 0.05). COVID-19 had a patchy or combination of GGO and consolidation opacities, while a cluster-like pattern and bronchial wall thickening were more frequently seen in influenza pneumonia (p < 0.05). The lesion number and attenuation, air bronchogram, tree-in-bud sign, interlobular septal thickening, and intralobular septal thickening were not significantly different between the two groups (all p > 0.05). CONCLUSIONS: Though viral pneumonias generally show similar imaging features, there are some characteristic CT findings which may help differentiating COVID-19 from influenza pneumonia. KEY POINTS: • CT can play an early warning role in the diagnosis of COVID-19 in the case of no epidemic exposure. • CT could be used for the differential diagnosis of influenza and COVID-19 with satisfactory accuracy. • COVID-19 had a patchy or combination of GGO and consolidation opacities with peripheral distribution and balanced lobe predomination. Springer Berlin Heidelberg 2020-04-22 2020 /pmc/articles/PMC7175830/ /pubmed/32323011 http://dx.doi.org/10.1007/s00330-020-06880-z Text en © European Society of Radiology 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Chest
Wang, Hao
Wei, Ran
Rao, Guihua
Zhu, Jie
Song, Bin
Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia
title Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia
title_full Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia
title_fullStr Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia
title_full_unstemmed Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia
title_short Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia
title_sort characteristic ct findings distinguishing 2019 novel coronavirus disease (covid-19) from influenza pneumonia
topic Chest
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175830/
https://www.ncbi.nlm.nih.gov/pubmed/32323011
http://dx.doi.org/10.1007/s00330-020-06880-z
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