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Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China
OBJECTIVES: To investigate CT images of 100 confirmed COVID-19 pneumonia patients to describe the lesion distribution, CT signs, and evolution during different courses. METHODS: A retrospective study of 100 COVID-19 pneumonia patients without ARDS was performed, and CT scans were reviewed. A COVID-1...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197364/ https://www.ncbi.nlm.nih.gov/pubmed/32367418 http://dx.doi.org/10.1007/s00330-020-06879-6 |
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author | Zhou, Shuchang Zhu, Tingting Wang, Yujing Xia, LiMing |
author_facet | Zhou, Shuchang Zhu, Tingting Wang, Yujing Xia, LiMing |
author_sort | Zhou, Shuchang |
collection | PubMed |
description | OBJECTIVES: To investigate CT images of 100 confirmed COVID-19 pneumonia patients to describe the lesion distribution, CT signs, and evolution during different courses. METHODS: A retrospective study of 100 COVID-19 pneumonia patients without ARDS was performed, and CT scans were reviewed. A COVID-19 pneumonia course diagram was drawn. Mann-Whitney U test was used to compare the lesion distribution and CT scores, χ(2) test was used to compare the CT findings between different stages. RESULTS: A total of 272 CT scans from 100 patients (mean age, 52.3 years ± 13.1) were investigated. Four patients with lung abnormalities on CT first showed negative RT-PCR result and turned positive afterwards. One hundred sixty-nine (62.1%) showed predominantly peripheral distribution. The CT scores of the upper zone (3.4 ± 3.6) were significantly lower than those of the middle (5.0 ± 3.9) and lower (4.8 ± 3.6) zones (p < 0.001). The CT scores of the anterior zones (4.9 ± 4.7) were significantly lower than those of the posterior zones (8.4 ± 6.2) (p < 0.001). In the early rapid progressive stage (1~7 days), ground glass opacity (GGO) plus reticular pattern (58.1%), GGO plus consolidation (43.0%), and GGO (41.9%) were all common. In the advanced stage (8~14 days), GGO plus consolidation (79.8%) and repairing CT signs (subpleural line, bronchus distortion, and fibrotic strips) showed a significant increase (p < 0.05). In the absorption stage, GGO plus consolidation (9.1%) sharply decreased (p < 0.05). CONCLUSION: CT imaging of COVID-19 pneumonia showed a predominantly peripheral, middle and lower, and posterior distribution. The early rapid progressive stage is 1~7 days from symptom onset, the advanced stage with peak levels of abnormalities on CT is 8~14 days, and the abnormalities started to improve after 14 days. KEY POINTS: • The course of COVID-19 pneumonia consists of three stages: 1~7 days is the early rapid progressive stage, 8~14 days is the advanced stage, and after 14 days, the abnormalities started to decrease. • In the early rapid progressive stage, GGO plus a reticular pattern, GGO plus consolidation, and GGO were all common signs; in the advanced stage, signs of progression and absorption coexisted; lung abnormalities showed an asynchronous process with parts with absorption and parts progressing. • Lung abnormalities mainly showed predominantly peripheral, middle, and lower distribution. |
format | Online Article Text |
id | pubmed-7197364 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-71973642020-05-05 Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China Zhou, Shuchang Zhu, Tingting Wang, Yujing Xia, LiMing Eur Radiol Chest OBJECTIVES: To investigate CT images of 100 confirmed COVID-19 pneumonia patients to describe the lesion distribution, CT signs, and evolution during different courses. METHODS: A retrospective study of 100 COVID-19 pneumonia patients without ARDS was performed, and CT scans were reviewed. A COVID-19 pneumonia course diagram was drawn. Mann-Whitney U test was used to compare the lesion distribution and CT scores, χ(2) test was used to compare the CT findings between different stages. RESULTS: A total of 272 CT scans from 100 patients (mean age, 52.3 years ± 13.1) were investigated. Four patients with lung abnormalities on CT first showed negative RT-PCR result and turned positive afterwards. One hundred sixty-nine (62.1%) showed predominantly peripheral distribution. The CT scores of the upper zone (3.4 ± 3.6) were significantly lower than those of the middle (5.0 ± 3.9) and lower (4.8 ± 3.6) zones (p < 0.001). The CT scores of the anterior zones (4.9 ± 4.7) were significantly lower than those of the posterior zones (8.4 ± 6.2) (p < 0.001). In the early rapid progressive stage (1~7 days), ground glass opacity (GGO) plus reticular pattern (58.1%), GGO plus consolidation (43.0%), and GGO (41.9%) were all common. In the advanced stage (8~14 days), GGO plus consolidation (79.8%) and repairing CT signs (subpleural line, bronchus distortion, and fibrotic strips) showed a significant increase (p < 0.05). In the absorption stage, GGO plus consolidation (9.1%) sharply decreased (p < 0.05). CONCLUSION: CT imaging of COVID-19 pneumonia showed a predominantly peripheral, middle and lower, and posterior distribution. The early rapid progressive stage is 1~7 days from symptom onset, the advanced stage with peak levels of abnormalities on CT is 8~14 days, and the abnormalities started to improve after 14 days. KEY POINTS: • The course of COVID-19 pneumonia consists of three stages: 1~7 days is the early rapid progressive stage, 8~14 days is the advanced stage, and after 14 days, the abnormalities started to decrease. • In the early rapid progressive stage, GGO plus a reticular pattern, GGO plus consolidation, and GGO were all common signs; in the advanced stage, signs of progression and absorption coexisted; lung abnormalities showed an asynchronous process with parts with absorption and parts progressing. • Lung abnormalities mainly showed predominantly peripheral, middle, and lower distribution. Springer Berlin Heidelberg 2020-05-04 2020 /pmc/articles/PMC7197364/ /pubmed/32367418 http://dx.doi.org/10.1007/s00330-020-06879-6 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 Zhou, Shuchang Zhu, Tingting Wang, Yujing Xia, LiMing Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China |
title | Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China |
title_full | Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China |
title_fullStr | Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China |
title_full_unstemmed | Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China |
title_short | Imaging features and evolution on CT in 100 COVID-19 pneumonia patients in Wuhan, China |
title_sort | imaging features and evolution on ct in 100 covid-19 pneumonia patients in wuhan, china |
topic | Chest |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197364/ https://www.ncbi.nlm.nih.gov/pubmed/32367418 http://dx.doi.org/10.1007/s00330-020-06879-6 |
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