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Computed Tomography Results of Patients with COVID-19: Typical and Atypical Findings

Year 2020, Volume: 4 Issue: 3, 109 - 116, 12.12.2020
https://doi.org/10.46332/aemj.792717

Abstract

Purpose: We aimed to investigate typical and atypical thorax computed tomography (CT) findings of COVID-19 pa-tients.

Material and Methods: Thorax CT scans of the patients with reverse-transcriptase polymerase chain reaction (RT-PCR) confirmed diagnosis of COVID-19 between March 2020 and April 2020 were reviewed retrospectively. The frequencies of ground-glass opacity, consolidation, prominence of bronchovascular marking, fibrosis, nodule, septal thickening, reversed halo, pleural effusion and, mediastinal lymphadenopathy were examined. Lesions were classified into the following categories: bilateral/unilateral involvement, peripheral/central involvement, upper/middle/lower lobe involvement.

Results: A total of 53 patients (Mean age 48,38±20,97) with RT-PCR confirmed COVID-19 was enrolled in the study. 14 (26%) patients showed no finding on Thorax CT. Among the remaining 39 patients (74%) with findings on CT, ground-glass opacity was detected in 85%, consolidation in 56%, ground glass density consolidation in 59%, promi-nent bronchovascular markings in 28% who have findings on computed tomography. Among atypical findings, nodule was seen in 20 %, septal thickening in 30%, fibrosis in 10%, pleural effusion in 8%, air bronchograms in 18%, re-versed halo sign in 5% of the patients. Mediastinal lymphadenopathy was not observed. Lesions tended to be multifo-cal and peripheral as they commonly located bilaterally in middle and lower lobes.

Conclusion: Thorax CT is a very important diagnostic aid for COVID-19 patients. Categorizing parenchymal involve-ment into typical and atypical findings may facilitate the diagnostic process.

References

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  • 2. WHO. Naming the coronavirus disease (COVID-19) and the virus that causes it. 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-technicalguidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Erişim tarihi: 22 Mart 2020.
  • 3. WHO Director-General's opening remarks at the media briefing on COVID-19. 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19 Erişim tarihi: 30 Mart 2020.
  • 4. WJ Guan, ZY Ni, Y Hu, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382 (18):1708-1720.
  • 5. Hu Z, Song C, Xu C, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China Sci China Life Sci. 2020;63(5):706-711.
  • 6. Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):32-40.
  • 7. Li Y, Yao L, Li J, et al. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol. 2020;92(7):903-908.
  • 8. Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):e4.
  • 9. Kim JY, Choe PG, Oh Y, et al. The First Case of 2019 Novel Coronavirus Pneumonia Imported into Korea from Wuhan, China: Implication for Infection Prevention and Control Measures. J Korean Med Sci. 2020;35(5):e61.
  • 10. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. 2020;30(6):3306-3309.
  • 11. Perlman S. Another Decade, Another Coronavirus. N Engl J Med. 2020;382(8):760-762.
  • 12. Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020;296(2):113-114.
  • 13. Pan F, Ye T, Sun P, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715-721.
  • 14. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology.2020;295(1):202-207.
  • 15. Kong W, Agarwal PP. Chest Imaging Appearance of COVID-19 Infection. Radiology: Cardiothoracic Imag-ing 2020;2(1):e200028
  • 16. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Du-ration of Infection. Radiology. 2020;295(3):200463.
  • 17. Bai HX, Hsieh B, Xiong Z, et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020;296(2):46-54.
  • 18. Franquet T. Imaging of pulmonary viral pneumonia. Radiology. 2011;260(1):18-39.
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  • 25. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
  • 26. Falaschi Z, Danna PSC, Arioli R, et al. Chest CT accuracy in diagnosing COVID-19 during the peak of the Italian epidemic: A retrospective correlation with RT-PCR testing and analysis of discordant cases. Eur J Radiol. 2020;130:109192.
  • 27. Caruso D, Zerunian M, Polici M, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):79-85.
  • 28. Meng H, Xiong R, He R, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect. 2020;81(1):33-39.
  • 29. Ye Z, Zhang Y, Wang Y, et al. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30(8):4381-4389.
  • 30. Yoon SH, Lee KH, Kim JY, et al. Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Ko-rea. Korean J Radiol. 2020;21(4):494-500.
  • 31. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425-434.
  • 32. Song F, Shi N, Shan F, et al. Emerging 2019 Novel Coro-navirus (2019-nCoV) Pneumonia. Radiology. 2020;295(1):210-217.
  • 33. Carotti M, Salaffi F, Sarzi-Puttini P, et al. Chest CT fea-tures of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists. Radiol Med. 2020;125(7):636-646.

COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular

Year 2020, Volume: 4 Issue: 3, 109 - 116, 12.12.2020
https://doi.org/10.46332/aemj.792717

Abstract

Amaç: Bu çalışmada COVID-19 tanısı alan hastaların toraks bilgisayarlı tomografi (BT) sonuçlarını inceleyip, tipik ve atipik bulguları literatür eşliğinde sunmayı amaçladık.

Araçlar ve Yöntem: Hastanemize mart ve nisan aylarında başvuran ve reverse transkriptaz-polimeraz zincir reaksiyo-nu (RT-PZR) ile COVID-19 tanısı alan hastaların toraks BT’leri retrospektif olarak değerlendirildi. Akciğer parankim bulgularından buzlu cam sahaları, konsolidasyon, vasküler genişleme, fibrozis, nodül, septal kalınlaşma (crazy pa-ving), ters halo, plevral effüzyon ve mediastinal LAP bulguları araştırıldı. Parankimdeki tutulum yerine göre bilateral-unilateral, periferik-santral, üst-orta-alt loblardaki odak sayılarına göre lezyonların dağılımı değerlendirildi.

Bulgular: PCR pozitif olan 53 hastanın (ortalama yaş 48,38±20,97) 14’ünde (% 26) toraks BT’de bulgu yoktu. BT’de bulgusu olan 39 hastada (%74), tipik bulgulardan buzlu cam sahası (%85), konsolidasyon (%56), buzlu cam ve konso-lidasyon birlikteliği (%59), vasküler genişleme (%28) izlendi. Atipik bulgulardan nodül (%20), septal kalınlaşma (%30), fibrozis (%10), plevral efüzyon (%8), hava bronkogramı (%18), ters halo bulgusu (%5) saptandı. Hastalarımız-da mediastinal LAP saptanmadı. Toraks BT’de bilateral, orta ve alt zonlarda periferik yerleşimli multifokal odaklar tipik tutulum şekliydi. 14 hastada toraks BT negatif olup herhangi bir bulguya rastlanmadı.

Sonuç: Toraks BT, COVID-19 hastaları için tanıya yardımcı çok önemli bir yöntem olup parankim tutulumunun tipik ve atipik bulgular şeklinde kategorize edilerek değerlendirilmesi tanı sürecini kolaylaştırabilir.

References

  • 1. Li Y, Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. AJR Am J Roentgenol. 2020;214(6):1280-1286.
  • 2. WHO. Naming the coronavirus disease (COVID-19) and the virus that causes it. 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-technicalguidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Erişim tarihi: 22 Mart 2020.
  • 3. WHO Director-General's opening remarks at the media briefing on COVID-19. 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19 Erişim tarihi: 30 Mart 2020.
  • 4. WJ Guan, ZY Ni, Y Hu, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382 (18):1708-1720.
  • 5. Hu Z, Song C, Xu C, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China Sci China Life Sci. 2020;63(5):706-711.
  • 6. Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):32-40.
  • 7. Li Y, Yao L, Li J, et al. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol. 2020;92(7):903-908.
  • 8. Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):e4.
  • 9. Kim JY, Choe PG, Oh Y, et al. The First Case of 2019 Novel Coronavirus Pneumonia Imported into Korea from Wuhan, China: Implication for Infection Prevention and Control Measures. J Korean Med Sci. 2020;35(5):e61.
  • 10. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol. 2020;30(6):3306-3309.
  • 11. Perlman S. Another Decade, Another Coronavirus. N Engl J Med. 2020;382(8):760-762.
  • 12. Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020;296(2):113-114.
  • 13. Pan F, Ye T, Sun P, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715-721.
  • 14. Chung M, Bernheim A, Mei X, et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology.2020;295(1):202-207.
  • 15. Kong W, Agarwal PP. Chest Imaging Appearance of COVID-19 Infection. Radiology: Cardiothoracic Imag-ing 2020;2(1):e200028
  • 16. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Du-ration of Infection. Radiology. 2020;295(3):200463.
  • 17. Bai HX, Hsieh B, Xiong Z, et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020;296(2):46-54.
  • 18. Franquet T. Imaging of pulmonary viral pneumonia. Radiology. 2011;260(1):18-39.
  • 19. Kligerman S, Raptis C, Larsen B, et al. Radiologic, Patho-logic, Clinical, and Physiologic Findings of Electronic Cigarette or Vaping Product Use-associated Lung Injury (EVALI): Evolving Knowledge and Remaining Questions. Radiology. 2020;294(3):491-505.
  • 20. Ellis SJ, Cleverley JR, Müller NL. Drug-induced lung disease: high-resolution CT findings. AJR Am J Roentgenol. 2000;175(4):1019-1024.
  • 21. Nishino M, Hatabu H, Hodi FS. Imaging of Cancer Immunotherapy: Current Approaches and Future Directions. Radiology. 2019;290(1):9-22.
  • 22. Obadina ET, Torrealba JM, Kanne JP. Acute pulmonary injury: high-resolution CT and histopathological spectrum. Br J Radiol. 2013;86(1027):20120614.
  • 23. Akçay M, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turkish Journal of Medical Sciences. 2020;50(S1):604-610.
  • 24. Yang W, Sirajuddin A, Zhang X, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). Eur Radiol. 2020;30(9):4874-4882.
  • 25. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
  • 26. Falaschi Z, Danna PSC, Arioli R, et al. Chest CT accuracy in diagnosing COVID-19 during the peak of the Italian epidemic: A retrospective correlation with RT-PCR testing and analysis of discordant cases. Eur J Radiol. 2020;130:109192.
  • 27. Caruso D, Zerunian M, Polici M, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):79-85.
  • 28. Meng H, Xiong R, He R, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect. 2020;81(1):33-39.
  • 29. Ye Z, Zhang Y, Wang Y, et al. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30(8):4381-4389.
  • 30. Yoon SH, Lee KH, Kim JY, et al. Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Ko-rea. Korean J Radiol. 2020;21(4):494-500.
  • 31. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425-434.
  • 32. Song F, Shi N, Shan F, et al. Emerging 2019 Novel Coro-navirus (2019-nCoV) Pneumonia. Radiology. 2020;295(1):210-217.
  • 33. Carotti M, Salaffi F, Sarzi-Puttini P, et al. Chest CT fea-tures of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists. Radiol Med. 2020;125(7):636-646.
There are 33 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Muhammed Alpaslan 0000-0003-4630-7959

Sercan Özkaçmaz 0000-0002-9245-0206

Yeliz Dadalı 0000-0002-9277-5078

İlyas Dündar 0000-0002-1429-077X

Publication Date December 12, 2020
Published in Issue Year 2020 Volume: 4 Issue: 3

Cite

APA Alpaslan, M., Özkaçmaz, S., Dadalı, Y., Dündar, İ. (2020). COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular. Ahi Evran Medical Journal, 4(3), 109-116. https://doi.org/10.46332/aemj.792717
AMA Alpaslan M, Özkaçmaz S, Dadalı Y, Dündar İ. COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular. Ahi Evran Med J. December 2020;4(3):109-116. doi:10.46332/aemj.792717
Chicago Alpaslan, Muhammed, Sercan Özkaçmaz, Yeliz Dadalı, and İlyas Dündar. “COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik Ve Atipik Bulgular”. Ahi Evran Medical Journal 4, no. 3 (December 2020): 109-16. https://doi.org/10.46332/aemj.792717.
EndNote Alpaslan M, Özkaçmaz S, Dadalı Y, Dündar İ (December 1, 2020) COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular. Ahi Evran Medical Journal 4 3 109–116.
IEEE M. Alpaslan, S. Özkaçmaz, Y. Dadalı, and İ. Dündar, “COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular”, Ahi Evran Med J, vol. 4, no. 3, pp. 109–116, 2020, doi: 10.46332/aemj.792717.
ISNAD Alpaslan, Muhammed et al. “COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik Ve Atipik Bulgular”. Ahi Evran Medical Journal 4/3 (December 2020), 109-116. https://doi.org/10.46332/aemj.792717.
JAMA Alpaslan M, Özkaçmaz S, Dadalı Y, Dündar İ. COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular. Ahi Evran Med J. 2020;4:109–116.
MLA Alpaslan, Muhammed et al. “COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik Ve Atipik Bulgular”. Ahi Evran Medical Journal, vol. 4, no. 3, 2020, pp. 109-16, doi:10.46332/aemj.792717.
Vancouver Alpaslan M, Özkaçmaz S, Dadalı Y, Dündar İ. COVID-19 Tanılı Hastalarımızın Bilgisayarlı Tomografi Sonuçları: Tipik ve Atipik Bulgular. Ahi Evran Med J. 2020;4(3):109-16.

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