scholarly journals The “Target Sign” in a 46-Year-Old Patient with COVID-19 Pneumonia

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Alexandra Pérez Pérez ◽  
Rahul Lazarus ◽  
Anju Dubey
Keyword(s):  
Ground Glass Opacity ◽  
Lung Parenchyma ◽  
Ground Glass ◽  
Multiple Target ◽  
Target Sign ◽  
Halo Sign ◽  
Perivascular Inflammation ◽  
Peripheral Ring ◽  
Initial Work ◽  
Work Up

COVID-19 has various imaging manifestations, most commonly peripheral ground-glass opacities with a basilar posterior predominance. Less common imaging manifestations include consolidations, findings typical of organizing pneumonia, such as “halo” or a “reverse halo” sign, and vascular enlargement. Our case describes a “target sign” on CT, which is uncommon but is increasingly being recognized. The target sign consists of a central nodular opacity with surrounding ground-glass opacity, then a surrounding relatively lucent ring, and a more peripheral ring of consolidation or ground-glass opacification. This may be the sequela of focal vascular enlargement, endothelial injury, microangiopathy, and perivascular inflammation. The case described involves a 46-year-old male who presented with subjective fevers, nonproductive cough, and hypoxia, subsequently diagnosed with COVID-19. CT imaging performed as part of initial work-up revealed multifocal ground-glass opacities scattered throughout the lung parenchyma, as well as multiple target sign lesions. Although it is a rare finding, the target sign, when present, may suggest the diagnosis of COVID-19.

scholarly journals Chest CT target sign in a couple with COVID-19 pneumonia

2020 ◽  
Vol 53 (4) ◽  
pp. 252-254 ◽  
Author(s):  
C. Isabela Silva Müller ◽  
Nestor L. Müller
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Real Time ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Chain Reaction ◽  
Target Sign ◽  
Peripheral Ring ◽  
Polymerase Chain

Abstract We describe a target sign on chest CT characterized by a combination of peripheral ring-like opacity and a central nodular ground-glass opacity surrounding a vessel in a couple with COVID-19 pneumonia confirmed by real-time reverse transcriptase fluorescence polymerase chain reaction sputum analysis.

scholarly journals Diagnostic performance of chest CT in differentiating COVID-19 from other causes of ground-glass opacities

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ali H. Elmokadem ◽  
Dalia Bayoumi ◽  
Sherif A. Abo-Hedibah ◽  
Ahmed El-Morsy
Keyword(s):  
Diagnostic Performance ◽  
Pulmonary Nodules ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Halo Sign ◽  
Traction Bronchiectasis ◽  
Chest Ct Scan

Abstract Background To evaluate the diagnostic performance of chest CT in differentiating coronavirus disease 2019 (COVID-19) and non-COVID-19 causes of ground-glass opacities (GGO). Results A total of 80 patients (49 males and 31 females, 46.48 ± 16.09 years) confirmed with COVID-19 by RT-PCR and who underwent chest CT scan within 2 weeks of symptoms, and 100 patients (55 males and 45 females, 48.94 ± 18.97 years) presented with GGO on chest CT were enrolled in the study. Three radiologists reviewed all CT chest exams after removal of all identifying data from the images. They expressed the result as positive or negative for COVID-19 and recorded the other pulmonary CT features with mention of laterality, lobar affection, and distribution pattern. The clinical data and laboratory findings were recorded. Chest CT offered diagnostic accuracy ranging from 59 to 77.2% in differentiating COVID-19- from non-COVID-19-associated GGO with sensitivity from 76.25 to 90% and specificity from 45 to 67%. The specificity was lower when differentiating COVID-19 from non-COVID-19 viral pneumonias (30.5–61.1%) and higher (53.1–70.3%) after exclusion of viral pneumonia from the non-COVID-19 group. Patients with COVID-19 were more likely to have lesions in lower lobes (p = 0.005), peripheral distribution (p < 0.001), isolated ground-glass opacity (p = 0.043), subpleural bands (p = 0.048), reverse halo sign (p = 0.005), and vascular thickening (p = 0.013) but less likely to have pulmonary nodules (p < 0.001), traction bronchiectasis (p = 0.005), pleural effusion (p < 0.001), and lymphadenopathy (p < 0.001). Conclusions Chest CT offered reasonable sensitivity when differentiating COVID-19- from non-COVID-19-associated GGO with low specificity when differentiating COVID-19 from other viral pneumonias and moderate specificity when differentiating COVID-19 from other causes of GGO.

scholarly journals Early Computed Tomography Findings of Novel Coronavirus Disease 2019 (COVID-19) Pneumonia

2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Pinar Diydem Yilmaz ◽  
Cengiz Kadiyoran ◽  
Suleyman Bakdik ◽  
Necdet Poyraz ◽  
Hulya Vatansev
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Pleural Thickening ◽  
Halo Sign ◽  
Ct Findings ◽  
Novel Coronavirus ◽  
Ct Features

Background: Novel coronavirus disease (COVID-19) pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and threatens human health. Chest computed tomography (CT) is an accurate imaging modality for diagnosis and follow-up. Objectives: To investigate early CT features of COVID-19 pneumonia. Methods: Retrospective study. Sixty-three patients with COVID-19 pneumonia (28 men, 35 women; age range, 21 - 85 years; mean, 59 years) confirmed by reverse transcription-polymerase chain reaction (RT-PCR) were enrolled in this retrospective study and CT findings were evaluated. Patients were classified into three groups for estimating COVID-19 pneumonia, according to CT features. Results: Nineteen (30%) patients classified as out of COVID-19 pneumonia had normal CT findings. Twenty-eight (44%) patients, classified as highly suggestive for COVID-19 pneumonia, had typical findings for COVID-19 pneumonia. In highly suggestive for COVID-19 pneumonia group most common CT features were peripheral (64%), multilobar (96%), patchy, and round (54%) ground-glass opacity (GGO) (57%). Air bronchogram (93%), crazy-paving patterns (79%), and vascular thickening (61%) were the most common special findings. We only detected these rare findings such as halo sign, reverse halo sign, lymphadenopathy, pleural and pericardial effusion, pleural thickening, and fibrotic lines in patients with COVID-19 with chronic diseases. Conclusions: The early CT findings are peripheral, multilobar, patchy, and round ground glass opacities accompanied by vascular thickening, crazy-paving pattern, or air bronchogram sign. Rare findings are only seen in the presence of concomitant diseases.

Atypical CT manifestations of pulmonary sarcoidosis

MedAlliance ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 71-81
Keyword(s):  
Abdominal Surgery ◽  
Lymph Nodes ◽  
Interstitial Pneumonia ◽  
Ground Glass Opacity ◽  
Lung Parenchyma ◽  
Pulmonary Sarcoidosis ◽  
Diagnostic Methods ◽  
Pulmonary Diseases ◽  
Ground Glass ◽  
Granulomatous Disease

SummarySarcoidosis is a granulomatous disease of unknown etiol-ogy that affects different organs and tissues. Pulmonary, mediastinal, and intrathoracic lymph nodes involvement occur in about 90% of patients with sarcoidosis. Radio-logical manifestations of pulmonary sarcoidosis vary sig-nificantly. This article describes focal and reticulonodu-lar changes, as well as consolidation zones and fibroticchanges. Isolated reticular changes due to thickening of intra-, and interlobular septa occur in approximately 50% of sarcoid patients. However, this CT pattern pre-vails only in 15–20% of patients. As a rule, in 80% of sar-coid patients changes in lung parenchyma are combined with intrathoracic lymphadenopathy. In the majority of cases, these changes are bilateral. In 10–13% of patients, foci 89–12 mm in diameter are detected. These foci have a homogenous structure and a well-defined outline. They locate mainly along costal and interlobar pleura, in interlobular septa, and may resemble metastases. In 2.4–4% of patients, these small foci, typical for sarcoid-osis are absent, while the changes are presented by larger nodular masses (>2 cm in diameter) or by masses with fuzzy outlines. Often sarcoidosis mimicking interstitial pneumonia is manifested by the ground-glass opacity of spot-like shape. Abnormalities are located in the up-per lobes. This sign occurs in 16–83% of sarcoidotic pa-tients, mainly at the onset of the disease. It usually com-bines with focal changes in the lungs and intrathoracic lymphadenopathy. Cavitary forms of sarcoidosis are also described. Conclusion. There are multiple pulmonary sarcoidosis manifestations on CT, and they vary a lot. The former allows suspecting the diagnosis, which is later confirmed clinically, morphologically, or by lab meth-ods. Аtypical radiological forms of lung sarcoidosis often mimic other pulmonary diseases. These forms require in-vasive diagnostic methods including abdominal surgery.

scholarly journals HRCT Chest Evaluation of COVID-19 Patients: Experience in Combined Military Hospital Dhaka, Bangladesh

2020 ◽  
pp. 21-28
Author(s):  
Syed Zoherul Alam ◽  
SMA Al Muid ◽  
Afroza Akhter ◽  
AKM Sharifur Rahman ◽  
Md Al Emran ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Military Hospital ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Pulmonary Lesions ◽  
Halo Sign ◽  
Polymerase Chain ◽  
Patients Experience

Background: HRCT Chest is an important tool in both diagnosis and management of COVID-19 patient, as well as it is an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose: The purpose of this study is to assess different patterns of manifestation in HRCT chest in COVID-19 infection & to grade the severity by observing a sample of 128 after the symptoms began. Method: From 11 April 2020 to 27 May 2020, 128 patients who were admitted in Combined Military Hospital Dhaka and underwent both HRCT chest and RT-PCR for COVID- 19 were included. Distribution and patterns of pulmonary lesions like ground glass opacity (GGO), consolidation, reverse halo sign, crazy paving, thickened vascular marking, lymphadenopathy and pleural effusion were evaluated. Result: Total 128 patients diagnosed (RT-PCR Positive) with COVID-19 were included. Among them, 112(87.5%) patients had fever, and 58(45.31%) patients had fatigability. The most frequent CT abnormality was ground glass opacity in 123(96.09%) cases. Amongst them 81(63.28%) cases had GGO plus consolidation and ground glass opacity alone were 42(32.81%) cases. Crazy-paving pattern was in 65(50.78%) cases. Most patients had multiple lesions and involved all the 5 lobes in 96(75.00%) cases. The lesions were mostly peripheral (123,96.09%) and posterior (103,80.47%) and in 65(50.78%) cases the distribution were diffuse but predominantly peripheral. Most commonly involved lobe is right lower lobe (120,93.75%) and left lower lobe(117,91.41%). Conclusion: HRCT chest can play an important role in the early diagnosis and prompt management of this global health emergency. J Bangladesh Coll Phys Surg 2020; 38(0): 21-28

scholarly journals Legionella pneumonia presenting with reverse halo sign

2020 ◽  
Vol 1 ◽  
pp. 35-38
Author(s):  
Chris Kyriakopoulos ◽  
Konstantinos Tatsis
Keyword(s):  
Legionella Pneumophila ◽  
Distress Syndrome ◽  
Ground Glass Opacity ◽  
Community Acquired Pneumonia ◽  
Ground Glass ◽  
Antigen Test ◽  
Cryptogenic Organizing Pneumonia ◽  
Radiographic Findings ◽  
Legionella Pneumonia ◽  
Halo Sign

A case of a previously healthy man with community-acquired pneumonia who progressed to acute respiratory distress syndrome, with reverse halo sign (RHS) on chest computed tomography, is reported. A urinary Legionella antigen test was positive for Legionella pneumophila. The typical radiographic features of Legionella pneumonia are bilateral or unilateral, single or multifocal airspace opacifications (most common), and/or ground-glass opacities. However, a wide variety of radiographic findings have been observed. The RHS is characterized by a central ground-glass opacity surrounded by a more or less complete ring of consolidation. First reported in cryptogenic organizing pneumonia, it was initially thought to be specific for this disease, but was subsequently described in a variety of neoplastic and non-neoplastic pulmonary diseases. In this manuscript, we present a case of Legionella pneumonia with a RHS.

scholarly journals Ground-glass opacity of the lung parenchyma: a guide to analysis with high-resolution CT.

1993 ◽  
Vol 160 (2) ◽  
pp. 249-251 ◽  
Author(s):  
C E Engeler ◽  
J H Tashjian ◽  
S W Trenkner ◽  
J W Walsh
Keyword(s):  
High Resolution ◽  
Ground Glass Opacity ◽  
Lung Parenchyma ◽  
Ground Glass ◽  
High Resolution Ct

scholarly journals Organizing pneumonia: chest HRCT findings

2015 ◽  
Vol 41 (3) ◽  
pp. 231-237 ◽  
Author(s):  
Igor Murad Faria ◽  
Gláucia Zanetti ◽  
Miriam Menna Barreto ◽  
Rosana Souza Rodrigues ◽  
Cesar Augusto Araujo-Neto ◽  
...  
Keyword(s):  
Random Distribution ◽  
Lung Parenchyma ◽  
Ground Glass ◽  
Common Finding ◽  
Organizing Pneumonia ◽  
Halo Sign ◽  
Lower Lung ◽  
Reversed Halo Sign ◽  
Hrct Finding ◽  
Interlobular Septal Thickening

OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia. METHODS: This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus. RESULTS: The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly bilateral, the middle and lower lung fields being the areas most commonly affected. CONCLUSIONS: Ground-glass opacities and consolidation were the most common findings, with a predominantly random distribution, although they were more common in the middle and lower thirds of the lungs.

scholarly journals Differential Diagnosis of New-Onset Pulmonary Ground Glass Changes During the COVID-19 Pandemic: a Case Report

2021 ◽  
Vol 101 (6) ◽  
pp. 358-368
Author(s):  
N. L. Karpina ◽  
I. V. Sivokozov ◽  
I. Yu. Shabalina ◽  
L. A. Semenova ◽  
R. B. Asanov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Case ◽  
Hypersensitivity Pneumonitis ◽  
Left Lung ◽  
Ground Glass Opacity ◽  
Lung Parenchyma ◽  
Diagnostic Error ◽  
Ground Glass ◽  
Biopsy Material ◽  
The Right

The paper describes a clinical case of hypersensitivity pneumonitis in a young patient during the COVID-19 pandemic when the patient having complaints of dyspnea and interstitial lung changes as ground glass opacity was initially unambiguously diagnosed with viral COVID-related bilateral pneumonia. The chief computed tomography manifestations in the lung were infiltrative inflammatory changes as numerous areas of predominantly interstitial infiltration by the type of ground glass, with consolidation areas and reticular changes, varying in extent, peripheral localization, mainly in the lower lobes and with the 25–50% involvement of the right and left lung parenchyma. The diagnosis of hypersensitivity pneumonitis was confirmed by cytological and histological examinations of the biopsy material obtained during bronchoscopy using a set of biopsies and endobronchial cryobiopsy.This clinical case demonstrates that the chest computed tomography detection of pulmonary ground glasstype changes is a reason for further patient examinations and requires morphological verification of the diagnosis, since the cost of a diagnostic error is the life of a patient.

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