scholarly journals Diagnosis of Coronavirus Disease 2019 (COVID-19): Neither Chest CT nor RT-PCR Fits All

2020 ◽  
Author(s):  
Yue Teng ◽  
Hui Dai ◽  
Yalei Shang ◽  
Jianguo Xia ◽  
Yuehua Chen ◽  
...  
Keyword(s):  
False Negative ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Imaging Features ◽  
Rt Pcr ◽  
Negative Results ◽  
Halo Sign ◽  
Solid Nodule ◽  
Ct Findings

Abstract BackgroundComputed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) are the recommended tools for the diagnosis of coronavirus disease 2019 (COVID-19). The present study aimed to investigate the correlation between chest CT and RT-PCR while describing the atypical CT imaging features of COVID-19.MethodsIn this study, 418 patients in Jiangsu, China, clinically diagnosed with COVID-19 from January 10 to February 17, 2020, were included. Patients who fulfilled the following conditions were evaluated further: (1) Patients had positive RT-PCR and negative CT; (2) Patients had initial negative RT-PCR and positive CT, and follow-up PT-PCR tests were positive; (3) Patients had atypical CT findings.ResultsOf the 418 initial chest CT scans, 30 (7.2%) patients had normal CT presentation, and 6 (1.4%) patients had initial negative RT-PCR results and positive CT scans. Next, 10 (2.4%) cases of patients showed atypical CT findings, including 2 case of solid nodule, 4 cases of halo sign (solid nodule or mass surrounded by ground glass opacity), and 4 cases of predominant fibrous stripes.ConclusionsFalse-negative results can be found on both chest CT and RT-PCR; hence, the diagnosis of COVID-19 should consider both CT and RT-PCR. CT manifestations, such as solitary nodule, halo sign, and pulmonary fibrous stripes, might indicate the possibility of COVID-19 to the radiologists.

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 CT findings of 795 COVID-19 positive cases: a multicenter study in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Mohamed Mohsen Tolba Fawzi ◽  
Eman Zaki Nossair ◽  
Safaa Mohamed El-Mandooh ◽  
Amira Aly Hegazy ◽  
...  
Keyword(s):  
Virus Disease ◽  
Chest Ct ◽  
Imaging Features ◽  
Rt Pcr ◽  
Relevant Research ◽  
Non Invasive ◽  
Ct Findings ◽  
Global Pandemic ◽  
Polymerase Chain ◽  
Ct Studies

Abstract Background Corona Virus Disease 2019 (COVID-19) outbreak was officially announced as a global pandemic by the WHO on March 11th 2020. Thorough understanding of CT imaging features of COVID-19 is essential for effective patient management; rationalizing the need for relevant research. The aim of this study was to analyze the chest CT findings of patients with real-time polymerase chain reaction (RT-PCR) proved COVID-19 admitted to four Egyptian hospitals. The recently published RSNA expert consensus statement on reporting COVID-19 chest CT findings was taken into consideration. Results Normal CT “negative for COVID-19” was reported in 26.1% of our RT-PCR proved COVID-19 cases. In descending order of prevalence, imaging findings of the positive CT studies (73.9%) included GGO (69%), consolidation (49.7%), crazy paving (15.4%), and peri-lobular fibrosis (40.6%). These showed a dominantly bilateral (68.2%), peripheral (72.4%), and patchy (64.7%) distribution. Remarkably, thymic hyperplasia was identified in 14.3% of studies. According to the RSNA consensus, CT findings were classified as typical in 68.9%, indeterminate in 3.6%, and atypical in 1.4% of the evaluated CT studies. Conclusion Although COVID-19 cannot be entirely excluded by chest CT, it can be distinguished in more than two-thirds of cases; making CT a widely available, non-invasive, and rapid diagnostic tool.

scholarly journals The halo sign: HRCT findings in 85 patients

2016 ◽  
Vol 42 (6) ◽  
pp. 435-439 ◽  
Author(s):  
Giordano Rafael Tronco Alves ◽  
◽  
Edson Marchiori ◽  
Klaus Irion ◽  
Carlos Schuler Nin ◽  
...  
Keyword(s):  
Immune Status ◽  
Ground Glass Opacity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Ct Scans ◽  
Pulmonary Lesions ◽  
Halo Sign ◽  
Immunosuppressed Patients ◽  
Primary Neoplasm ◽  
Immunocompetent Patients

ABSTRACT Objective: The halo sign consists of an area of ground-glass opacity surrounding pulmonary lesions on chest CT scans. We compared immunocompetent and immunosuppressed patients in terms of halo sign features and sought to identify those of greatest diagnostic value. Methods: This was a retrospective study of CT scans performed at any of seven centers between January of 2011 and May of 2015. Patients were classified according to their immune status. Two thoracic radiologists reviewed the scans in order to determine the number of lesions, as well as their distribution, size, and contour, together with halo thickness and any other associated findings. Results: Of the 85 patients evaluated, 53 were immunocompetent and 32 were immunosuppressed. Of the 53 immunocompetent patients, 34 (64%) were diagnosed with primary neoplasm. Of the 32 immunosuppressed patients, 25 (78%) were diagnosed with aspergillosis. Multiple and randomly distributed lesions were more common in the immunosuppressed patients than in the immunocompetent patients (p < 0.001 for both). Halo thickness was found to be greater in the immunosuppressed patients (p < 0.05). Conclusions: Etiologies of the halo sign differ markedly between immunocompetent and immunosuppressed patients. Although thicker halos are more likely to occur in patients with infectious diseases, the number and distribution of lesions should also be taken into account when evaluating patients presenting with the halo sign.

scholarly journals Evaluation of chest computed tomography features in COVID-19: a single-center retrospective study

2021 ◽  
Vol 4 (4) ◽  
pp. 588-594
Author(s):  
Akshat Sanjay Shukla ◽  
Sanjay Rajendraprasad Shukla ◽  
Feral Ravi Daruwala
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
False Negative ◽  
Chest Ct ◽  
Single Center ◽  
Rt Pcr ◽  
Pulmonary Vessel ◽  
Ct Findings ◽  
Diagnostic Center ◽  
Second Wave

Background: Even though Real-Time Polymerase Chain Reaction (RT-PCR) is a gold standard for confirming COVID-19, it continues to be plagued by a lack of RT-PCR kits and the potential of false-negative results. Hence, during the second wave of COVID-19 in India, Computed Tomography (CT) scan is an emerging diagnostic tool in evaluating the severity of illness in COVID-19 pneumonia. The present study endeavored to assess chest CT features of COVID-19 pneumonia in Indian population. Methods: This was a single-center, retrospective, observational study conducted in 300 consecutive adults RT-PCR confirmed COVID-19 patients from 1, Jan 2021 to 31, March 2021 at a private radio diagnostic center.  Data regarding baseline demographics, clinical and laboratory characteristics, extent, pattern, and type of abnormal CT findings were noted. Results: The study population (204 males and 108 females) had mean age of 43.18 ± 8.27 years.  Our study's most common clinical presentation was cough (48.1%) and fever (47.1%), respectively. Lung parenchymal abnormalities were found in 294 (94.2%) patients. Abnormal CT findings revealed the involvement of bilateral (45.6%) and multilobar (42.9%) with a predominant peripheral (92.3%) and posterior (80.8%) distribution. According to the type of opacity, Ground Glass Opacity (GGO) was the dominant abnormality found in 270 (91.8%) patients, in which pure GGO (36.7%), GGO with crazy paving pattern (39.8%), and GGO mixed with consolidation (52.0 %) were noted. Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was found in 192 (65.3 %) patients. Conclusion: During the second wave of COVID-19, a chest CT scan is a modality of choice in diagnosing COVID-19 pneumonia and related lung parenchymal changes.

scholarly journals Early chest computed tomography to diagnose COVID-19 from suspected patients: A multicenter retrospective study

2020 ◽  
Author(s):  
Congliang Miao ◽  
Mengdi Jin ◽  
Li Miao ◽  
Xinying Yang ◽  
Peng Huang ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
High Specificity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Imaging Features ◽  
Rt Pcr ◽  
Polymerase Chain ◽  
Low Sensitivity ◽  
Chest Ct Scan ◽  
Ct Features

AbstractObjectiveThe purpose of this study is to distinguish the imaging features of COVID-19 with other chest infectious diseases and evaluate diagnostic value of chest CT for suspected patients.MethodsAdult suspected patients aged>18 years within 14 days who underwent chest CT scan and reverse-transcription polymerase-chain-reaction (RT-PCR) tests were enrolled. The enrolled patients were confirmed and grouped according to results of RT-PCR tests. The data of basic demographics, single chest CT features, and combined chest CT features were analyzed for confirmed and non-confirmed groups.ResultsA total of 130 patients were enrolled with 54 cases positive and 76 cases negative. The typical CT imaging features of positive group were ground glass opacity (GGO), crazy-paving pattern and air bronchogram. The lesions were mostly distributed bilaterally, close to the lower lungs or the pleura. When features combined, GGO with bilateral pulmonary distribution and GGO with pleural distribution were more common, of which were 31 cases (57.4%) and 30 cases (55.6%) respectively. The combinations were almost presented statistically significant (P<0.05) except for the combination of GGO with consolidation. Most combinations presented relatively low sensitivity but extremely high specificity. The average specificity of these combinations is around 90%.ConclusionsThe combinations of GGO could be useful in the identification and differential diagnosis of COVID-19, which alerts clinicians to isolate patients for treatment promptly and repeat RT-PCR tests until incubation ends.

scholarly journals COVID-19 pneumonia: a pictorial review of CT findings and differential diagnosis

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Fattane Shirani ◽  
Azin Shayganfar ◽  
Somayeh Hajiahmadi
Keyword(s):  
Differential Diagnosis ◽  
Ct Scan ◽  
Screening Tool ◽  
False Negative ◽  
Imaging Findings ◽  
Rt Pcr ◽  
Negative Results ◽  
Ct Findings ◽  
Pictorial Review ◽  
False Negative Results

Abstract Background The gold standard for verifying COVID-19 mostly depends on microbiological tests like real-time polymerase chain reaction (RT-PCR). However, the availability of RT-PCR kits can be known as a problem and false negative results may be encountered. Although CT scan is not a screening tool for the diagnosis of COVID-19 pneumonia, given the widespread acquisition of it in the pandemic state, familiarity with different CT findings and possible differential diagnosis is essential in this regard. Main text In this review, we introduced the typical and atypical CT features of COVID-19 pneumonia, and discussed the main differential diagnosis of COVID-19 pneumonia. Conclusions The imaging findings in this viral pneumonia showed a broad spectrum, and there are no pathognomonic imaging findings for COVID-19 pneumonia. Although CT scan is not a diagnostic and screening tool, familiarity with different imaging findings and their differential diagnosis can be helpful in a rapid and accurate decision-making.

scholarly journals Analysis of SARS-CoV-2 PCR and Chest CT Findings at a Single Facility in Tokyo (Machida Municipal Hospital)

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Taisuke Kazuyori ◽  
Akihito Sato ◽  
Yasuhiro Morimoto ◽  
Kazuyoshi Kuwano
Keyword(s):  
Chest Ct ◽  
Background Characteristics ◽  
Rt Pcr ◽  
Important Indicator ◽  
Negative Results ◽  
Ct Findings ◽  
Positive Rate ◽  
Polymerase Chain ◽  
The City ◽  
Positive Results

Introduction. The SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test is useful for diagnosing COVID-19, and the RT-PCR positive rate is an important indicator for estimating the incidence rate and number of infections. COVID-19 pneumonia is also associated with characteristic findings on chest CT, which can aid in diagnosis. Methods. We retrospectively evaluated patient background characteristics, the number of cases, the positivity rate, and chest CT findings for positive and negative cases in 672 patients who underwent RT-PCR for suspected COVID-19 at our hospital between April 3 and August 28, 2020. In addition, we compared trends in the positive rates at approximately weekly intervals with trends in the number of new infections in Machida City, Tokyo. Results. The study included 323 men and 349 women, with a median age of 46 years (range: 1 month–100 years). RT-PCR findings were positive in 37 cases, and the positive rate was 5.51%. Trends in the positive rate at our hospital and the number of new COVID-19 cases in the city were similar during the study period. Among patients with positive results, 15 (40.5%) had chest CT findings, and 14 had bilateral homogeneous GGOs. Among patients with negative results, 190 had chest CT findings at the time of examination, and 150 were diagnosed with bacterial pneumonia or bronchitis, with main findings consisting of consolidations and centrilobular opacities. Only 11 of these patients exhibited bilateral homogeneous GGOs. Conclusion. Bilateral homogeneous GGOs are characteristic of COVID-19 pneumonia and may aid in the diagnosis of COVID-19.

scholarly journals Artificial intelligence-enabled rapid diagnosis of COVID-19 patients

2020 ◽  
Author(s):  
Xueyan Mei ◽  
Hao-Chih Lee ◽  
Kai-yue Diao ◽  
Mingqian Huang ◽  
Bin Lin ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Clinical Symptoms ◽  
False Negative ◽  
Clinical History ◽  
Alternative Methods ◽  
Ct Scans ◽  
Rt Pcr ◽  
Negative Results ◽  
Radiologic Findings ◽  
Pcr Test

AbstractFor diagnosis of COVID-19, a SARS-CoV-2 virus-specific reverse transcriptase polymerase chain reaction (RT-PCR) test is routinely used. However, this test can take up to two days to complete, serial testing may be required to rule out the possibility of false negative results, and there is currently a shortage of RT-PCR test kits, underscoring the urgent need for alternative methods for rapid and accurate diagnosis of COVID-19 patients. Chest computed tomography (CT) is a valuable component in the evaluation of patients with suspected SARS-CoV-2 infection. Nevertheless, CT alone may have limited negative predictive value for ruling out SARS-CoV-2 infection, as some patients may have normal radiologic findings at early stages of the disease. In this study, we used artificial intelligence (AI) algorithms to integrate chest CT findings with clinical symptoms, exposure history, and laboratory testing to rapidly diagnose COVID-19 positive patients. Among a total of 905 patients tested by real-time RT-PCR assay and next-generation sequencing RT-PCR, 419 (46.3%) tested positive for SARSCoV-2. In a test set of 279 patients, the AI system achieved an AUC of 0.92 and had equal sensitivity as compared to a senior thoracic radiologist. The AI system also improved the detection of RT-PCR positive COVID-19 patients who presented with normal CT scans, correctly identifying 17 of 25 (68%) patients, whereas radiologists classified all of these patients as COVID-19 negative. When CT scans and associated clinical history are available, the proposed AI system can help to rapidly diagnose COVID-19 patients.

scholarly journals Pulmonary Sequelae in Patients After Recovery From Coronavirus Disease 2019: A Follow-Up Study With Chest CT

2022 ◽  
Vol 8 ◽  
Author(s):  
Xuejiao Liao ◽  
Dapeng Li ◽  
Zhi Liu ◽  
Zhenghua Ma ◽  
Lina Zhang ◽  
...  
Keyword(s):  
Disease Severity ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Trend Test ◽  
Lung Involvement ◽  
Follow Up Study ◽  
Ct Findings ◽  
Over Time

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge.Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement.Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P &lt; 0.001) and 6 months follow-up (trend test P &lt; 0.001). Patients with different disease severity represented diverse CT patterns over time.Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

scholarly journals Computed Tomography (CT) Imaging Features of Patients with COVID-19: Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Ephrem Awulachew ◽  
Kuma Diriba ◽  
Asrat Anja ◽  
Eyob Getu ◽  
Firehiwot Belayneh
Keyword(s):  
Ground Glass Opacity ◽  
Ct Imaging ◽  
Chest Ct ◽  
Ground Glass ◽  
Cochrane Library ◽  
Imaging Features ◽  
Severe Respiratory Distress ◽  
Ct Findings ◽  
Open Access Journals ◽  
Bilateral Lung

Introduction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious disease, and its first outbreak was reported in Wuhan, China. A coronavirus disease (COVID-19) causes severe respiratory distress (ARDS). Due to the primary involvement of the respiratory system, chest CT is strongly recommended in suspected COVID-19 cases, for both initial evaluation and follow-up. Objective. The aim of this review was to systematically analyze the existing literature on CT imaging features of patients with COVID-19 pneumonia. Methods. A systematic search was conducted on PubMed, Embase, Cochrane Library, Open Access Journals (OAJ), and Google Scholar databases until April 15, 2020. All articles with a report of CT findings in COVID-19 patients published in English from the onset of COVID-19 outbreak to April 20, 2020, were included in the study. Result. From a total of 5041 COVID-19-infected patients, about 98% (4940/5041) had abnormalities in chest CT, while about 2% have normal chest CT findings. Among COVID-19 patients with abnormal chest CT findings, 80% (3952/4940) had bilateral lung involvement. Ground-glass opacity (GGO) and mixed GGO with consolidation were observed in 2482 (65%) and 768 (18%) patients, respectively. Consolidations were detected in 1259 (22%) patients with COVID-19 pneumonia. CT images also showed interlobular septal thickening in about 691 (27%) patients. Conclusion. Frequent involvement of bilateral lung infections, ground-glass opacities, consolidation, crazy paving pattern, air bronchogram signs, and intralobular septal thickening were common CT imaging features of patients with COVID-19 pneumonia.

Sign in / Sign up

Export Citation Format

Share Document