Analysis of 4 imaging features in patients with COVID-19

Abstract Background : The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19. Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results. Results: There were 22 patients (65.2 %) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity(GGO), thickened blood vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The “rime sign” was characterized by numerous alveolar edemas. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients. Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features in patients with COVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

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Analysis of 4 imaging features in patients with COVID-19

10.21203/rs.3.rs-32496/v2 ◽

2020 ◽

Author(s):

JUN JIN ◽

De-hong Gao ◽

Xin Mo ◽

Si-ping Tan ◽

Zhen-xia Kou ◽

...

Keyword(s):

Interstitial Fibrosis ◽

Ground Glass Opacity ◽

Inflammatory Cells ◽

Clinical Work ◽

Chest Ct ◽

Wall Thickening ◽

Imaging Features ◽

Accurate Identification ◽

Pulmonary Interstitial Fibrosis ◽

Diagnosis Rate

Abstract Background: The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19.Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results.Results: There were 22 patients (65.2 %) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity(GGO), thickened blood vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The “rime sign” was characterized by numerous alveolar edemas. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients.Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features in patients withCOVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

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Analysis of 4 imaging features in patients with COVID-19

10.21203/rs.3.rs-32496/v1 ◽

2020 ◽

Author(s):

JUN JIN ◽

De-hong Gao ◽

Xin Mo ◽

Si-ping Tan ◽

Zhen-xia Kou ◽

...

Keyword(s):

Interstitial Fibrosis ◽

Ground Glass Opacity ◽

Inflammatory Cells ◽

Clinical Work ◽

Chest Ct ◽

Wall Thickening ◽

Imaging Features ◽

Accurate Identification ◽

Pulmonary Interstitial Fibrosis ◽

Diagnosis Rate

Abstract Purpose: This study aimed to analyze 4 chest CT imaging features of patients with coronavirus disease 2019 (COVID-19) in Shenzhen, China in order to improve the diagnosis of COVID-19 . Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. A nalyses were performed to investigate the pathological basis of 4 imaging features ( “feather sign” , “dandelion sign” , “pomegranate sign”, and “rime sign” ) and to summarize the follow-up results. Results: There were 22 patients (65.2 %) with typical “feather sign”, and 18 (52.9 %) with “dandelion sign”; few patients had “pomegranate sign”, and “rime sign”. The“feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity ( GGO ) , thickened blood vessels, and small-thickened interlobular septa. The “pomegranate sign” can be characterized as follows: the range of GGO further increases, the thickening of the interlobular septum become more significant, complicated with a small amount of punctate alveolar hemorrhage . The “rime sign” is characterized by numerous alveolar edema. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion are seen, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients . Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features of COVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature . In clinical work, accurate identification of various chest CT signs in can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

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

10.1101/2020.03.24.20042432 ◽

2020 ◽

Cited By ~ 3

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.

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

10.21203/rs.3.rs-27336/v1 ◽

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.

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

Radiology Research and Practice ◽

10.1155/2020/1023506 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 3

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.

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Exploring the diagnostic value of multilayer spiral computed tomography (MSCT) in thoracogastric airway fistula

10.21203/rs.2.24773/v1 ◽

2020 ◽

Author(s):

Yue Zhao ◽

Yan-Wei Zeng ◽

Mei-Pan Yin ◽

Zhen Li ◽

Chun-Xia Li ◽

...

Keyword(s):

Computed Tomography ◽

Distant Metastasis ◽

Interstitial Fibrosis ◽

Rare Complication ◽

Gastric Wall ◽

Diagnostic Value ◽

Spiral Computed Tomography ◽

Wall Thickening ◽

Spiral Computed ◽

Pulmonary Interstitial Fibrosis

Abstract Background Thoracostomach-airway fistula is a rare complication of esophageal-cancer resection. We intended to explore the diagnostic value of multilayer spiral computed tomography (MSCT) in thoracostomach-airway fistula, to enhance its clinical understanding; evaluate an effective, convenient, and non-invasive diagnostic method; and provide the fundamentals for subsequent treatment. Methods The MSCT images and complete clinical data of 216 consecutive patients diagnosed with thoracogastric airway fistula were retrospectively analyzed. Results MSCT was able to determine the exact location, size of the fistula, and the adjacent bronchus between the fistula and bronchus in 192 out of 216 patients with thoracogastric airway fistula. All patients had pulmonary lesions including emphysema (n=68), ground glass density (n=25), bronchial wall thickening (n=28), patchy high densities along the lung texture (n=207), pulmonary consolidation (n=104), atelectasis (n=11), pulmonary nodules (n=53), bronchiectasis (n=19), lobular septal thickening (n=5), cavity (n=14), and pulmonary interstitial fibrosis (n=6). Further, 95 cases showed pleural effusion, 184 showed pleural thickening, 4 had pneumothorax, and 2 had subcutaneous pneumothorax. 12 patients with thoracogastric airway fistula had anastomotic wall thickening (mean: 20.63±9.57, range: 9.19–43.37 mm), while 13 patients showed thoracic gastric wall thickening (mean: 22.83(±)5.58 mm, range: 12.32–31.24 mm) on. 23 patients showed distant metastasis on MSCT. Conclusions MSCT can accurately display the location and size of thoracogastric airway fistula, as well as lung lesions, tumor recurrence, and distant metastasis, and provide the basis for the next therapy.

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Deep learning Enables Accurate Diagnosis of Novel Coronavirus (COVID-19) with CT images

10.1101/2020.02.23.20026930 ◽

2020 ◽

Cited By ~ 45

Author(s):

Song Ying ◽

Shuangjia Zheng ◽

Liang Li ◽

Xiang Zhang ◽

Xiaodong Zhang ◽

...

Keyword(s):

Deep Learning ◽

Ground Glass Opacity ◽

Ct Images ◽

Chest Ct ◽

Accurate Diagnosis ◽

Ct Diagnosis ◽

Accurate Identification ◽

The World ◽

Novel Coronavirus ◽

Healthy Persons

BackgroundA novel coronavirus (COVID-19) has emerged recently as an acute respiratory syndrome. The outbreak was originally reported in Wuhan, China, but has subsequently been spread world-widely. As the COVID-19 continues to spread rapidly across the world, computed tomography (CT) has become essentially important for fast diagnoses. Thus, it is urgent to develop an accurate computer-aided method to assist clinicians to identify COVID-19-infected patients by CT images.Materials and MethodsWe collected chest CT scans of 88 patients diagnosed with the COVID-19 from hospitals of two provinces in China, 101 patients infected with bacteria pneumonia, and 86 healthy persons for comparison and modeling. Based on the collected dataset, a deep learning-based CT diagnosis system (DeepPneumonia) was developed to identify patients with COVID-19.ResultsThe experimental results showed that our model can accurately identify the COVID-19 patients from others with an excellent AUC of 0.99 and recall (sensitivity) of 0.93. In addition, our model was capable of discriminating the COVID-19 infected patients and bacteria pneumonia-infected patients with an AUC of 0.95, recall (sensitivity) of 0.96. Moreover, our model could localize the main lesion features, especially the ground-glass opacity (GGO) that is of great help to assist doctors in diagnosis. The diagnosis for a patient could be finished in 30 seconds, and the implementation on Tianhe-2 supercompueter enables a parallel executions of thousands of tasks simultaneously. An online server is available for online diagnoses with CT images by http://biomed.nscc-gz.cn/server/Ncov2019.ConclusionsThe established models can achieve a rapid and accurate identification of COVID-19 in human samples, thereby allowing identification of patients.

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Clinical and CT Features of the COVID-19 Infection: Comparison among different four age groups

10.21203/rs.3.rs-30392/v1 ◽

2020 ◽

Author(s):

Wei Li ◽

Yijie Fang ◽

Jianwei Liao ◽

Wenjun Yu ◽

Lin Yao ◽

...

Keyword(s):

Older Patients ◽

Clinical Symptoms ◽

Correct Diagnosis ◽

Age Groups ◽

Ground Glass Opacity ◽

Chest Ct ◽

Polymerase Chain Reaction Test ◽

Imaging Features ◽

Chain Reaction Test ◽

Ct Features

Abstract Purpose: To compare and analyze the clinical and CT features of coronavirus disease 2019 (COVID-19) among different four age groups.Methods: 97 patients with chest CT examination and positive reverse transcriptase polymerase chain reaction test (RT-PCR) from January 17, 2019 to February 21, 2020 were reviewed. The first clinical symptoms of each patient were collected and their first chest CT images were observed by dividing them into 4 groups according to age: junior, young, middle-age, and senior.Results: Comorbidities are more common in the senior group. Cluster onset is more common in junior group and senior group. Older patients have shown higher incidence with the highest clinical classification of severe or critical in these 4 groups. Senior patients have a higher incidence of large/multiple ground-glass opacity (GGO). Junior patients are mostly negative for chest CT or involve only one lobe of the lung. While in elderly patients, older patients have a higher incidence of involvement of 4 or 5 lung lobes. The frequency of lobe involvement also has significant differences in 4 different age groups. Conclusion: The clinical and imaging features of patients in different age groups are significantly different. Understanding of these features correctly and making the correct diagnosis promptly is of great significance for the scanning, diagnosis and prevention of COVID-19.

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A Review of COVID-19: Data Obtained from Chest CT Imaging and RT-PCR

Iranian Journal of Radiology ◽

10.5812/iranjradiol.106852 ◽

2021 ◽

Vol 18 (2) ◽

Author(s):

Hossein Akbari-Lalimi ◽

Somayyeh Seyedi ◽

Hadi Akbari-Zadeh ◽

Milad Najafzadeh ◽

Alireza Montazerabadi ◽

...

Keyword(s):

Ct Scan ◽

Ground Glass Opacity ◽

Ct Imaging ◽

Chest Ct ◽

Disease Stage ◽

Imaging Features ◽

Rt Pcr ◽

Bilateral Lung ◽

Risk Of Cancer ◽

Chest Ct Scan

Context: This review aimed to investigate the computed tomography (CT) imaging features of COVID-19. Evidence Acquisition: Bilateral lung involvement (70%), peripheral distribution (67.5%), multifocal involvement (67.3%) and ground glass opacity (66.1%) were observed in most infected patients Results: Evaluation of the number of lobes involved in infected patients showed no abnormalities in 7.2% (85/1177) of the patients. Regarding the performance of RT-PCR and chest CT scan, the sensitivity of RT-PCR and chest CT imaging was estimated at 70% (925/1311) and 89% (6605/7396) upon admission, respectively; nevertheless, the sensitivity of CT imaging increased as the time from the symptom onset increased. The CT image acquisition parameters affecting image quality and patient dose were also discussed. Studies suggested that these factors should be adjusted according to the disease stage. Based on our findings, sensitivity was adequately high eight days after the onset of symptoms. Conclusion: Therefore, there is no need for high-resolution chest CT scan after this interval. Using ImpactDose software, the mean effective doses were 4.38 and 5.71 mSv in male and female groups, respectively. The risk of cancer was 36% higher in females than males, as shown by PCXMC program.

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A Case Report of Spontaneous Pneumothorax in the 2019 Novel Coronavirus–Infected Pneumonia

10.21203/rs.3.rs-34276/v1 ◽

2020 ◽

Author(s):

Yunhu Pan ◽

Shuo Wei ◽

Guang Chen ◽

Yuancheng Hong

Keyword(s):

Early Onset ◽

Spontaneous Pneumothorax ◽

Ground Glass Opacity ◽

Chest Ct ◽

Imaging Features ◽

Wuhan City ◽

Case Presentation ◽

Bilateral Lung ◽

Novel Coronavirus ◽

The Right

Abstract Background: COVID-19,which pathogen virus officially named SARS-CoV-2, started in China Wuhan city and so far rapidly spread to a global outbreak. Since the lung is the main lesion organ for virus invasion, Chest CT is strongly recommended in COVID-19 on either initial diagnosis and follow-up.Multiple patchy shadows and ground glass opacity of bilateral lung are typical features of CT scan,and spontaneous pneumothorax appeared in the early onset of COVID-19 is rare. Case Presentation: We reported one case of spontaneous pneumothorax in the early onset of COVID-19, chest CT showed only a small amount of pneumothorax were seen in the right lobe.After receiving 4 days of treatment, re-examination chest CT shows right pneumothorax disappeared, but the patient was clinically worse, and progressive multiple diffuse consolidation. Although treatment with extracorporeal membrane oxygenator,the patient died 15 days after admission. Conclusion: Spontaneous pneumothorax in the early stages of COVID-19 is rare,which imaging features differ from other lung diseases complicated with pneumothorax,such as COPD.More than we usually know,the improvement of pneumothorax and the outcome of COVID-19 may be inconsistent.

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