scholarly journals An Illustrated Guide to the Imaging Evolution of COVID in Non-Epidemic Areas of Southeast China

2021 ◽  
Vol 8 ◽  
Author(s):  
Lihua Wang ◽  
Yeerfan Jiaerken ◽  
Qian Li ◽  
Peiyu Huang ◽  
Zhujing Shen ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Wall Thickening ◽  
Appearance Time ◽  
Disease Evolution ◽  
Bronchial Wall ◽  
Absorption Time ◽  
Southeast China ◽  
Developmental Abnormalities

Purpose: By analyzing the CT manifestations and evolution of COVID in non-epidemic areas of southeast China, analyzing the developmental abnormalities and accompanying signs in the early and late stages of the disease, providing imaging evidence for clinical diagnosis and identification, and assisting in judging disease progression and monitoring prognosis.Methods: This retrospective and multicenter study included 1,648 chest CT examinations from 693 patients with laboratory-confirmed COVID-19 infection from 16 hospitals of southeast China between January 19 and March 27, 2020. Six trained radiologists analyzed and recorded the distribution and location of the lesions in the CT images of these patients. The accompanying signs include crazy-paving sign, bronchial wall thickening, microvascular thickening, bronchogram sign, fibrous lesions, halo and reverse-halo signs, nodules, atelectasis, and pleural effusion, and at the same time, they analyze the evolution of the abovementioned manifestations over time.Result: There were 1,500 positive findings in 1,648 CT examinations of 693 patients; the average age of the patients was 46 years, including 13 children; the proportion of women was 49%. Early CT manifestations are single or multiple nodular, patchy, or flaky ground-glass–like density shadows. The frequency of occurrence of ground-glass shadows (47.27%), fibrous lesions (42.60%), and microvascular thickening (40.60%) was significantly higher than that of other signs. Ground-glass shadows increase and expand 3–7 days after the onset of symptoms. The distribution and location of lesions were not significantly related to the appearance time. Ground-glass shadow is the most common lesion, with an average absorption time of 6.2 days, followed by consolidation, with an absorption time of about 6.3 days. It takes about 8 days for pure ground-glass lesions to absorb. Consolidation change into ground glass or pure ground glass takes 10–14 days. For ground-glass opacity to evolve into pure ground-glass lesions, it takes an average of 17 days. For ground-glass lesions to evolve into consolidation, it takes 7 days, pure ground-glass lesions need 8 days to evolve into ground-glass lesions. The average time for CT signs to improve is 10–15 days, and the first to improve is the crazy-paving sign and nodules; while the progression of the disease is 6–12 days, the earliest signs of progression are air bronchogram signs, bronchial wall thickening, and bronchiectasis. There is no severe patient in this study.Conclusion: This study depicts the CT manifestation and evolution of COVID in non-epidemic origin areas, and provides valuable first-hand information for clinical diagnosis and judgment of patient’s disease evolution and prediction.

scholarly journals Differences and similarities of high-resolution computed tomography features between pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Chun-Jing Du ◽  
Jing-Yuan Liu ◽  
Hui Chen ◽  
Shuo Yan ◽  
Lin Pu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ground Glass Opacity ◽  
Pneumocystis Pneumonia ◽  
Ground Glass ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Aids Patients ◽  
Similar Frequency ◽  
Cytomegalovirus Pneumonia ◽  
Ct Features

Abstract Background Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the computerized tomography (CT) features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies. Methods A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 cytomegalovirus pneumonia) at Beijing Ditan Hospital from January 2017 to May 2019 were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Binary logistic regression analyses were conducted to identify the significant parameters that distinguished pneumocystis pneumonia from cytomegalovirus pneumonia. Correlations were analyzed by Pearson or Spearman correlation analyses. Result were considered significant if P < 0.05. Results The presence of consolidation, halo signs, and nodules (all P < 0.05) were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, P < 0.001) without perilymphatic distribution were particularly common in patients with cytomegalovirus pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity, reticulation, and bronchial wall thickening (all P > 0.05) were common in both groups. Conclusions Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients. CT features are potentially useful for the differential diagnosis of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients.

scholarly journals Differences and similarities of high-resolution computed tomography features between Pneumocystis pneumonia and Cytomegalovirus pneumonia in AIDS patients

2020 ◽  
Author(s):  
Chunjing Du ◽  
Jingyuan Liu ◽  
Hui Chen ◽  
Shuo Yan ◽  
Lin Pu ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
Pneumocystis Pneumonia ◽  
Ground Glass ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Aids Patients ◽  
Chi Square ◽  
Similar Frequency ◽  
Cytomegalovirus Pneumonia ◽  
Ct Features

Abstract Background Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the CT features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies.Methods A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 were cytomegalovirus pneumonia) were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square (χ2) test.Results The presence of consolidation (61.77% in cytomegalovirus pneumonia, 35.9% in pneumocystis pneumonia, p=0.011), halo signs (32.35% in cytomegalovirus pneumonia, 11.54% in pneumocystis pneumonia, p＜0.001), and nodules (47.06% in cytomegalovirus pneumonia, 8.97% in pneumocystis pneumonia, p＜0.001), especially small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, p＜0.001) without perilymphatic distribution, were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity (100% in pneumocystis pneumonia and cytomegalovirus pneumonia), reticulation (57.69% in pneumocystis pneumonia, 52.94% in cytomegalovirus pneumonia, p=0.782) and bronchial wall thickening (34.62% in pneumocystis pneumonia, 47.06% in cytomegalovirus pneumonia, p=0.213) were common in both groups. Conclusions Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients.

scholarly journals Differences and similarities of high-resolution computed tomography features between Pneumocystis pneumonia and Cytomegalovirus pneumonia in AIDS patients

2020 ◽  
Author(s):  
Chunjing Du ◽  
Jingyuan Liu ◽  
Hui Chen ◽  
Shuo Yan ◽  
Lin Pu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ground Glass Opacity ◽  
Pneumocystis Pneumonia ◽  
Ground Glass ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Aids Patients ◽  
Similar Frequency ◽  
Cytomegalovirus Pneumonia ◽  
Ct Features

Abstract Background: Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the computerized tomography (CT) features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies.Methods: A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 cytomegalovirus pneumonia) at Beijing Ditan Hospital from January 2017 to May 2019 were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square (χ2) test. Binary logistic regression analyses were conducted to identify the significant parameters that distinguished pneumocystis pneumonia from cytomegalovirus pneumonia. Correlations were analyzed by Pearson or Spearman correlation analyses. Result were considered significant if P < 0.05.Results: The presence of consolidation, halo signs, and nodules (all P＜0.05) were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, P＜0.001) without perilymphatic distribution were particularly common in patients with cytomegalovirus pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity, reticulation, and bronchial wall thickening (all P > 0.05) were common in both groups. Conclusions: Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients. CT features are potentially useful for the differential diagnosis of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients. Add potential implications

scholarly journals Differences and similarities of high-resolution computed tomography features between pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients

2020 ◽  
Author(s):  
Chunjing Du ◽  
Jingyuan Liu ◽  
Hui Chen ◽  
Shuo Yan ◽  
Lin Pu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Ground Glass Opacity ◽  
Pneumocystis Pneumonia ◽  
Ground Glass ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Aids Patients ◽  
Similar Frequency ◽  
Cytomegalovirus Pneumonia ◽  
Ct Features

Abstract Background: Accurately differentiating pneumocystis from cytomegalovirus pneumonia is crucial for correct therapy selection in AIDS patients. Hence, the goal of this study was to compare the computerized tomography (CT ) features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and identify clinical hallmarks to accurately distinguish these two pathologies. Methods: A total of 112 AIDS patients (78 with pneumocystis pneumonia and 34 cytomegalovirus pneumonia) at Beijing Ditan Hospital from January 2017 to May 2019 were included in this study. Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Binary logistic regression analyses were conducted to identify the significant parameters that distinguished pneumocystis pneumonia from cytomegalovirus pneumonia. Correlations were analyzed by Pearson or Spearman correlation analyses. Result were considered significant if P < 0.05. Results: The presence of consolidation, halo signs, and nodules (all P ＜0.05) were significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, P ＜0.001) without perilymphatic distribution were particularly common in patients with cytomegalovirus pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity, reticulation, and bronchial wall thickening (all P > 0.05) were common in both groups. Conclusions: Analysis of consolidation, nodules, and halo signs may contribute to the differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typical in one or other diseases appear with similar frequency in both cohorts of AIDS patients. CT features are potentially useful for the differential diagnosis of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients.

Serial high-resolution computed tomography imaging in patients with wegener granulomatosis: differentiation between active inflammatory and chronic fibrotic lesions

2005 ◽  
Vol 46 (5) ◽  
pp. 484-491 ◽  
Author(s):  
C. Lohrmann ◽  
M. Uhl ◽  
O. Schaefer ◽  
N. Ghanem ◽  
E. Kotter ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ground Glass ◽  
Mediastinal Lymphadenopathy ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Wegener Granulomatosis ◽  
Bronchial Wall ◽  
Inflammatory Lesions ◽  
Ground Glass Attenuation

Purpose: To evaluate pulmonary pathologies in Wegener granulomatosis with sequential computed tomography (CT) in order to differentiate active inflammatory lesions from chronic fibrotic lesions. Material and Methods: Serial CT findings in 38 patients with Wegener granulomatosis were retrospectively analyzed (mean follow-up period, 21 months). The presence, extension, and distribution of the following findings were evaluated with CT: parenchymal nodules, masses, ground-glass attenuation, airspace consolidation, bronchial wall-thickening, bronchiectasis, linear areas of attenuation, pleural irregularities, pleural effusions, hilar and mediastinal lymphadenopathy. Results: Observed in 92% of patients, nodules were the most common CT pathology. Areas of ground-glass attenuation, consolidation, masses of linear attenuation, and tracheal/bronchial wall-thickening were detected in 24%, 26%, 32%, 39%, and 68% of patients. At follow-up, the clearance of lesions was most consistent for areas of ground-glass attenuation (89%), masses (87%), and cavitated nodules (85%). In the follow-up scan, 58% of all nodules, 47% of pulmonary consolidations, and 66% of bronchial wall-thickening were completely resolved. Areas of bronchiectasis and septal/non-septal lines remained stable in 70% and 71% of patients. Conclusion: The majority of the lesions decreased or resolved completely with or without areas of linear attenuation. Ground-glass attenuation, cavitated nodules and masses appear to represent active inflammatory lesions. In most probability, areas of bronchiectasis and septal/non-septal lines more often represent chronic fibrotic changes rather than active inflammatory changes. In combination with clinical evaluation and bronchoscopy, CT assists in the assessment of disease activity.

scholarly journals Influenza A (H1N1) pneumonia: HRCT findings

2013 ◽  
Vol 39 (3) ◽  
pp. 323-329 ◽  
Author(s):  
Viviane Brandao Amorim ◽  
Rosana Souza Rodrigues ◽  
Miriam Menna Barreto ◽  
Glaucia Zanetti ◽  
Bruno Hochhegger ◽  
...  
Keyword(s):  
Influenza A ◽  
H1n1 Virus ◽  
Ground Glass ◽  
Wall Thickening ◽  
H1n1 Infection ◽  
Air Trapping ◽  
Bronchial Wall ◽  
Influenza A H1n1 ◽  
H1n1 Pneumonia ◽  
Interlobular Septal Thickening

OBJECTIVE: To describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. METHODS: We retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. RESULTS: The most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. CONCLUSIONS: The most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or craniocaudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms.

scholarly journals Differences and Similarities of High-resolution Computed Tomography Features Between Pneumocystis Pneumonia and Cytomegalovirus Pneumonia in Aids Patients

2020 ◽  
Author(s):  
Chunjing Du ◽  
Jingyuan Liu ◽  
Hui Chen ◽  
Shuo Yan ◽  
Lin Pu ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
Pneumocystis Pneumonia ◽  
Ground Glass ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Aids Patients ◽  
Chi Square ◽  
Similar Frequency ◽  
Cytomegalovirus Pneumonia ◽  
Ct Features

Abstract Background: Accurate differentiating diagnosis of pneumocystis pneumonia and cytomegalovirus pneumonia is crucial for choosing therapies in AIDS patients. Hence, the purposes of this study was to compare the CT features of pneumocystis pneumonia and cytomegalovirus pneumonia in AIDS patients and to spot the valuable findings which might contribute to an accurate diagnosis between two cohorts.MethodsA total of 112 AIDS patients, 78 withpneumocystis pneumoniaand 34 werecytomegalovirus pneumonia,were included in this study.Two experienced chest radiologists retrospectively reviewed CT images for 17 features including ground-glass opacity, consolidation, nodules, and halo sign. Significance was calculated by the chi-square(χ2)test.ResultsThe presence of consolidation (61.77% in cytomegalovirus pneumonia,35.9% in pneumocystis pneumonia, p=0.011), halo signs (32.35% in cytomegalovirus pneumonia, 11.54% in pneumocystis pneumonia, p＜0.001), and nodules (47.06% in cytomegalovirus pneumonia,8.97% in pneumocystis pneumonia, p＜0.001), especially small nodules (32.5% in cytomegalovirus pneumonia, 6.41% in pneumocystis pneumonia, p＜0.001) without perilymphatic distribution,was significantly more frequent in patients with cytomegalovirus pneumonia than in those with pneumocystis pneumonia. Large nodules were not found in any of patients with cytomegalovirus pneumonia. The presence of ground-glass opacity (100% in pneumocystis pneumonia and cytomegalovirus pneumonia), reticulation(57.69% in pneumocystis pneumonia, 52.94% in cytomegalovirus pneumonia, p=0.782) andbronchial wall thickening (34.62% in pneumocystis pneumonia, 47.06% in cytomegalovirus pneumonia, p=0.213) were common in both groups.ConclusionsAnalysis of consolidation, nodules, and halo signs may contribute to prioritize differential diagnosis of pneumocystis pneumonia or cytomegalovirus pneumonia. However, some CT features considered typicalin oneor other diseases appear with similar frequency in both cohorts of AIDS patients.

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