Radiological Findings From 101 Patients With Novel Coronavirus Disease 2019 (COVID-19) in Hamadan, West of Iran: Typical and Atypical Features

Farideh Gharekhanloo, S. Hashemi, F. Keramat, F. Esna-Ashari, M. Mamani, Mohammad Mahdi Majzoubi, S. Bashirian, Mahsa Gharekhanloo, S. Khazaei
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Abstract

Background and aims: Coronavirus disease 2019 (COVID-19) has spread widely throughout the world and become a pandemic disease. In this study, we decided to investigate the chest computed tomography (CT) findings in COVID-19 patients in Hamadan, west of Iran. Methods: This cross-sectional study was conducted on 101 patients with confirmed COVID-19 infection from February to March 2020. Demographic, clinical, laboratory, and chest CT findings of identified COVID-19 patients were assessed. Results: The mean age of the patients was 55.21 ± 14.08 years, and 54 (53.47%) of them were male. With regard to clinical manifestations, 82.18%, 72.28% and 54.46% of COVID-19 patients had dry cough, dyspnea, and fever, respectively. The right lower lobe was the most commonly and severely involved lope (69%), followed by left lower lobe, right middle lobe, and lingual segment; however, the anterior segment of upper lobes showed the least involvement with abnormality in the late course of the disease. The most common pattern was ground glass opacity (GGO), but atypical patterns such as round pneumonia, moderate to severe pleural effusion, and segmental lobar consolidation were seen without evidence of mediastinal adenopathy, cavitation, or nodular lesion. Chest X-ray (CXR) was not a sensitive method as the first-line imaging method because 34.65% of them were normal. Conclusion: CXR is not a sensitive method as the first-line imaging method (34.65% normal first CXR), but chest CT is a very sensitive and nonspecific modality for diagnosis of COVID-19. The lower lobe and posterior basal segments of the lungs are the most involved sites in most cases. About 12% showed atypical chest CT findings.
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伊朗西部哈马丹101例新型冠状病毒病2019 (COVID-19)的影像学表现:典型和不典型特征
背景与目的:2019冠状病毒病(COVID-19)已在全球广泛传播,成为一种大流行疾病。在这项研究中,我们决定调查伊朗西部哈马丹市COVID-19患者的胸部计算机断层扫描(CT)结果。方法:对2020年2月至3月确诊的101例COVID-19感染患者进行横断面研究。对确诊的COVID-19患者的人口学、临床、实验室和胸部CT表现进行评估。结果:患者平均年龄55.21±14.08岁,男性54例(53.47%)。临床表现方面,干咳占82.18%,呼吸困难占72.28%,发热占54.46%。右下叶是最常见和严重受累的(69%),其次是左下叶、右中叶和舌段;然而,在疾病的晚期,上叶的前段表现出最少的异常。最常见的表现为磨玻璃样混浊(GGO),但也有非典型表现,如圆形肺炎、中重度胸腔积液和节段性肺叶实变,但未见纵隔腺病、空化或结节性病变。胸部x线片(CXR)作为一线影像学检查方法不敏感,其正常率为34.65%。结论:CXR不像一线影像学方法那样敏感(首次CXR正常34.65%),而胸部CT是诊断COVID-19的一种非常敏感且非特异性的方式。在大多数病例中,肺下叶和后基段是最受累的部位。约12%的胸部CT表现不典型。
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