Chinese Journal of Academic Radiology最新文献

Objective: To analyze the evolution of chest computed tomography (CT) findings from admission to follow-up in moderate to severe patients with coronavirus disease-19 (COVID-19) pneumonia.

Methods: During December 2019-April 2020, the sequential CT images of 30 patients with COVID-19 pneumonia were retrospectively analyzed from admission to follow-up. The qualitative evolution tendency of lung abnormalities and semi-quantitative CT scores were analyzed for temporal change.

Results: The mean hospitalized period was 24.5 ± 9.6 days (range 6-49 days). The average time from the first, second, third, fourth and follow-up CT examination to the initial symptom onset were 4.2 ± 3.1 days, 10.7 ± 4.4 days, 17.1 ± 3.9 days, 24.6 ± 7.5 days, and 42.4 ± 15.6 days, respectively. During illness day 0-5, groundglass opacity (GGO) was the main pattern. The following illness day 6-11, the main CT pattern was consolidation and reticular pattern. The consolidation and reticular pattern gradually dissipate during illness day 12-23, and the reticular pattern and light GGO increased. When illness day was ≥ 24 days, the reticular pattern and light GGO gradually decrease until complete dissipation. The highest CT score was at illness day 6-11. Pearson correlation analysis showed that the mean and maximum CT score were not correlated with the length of fever (r = 0.018, p = 0.923 and r = 0.086, p = 0.652) and hospitalization (r = 0.192, p = 0.31 and r = 0.273, p = 0.144).

Conclusions: The dynamic evolution of CT manifestation in moderate to severe COVID-19 pneumonia patients followed a specific pattern over time. During illness day 6-11, the extent of lung abnormalities on chest CT was the most severe.

Supplementary information: The online version contains supplementary material available at 10.1007/s42058-021-00058-2.

COVID-19 pneumonia represents a global threatening disease, especially in severe cases. Chest imaging, with X-ray and high-resolution computed tomography (HRCT), plays an important role in the initial evaluation and follow-up of patients with COVID-19 pneumonia. Chest imaging can also help in assessing disease severity and in predicting patient's outcome, either as an independent factor or in combination with clinical and laboratory features. This review highlights the current knowledge of imaging features of COVID-19 pneumonia and their temporal evolution over time, and provides recent evidences on the role of chest imaging in the prognostic assessment of the disease.

Objective: This study aimed to compare quantifiable radiologic findings and their dynamic change throughout the clinical course of common and severe coronavirus disease 2019 (COVID-19), and to provide valuable evidence for radiologic classification of the two types of this disease.

Methods: 112 patients with laboratory-confirmed COVID-19 were retrospectively analyzed. Volumetric percentage of infection and density of the lung were measured by a computer-aided software. Clinical parameters were recorded to reflect disease progression. Baseline data and dynamic change were compared between two groups and a decision-tree algorithm was developed to determine the cut-off value for classification.

Results: 93 patients were finally included and were divided into common group (n = 76) and severe group (n = 17) based on current criteria. Compared with common patients, severe patients experienced shorter advanced stage, peak time and plateau, but longer absorption stage. The dynamic change of volume and density coincided with the clinical course. The interquartile range of volumetric percentage of the two groups were 1.0-7.2% and 11.4-31.2%, respectively. Baseline volumetric percentage of infection was significantly higher in severe group, and the cut-off value of it was 10.10%.

Conclusions: Volumetric percentage between severe and common patients was significantly different. Because serial CT scans are systemically performed in patients with COVID-19 pneumonia, this quantitative analysis can simultaneously provide valuable information for physicians to evaluate their clinical course and classify common and severe patients accurately.

Purpose: The Corona Virus Disease 2019 (COVID-19) was first reported in December 2019 from an outbreak of unexplained pneumonia in Wuhan (Hubei, China) that subsequently spread rapidly around the world. Because of the public health emergency, chest CT has been widely used for sensitive detection and diagnosis, monitoring the changes of lesions and also for treatment evaluation. The purpose of this study was to investigate radiation dose and image quality of chest CT scans received by COVID-19 patients and to evaluate the oncogenic risk of multiple chest CT examinations.

Methods: A retrospective review of 33 patients with RT-PCR confirmed COVID-19 infection was performed from January 31, 2020 to February 19, 2020. The date of each CT exam and respective radiation dose for each exam was recorded for all patients. Multiple pulmonary CT scans were obtained during diagnosis and treatment procedure. Scan frequency, total scan times, radiation dose, and image quality were determined.

Results: Thirty-three patients (15 males and 18 females, age 21-82 years) with confirmed COVID-19 pneumonia underwent a total of 143 chest CT scans. The number of CT scans per patient was 4 ± 1, with a range of 2-6. The time interval between two consecutive chest CT scans was 3 ± 1 days. The average effective dose from a single chest CT scan was 1.21 ± 0.10 mSv, with a range of 1.02-1.44 mSv. The average cumulative effective dose per patient was 5.25 ± 1.52 mSv, with a range of 2.24-7.48 mSv. The maximum cumulative effective dose was 7.48 mSv for six CT examinations during COVID-19 treatment. Based on subjective image quality analysis, the visual scoring of CT findings was 11.23 ± 1.35 points out of 15 points.

Conclusions: The frequency, total number and image quality of chest CT scans should be reviewed carefully to guarantee minimally required CT scans during the COVID-19 management.