Radiology of Infectious Diseases最新文献

Objective

To explore the clinical and radiological characteristics of COVID-19 patients with progressive and non-progressive CT manifestations.

Methods

160 patients with COVID-19 were retrospectively included from Wenzhou and Wuhan, China. CT features including lesion position, attenuation, form and total scores (0–4) at the segment level were evaluated. Other images signs were also assessed. 65 patients were classified as progressive (Group 1) and 95 as non-progressive CT (Group 2) groups according to score changes between the initial and second CT.

Results

Symptoms onset-initial CT interval time in group 1 [5 (2, 7) days] were significantly shorter than that in group 2 [10 (8, 14) days] (P < 0.001). Group 2 had higher radiological scores, with more lobes and segments affected, and other CT signs (P < 0.05). In group 1, radiological scores, the number of lobes and segments affected as well as lesions in both peripheral and central distribution, mixed ground grass opacity and consolidation density, and patchy form increased in the second CT (P < 0.05). More reticular pattern, subpleural linear opacity and bronchial dilatation were also found (P < 0.05).

Conclusion

Typically radiological characteristics of progressive CT patients could potentially help to predict changes and increase understanding of the natural history of COVID-19.

Objective

This study aimed to investigate the atypical computed tomography (CT) presentations of coronavirus disease 2019 (COVID-19) patients to comprehensively understand this highly infectious disease.

Methods

The clinical and chest CT imaging data of 16 patients diagnosed with COVID-19 were retrospectively analyzed, and patients with atypical CT presentations were selected for analysis and review.

Results

Of the 16 patients, 6 had atypical CT presentations, including 2 with faint ground glass opacities, 2 with single nodule, 1 with predominantly linear opacities, and 1 with predominantly reticular opacities. The dynamic changes of CT showed the faint ground glass opacities gradually became weak (2 cases). The scope of the single nodule was enlarged, and it developed into consolidation and residual fibrosis (2 cases). There was no obvious change of linear opacity (1 case). The reticular opacities were enlarged, then partially absorbed and new developed ground-glass opacities were found. Finally, the lesions were absorbed with residual fibrosis (1 case).

Conclusion

Atypical CT presentations of COVID-19 can be classified as faint ground glass opacities, single nodule, linear opacities, and reticular opacities. Understanding the atypical presentation of COVID-19 is beneficial in the assessment and epidemic prevention and control of this disease.

Objective

To investigate changes in CT manifestations and results of reverse transcription polymerase chain reaction (RT-PCR) testing between afferent and second-generation coronavirus disease 2019 (COVID-19) outside the original city (Wuhan) until recovery.

Methods

We collected 26 consecutive COVID-19 patients undergoing initial and follow-up CT scans together with RT-PCR until recovery from 2 hospitals outside the original city. Seventeen patients with afferent infection and 9 with second-generation infection were assigned to Group A and B, respectively. By observing CT manifestations, we scored COVID-19, and statistically analyzed numbers of patients with changes in CT scores and RT-PCR results between stages.

Results

The total score of COVID-19 on initial CT manifestations was higher in Group A than in Group B (P < 0.05). COVID-19 progressed more frequently from stage 1–2, and relieved from stage 3–4 in Group A (P < 0.05). The similar trend in Group A could not be found in Group B. Results of RT-PCR in most of patients in Group A turned negative at stage 4 while those in Group B turned negative at stage 3 (P < 0.05).

Conclusion

Changes in CT manifestation and RT-PCR result can be different between afferent and second-generation COVID-19 until recovery.

Hepatic Echinococcosis is a zoonotic parasitic disease spread globally. Imaging technology had been proven to be very useful in the early diagnosis, preoperative evaluation and therapeutic surveillance. To promote regular, effective and safe diagnosis and treatment of the disease, and in line with the principle of establishing guidelines and standards from evidence-based medicine, several infectious disease radiologists from multiple hospitals in Beijing, Xinjiang and Inner Mongolia discussed and reached consensus on the imaging diagnostic criteria of hepatic echinococcosis through accepting the most recent research, and taking into account clinical practice and imaging experience, so as to provide clear diagnostic criteria and a guide for the rational and comprehensive treatment of this disease.

This case is about a 9-year-old child diagnosed with COVID-19, with a history of epidemiology; SARS-CoV-2 nucleic acids testing was positive, while chest CT examination was negative. The clinical classification was light. Nonetheless, isolation measures should still be taken to avoid infecting others.

Since December 2019, the novel coronavirus disease (COVID-19) has spread rapidly throughout China. This article reviews the chest CT features of COVID-19 and analyzes the role of chest CT in this health emergency.

Objective

To quantify coronavirus diseases 2019 (COVID-19) pneumonia and to explore whether quantitative computer tomography (CT) could be used to assess severity on admission.

Materials and methods

From January 17 to February 9, 2020, 38 hospitalized patients with COVID-19 pneumonia were consecutively enrolled in our hospitals. All clinical data and the chest CT on admission were retrospectively reviewed and analyzed. Firstly, a quantitative method based on multi-scale convolutional neural networks was used to assess the infected lung segments and this was compared with the semi-quantitative method. Secondly, the quantitative method was tested with laboratory results and the pneumonia severity index (PSI) by correlation analyses. Thirdly, both quantitative and semi-quantitative parameters between patients with different PSI were compared.

Results

Thirty cases were finally enrolled: 16 (53.33%) of them were male, and the mean age was 48 years old. The interval from onset symptoms to first chest CT scan was 8 days. The proportion of ground glass opacity (GGO), consolidation and the total lesion based on the quantitative method was positively correlated with the semi-quantitative CT score (P < 0.001 for all; rs = 0.88, 0.87, 0.90), CRP (P = 0.0278, 0.0168, 0.0078; rs = 0.40, 0.43, 0.48) and ESR (P = 0.0296, 0.0408, 0.0048; rs = 0.46, 0.44, 0.58), respectively, and was negatively correlated with the lymphocyte count (P = 0.0222, 0.0024, 0.0068; rs = −0.42, −0.53, −0.48). There was a positive correlation trend between the proportion of total infection and the pneumonia severity index (P = 0.0994; rs = 0.30) and a tendency that patients with severe COVID-19 pneumonia had higher percentage of consolidation and total infection (P = 0.0903, 0.0989).

Conclusions

Quantitative CT may have potential in assessing the severity of COVID-19 pneumonia on admission.

Coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is mainly characterized by pulmonary inflammation. The preferred imaging modality is chest computed tomography (CT) which plays an important role in early diagnosis, quarantine, and treatment as well as in the evaluation of therapeutic efficacy. We report the imaging data from a confirmed case of COVID-19 admitted to our hospital. Our aims are to improve understanding of this disease and to facilitate early diagnosis and evaluation of therapeutic efficacy.

A 70-year-old woman living in the epidemic area presented with a 2-day history of intermittent fever. Chest CT revealed multiple ground glass opacities in both lungs, mainly distributed subpleurally and in the middle and lateral lung fields, particularly in the right lung, where they had partially fused into patches. Local interlobular septal thickening was also observed. Throat swabs were positive for the SARS-CoV-2 nucleic acid, which confirmed the diagnosis of COVID-19.

Chest CT plays a key role in the diagnosis of COVID-19, providing an accurate diagnosis and is a sensitive technique for evaluation of therapeutic efficacy. It has the advantages of promptness, convenience, and high efficiency.

Since December 2019, multiple cases of 2019 coronavirus disease (COVID-19) have been reported in Wuhan in China's Hubei Province, a disease which has subsequently spread rapidly across the entire country. Highly infectious, COVID-19 has numerous transmission channels and humans are highly susceptible to infection. The main clinical symptoms of COVID-19 are fever, fatigue, and a dry cough. Laboratory examination in the early stage of the disease shows a normal or decreased white blood cell count, and a decreased lymphocyte count. While CT examination serves as the screening and diagnostic basis for COVID-19, its accuracy is limited. The nucleic acid testing is the gold standard for the diagnosis of COVID-19, but has a low sensitivity is low. There is clearly a divide between the two means of examination. This paper reviews the published literature, guidelines and consensus, and summarizes the clinical and imaging characteristics of COVID-19, in order to provide a reliable basis for early diagnosis and treatment.

Objective

To discuss the high resolution computed tomography (HRCT) manifestations of coronavirus disease 2019 (COVID-19) patients among different clinical types on initial and follow-up CT.

Methods

Seven COVID-19 patients admitted to the Affiliated Hospital of North Sichuan Medical Collage were enrolled. All patients underwent initial and follow-up chest HRCT. The main CT features and semi-quantitative score which represent disease severity among different clinical types were evaluated.

Result

On initial CT, the main abnormalities observed in common and severe cases respectively were pure ground glass opacities (GGOs) and patchy consolidation surrounded by GGOs. Critical cases had multiple consolidation surrounded by wide range of GGOs distributed in the whole lung fields. The scope and density score in common (4.5 and 5), severe (9.5 and 9.5) and critical (19 and 12) cases were increased by gradient. On follow-up CT, common and severe types manifested as decreasing density of lesion, absorbed consolidation and GGOs. Critical cases showed progression of the disease. The extent and progression scores in common and severe patients were significantly decreased, while the range score of patients with critical disease reached the highest points, accompanied with an increase in the density score.

Conclusion

CT scanning can accurately assess the severity of COVID-19, and help to monitor disease transformation during follow-up among different clinical conditions.