PMC:7156903 / 11970-16403 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7156903","sourcedb":"PMC","sourceid":"7156903","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7156903","text":"The typical chest CT imaging characteristics of COVID-19 include multiple, peripheral, bilateral, patchy, sub-segmental, or segmental ground glass opacities and areas of consolidation, which are mostly distributed along the bronchovascular bundles and subpleural space. The presence of associated interlobular septal thickening in the areas of ground glass opacity can give a crazy paving appearance. Air bronchograms with the areas of consolidation and bronchial wall thickening are often present. More rarely, there is a thickening of the adjacent pleura or interlobar pleura, and a small amount of pleural effusion. There is no obvious lymphadenopathy [15] (Tables 2, 3). The imaging features mentioned above are consistent with the findings from 81 patients in a recently reported article, in which the predominant pattern of abnormality observed was bilateral, peripheral, ill-defined, and ground glass opacification, mainly involving the right lower lobes [20]. Furthermore, in the currently available reports, the most common chest CT findings in COVID-19 patients are the peripheral areas of ground glass opacity/consolidation (without subpleural sparing) which are bilateral in distribution [21–23]. In one study, of 21 patients, most had more than two lobes affected (15 of 21, 71%) with bilateral involvement (16 of 21, 76%) [24]. Another study showed that the most common patterns of COVID-19 on thin-section CT images are pure ground glass opacity, ground glass opacity with intra- and/or interlobular septal thickening, and ground glass opacity with consolidation and consolidation, with prominent distribution in the posterior and peripheral part of the lungs [25]. In a large research cohort study, chest CT findings showed a bilateral distribution of patchy ground glass opacity and consolidation in 138 patients [26]. Typical chest radiograph and chest CT of COVID-19 are shown in Figs. 2 and 3.\nTable 2 The typical features on CT imaging of COVID-19\nParameter Characteristic manifestations on CT imaging\nDensity Ground glass opacity and consolidation, possible interlobular septal thickening\nShape Patchy, sub-segmental, or segmental\nDistribution Mid and lower lungs along the bronchovascular bundles with bilateral involvement\nLocation Peripheral and subpleural areas of the lung parenchyma\nConcomitant signs (variable) Air bronchogram, a small amount of pleural effusion, no obvious lymphadenopathy\nTable 3 Frequency of chest CT findings in COVID-19\nCT signs Frequency Stage\nGround glass opacity ++++ E/A/S\nConsolidation without ground glass opacity ++ S\nGround glass opacity and crazy paving ++ E/A/S\nGround glass opacity with consolidation +++ E/A/S\nPatchy ground glass opacity +++ E\nBilateral distribution ++++ E/A/S/D\nPeripheral distribution +++ E\nAir bronchogram ++ E/A/S\nPleural effusion + S\nStrip-like opacity + D\nThe appearance frequency of each CT characteristic is described in order from low to high as (+~++++); E, A, S, and D stand for stage early, advanced, severe, and dissipation\nFig. 2 Chest radiograph (a) in a 61-year-old man shows bilateral patchy, somewhat nodular opacities in the mid to lower lungs [16]. Unenhanced computed tomography (CT) images (b) in a 33-year-old woman., Images show multiple ground glass opacities in the periphery of the bilateral lungs. The bilateral, peripheral patterns of opacities without subpleural sparing are common and characteristic CT findings of the 2019 novel coronavirus pneumonia [22]. Chest CT image of a 71-year-old male (c) shows consolidation in the peripheral right upper lobe and a patchy area of ground glass opacity with some associated consolidation intra- and interlobular septal thickening within the left upper lobe [25]\nFig. 3 Typical CT findings of COVID-19. Chest CT (a) in a 75-year-old male show multiple patchy areas of pure ground glass opacity (GGO) and GGO with reticular and/or interlobular septal thickening [25]. Chest CT image of a 38-year-old male (b) shows multiple patches, grid-like lobule, and thickening of interlobular septa, typical “paving stone-like” signs [19]. An axial CT image obtained in 65-year-old female (c) shows bilateral ground glass and consolidative opacities with a striking peripheral distribution [23]. CT image of a 65-year-old male (d) shows large consolidation in the right middle lobe, patchy consolidation in the posterior and basal segment of right lower lobe, with air bronchogram inside 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