Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia

Objectives To investigate the different CT characteristics which may distinguish influenza from 2019 coronavirus disease (COVID-19). Methods A total of 13 confirmed patients with COVID-19 were enrolled from January 16, 2020, to February 25, 2020. Furthermore, 92 CT scans of confirmed patients with i...

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Veröffentlicht in:European radiology Jg. 30; H. 9; S. 4910 - 4917
Hauptverfasser: Wang, Hao, Wei, Ran, Rao, Guihua, Zhu, Jie, Song, Bin
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2020
Springer Nature B.V
Schlagworte:
Adult
Aged
Attenuation
Betacoronavirus
Chest
Computed tomography
Consolidation
Contours
Coronaviridae
Coronavirus Infections - diagnostic imaging
Coronaviruses
COVID-19
Diagnosis
Diagnosis, Differential
Diagnostic Radiology
Differential diagnosis
Epidemics
Female
Humans
Imaging
Influenza
Influenza A
Influenza B
Influenza, Human - diagnostic imaging
Internal Medicine
Interventional Radiology
Lesions
Localization
Male
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Opacity
Pandemics
Pleural Effusion
Pneumonia
Pneumonia, Viral - diagnostic imaging
Pulmonary lesions
Radiology
Retrospective Studies
SARS-CoV-2
Shape
Thickening
Tomography, X-Ray Computed
Ultrasound
Viral diseases
Young Adult
Virus
Pneumonia
Coronavirus
Influenza
Tomography, X-ray
ISSN:0938-7994, 1432-1084, 1432-1084
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Zusammenfassung:Objectives To investigate the different CT characteristics which may distinguish influenza from 2019 coronavirus disease (COVID-19). Methods A total of 13 confirmed patients with COVID-19 were enrolled from January 16, 2020, to February 25, 2020. Furthermore, 92 CT scans of confirmed patients with influenza pneumonia, including 76 with influenza A and 16 with influenza B, scanned between January 1, 2019, to February 25, 2020, were retrospectively reviewed. Pulmonary lesion distributions, number, attenuation, lobe predomination, margin, contour, ground-glass opacity involvement pattern, bronchial wall thickening, air bronchogram, tree-in-bud sign, interlobular septal thickening, intralobular septal thickening, and pleural effusion were evaluated in COVID-19 and influenza pneumonia cohorts. Results Peripheral and non-specific distributions in COVID-19 showed a markedly higher frequency compared with the influenza group ( p  < 0.05). Most lesions in COVID-19 showed balanced lobe localization, while in influenza pneumonia they were predominantly located in the inferior lobe ( p  < 0.05). COVID-19 presented a clear lesion margin and a shrinking contour compared with influenza pneumonia ( p  < 0.05). COVID-19 had a patchy or combination of GGO and consolidation opacities, while a cluster-like pattern and bronchial wall thickening were more frequently seen in influenza pneumonia ( p  < 0.05). The lesion number and attenuation, air bronchogram, tree-in-bud sign, interlobular septal thickening, and intralobular septal thickening were not significantly different between the two groups (all p  > 0.05). Conclusions Though viral pneumonias generally show similar imaging features, there are some characteristic CT findings which may help differentiating COVID-19 from influenza pneumonia. Key Points • CT can play an early warning role in the diagnosis of COVID-19 in the case of no epidemic exposure. • CT could be used for the differential diagnosis of influenza and COVID-19 with satisfactory accuracy. • COVID-19 had a patchy or combination of GGO and consolidation opacities with peripheral distribution and balanced lobe predomination.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0938-7994
1432-1084
1432-1084
DOI:10.1007/s00330-020-06880-z