Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (5): 38-45.doi: 10.6040/j.issn.1671-7554.0.2020.541

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Chest CT features of 105 patients with COVID-19: a multicenter retrospective study in Shandong Province

CHENG Zhaoping1, DUAN Yanhua1, YAO Jinkun2, LI Yan3, GU Hui4, YUAN Xianshun4, LIU Bin5, BI Wanli1, SONG Zhaoliang5, NIE Pei6, CHEN Yueqin7, SUN Zhanguo7, LIU Shanping8, WANG Luguang9, TANG Zhongren10, WEI Xianglei11, DONG Liang12, WANG Chunting13, WANG Ximing4   

  1. 1. Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan 250021, Shandong, China;
    2. Department of Radiology, Linyi Peoples Hospital, Linyi 276100, Shandong, China;
    3. Department of Radiology, Yantai Qishan Hospital, Yantai 264001, Shandong, China;
    4. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    5. Department of Radiology, Zaozhuang Municipal Hospital, Zaozhuang 277102, Shandong, China;
    6. Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China;
    7. Department of Radiology, The Affiliated Hospital of Jining Medical College, Jining 272029, Shandong, China;
    8. Department of Radiology, Xintai Peoples Hospital, Xintai 271200, Shandong, China;
    9. Department of Radiology, Dongchangfu Peoples Hospital, Liaocheng 252000, Shandong, China;
    10. Department of Radiology, Haiyang Peoples Hospital, Haiyang 265100, Shandong, China;
    11. Department of Radiology, Linyi Central Hospital, Linyi 276400, Shandong, China;
    12. Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    13. Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To explore the chest CT features of patients with coronavirus disease 19(COVID-19)and the clinical application value. Methods The epidemiological, clinical and chest CT data of 105 COVID-19 cases confirmed by nucleic acid test in accordance with Diagnosis and Treatment of Novel Coronavirus Pneumonia(trial version sixth)who were treated and cured(or died)during Jan. and Mar. 2020 were retrospectively analyzed. The patients included 92 common cases and 13 severe or critical cases, averaged 48±14(21-88)years old. The basic and dynamic characteristics of chest CT images were analyzed and compared between the two groups. Results All patients had a clear epidemiological history. The main initial clinical symptoms were fever(85%, 90/105), cough and expectoration(72%, 75/105). Both leucocyte count(11%, 12/105)and lymphocyte count(38%, 40/105)were decreased. Chest CT showed that in the early stage, multiple ground glass opacity(GGO, 98%)was observed in bilateral lungs involving 3 lobes(2, 5)in average, mainly distributed in the middle and outer zone of the lung under pleura; in the progressive stage, GGO consolidated(96%), with interlobular septal thickening(64%), paving stone sign(42%), reactive pleura thickening(23%), pleural effusion(3 cases), pneumothorax(1 case); in the recovery stage, fibrous streak sign was observed(49%). Another important feature was typical air bronchogram sign(ABS, 41%)and microvascular dilation sign(MVDS, 40%)in the extrapulmonary zone. Compared with the common cases, the severe cases had more lobes involved (P<0.001), higher semi-quantitative score (P<0.001), and higher incidences of paving stone sign(85% vs 34%, P=0.001), interlobular septal thickening(92% vs 61%, P=0.029), pleural thickening(69% vs 16%, P<0.001), and fibrous streak sign(85% vs 43%, P=0.007). Dynamic image analysis showed that in the initial stage, positive image manifested later than clinical symptoms: chest CT showed positive signs of the disease on day 5(5, 6), the disease progressed on day 5(5, 7)until day 11(10, 14), and showed possible outcome after another 12(11, 15)days. The span between progression and outcome was related to the severity of disease, and CT outcome was delayed after nucleic acid test was negative. Conclusion COVID-19 shows some specific manifestations on chest CT, characterized by GGO, dynamic evolution, ABS and MVDS. The above manifestations and semi-quantitative evaluation can provide reliable basis for the early diagnosis, clinical classification and prognosis evaluation of COVID-19.

Key words: Coronavirus disease 19, Chest, Tomography, X-ray computed

CLC Number: 

  • R563.1
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