An axial CT image obtained without intravenous contrast in a 36‐year‐old male (Panel A) shows bilateral ground‐glass opacities in the upper lobes with a rounded morphology (arrows). Image courtesy of Radiology Online.
February 20, 2020 — In new research published today in the journal Radiology, researchers from Mount Sinai Health System in New York demonstrated that computed tomography (CT) findings in coronavirus disease 19 (COVID-19) cases are related to infection time course.
“Chest CT is a vital component in the diagnostic algorithm for patients with suspected COVID-19 infection. Indeed, given the limited number of rRT-PCR kits in some centers and the possibility of false negative rRT-PCR results, the National Health Commission of the People’s Republic of China has encouraged diagnosis based on clinical and chest CT findings alone,” the authors wrote.
The researchers analyzed chest CTs of 121 symptomatic patients infected with COVID-19 from four centers in China from January 18, 2020, to February 2, 2020, for common CT findings in relationship to the time between symptom onset and the initial CT scan.
They found ground-glass abnormality in early disease, followed by development of “crazy paving,” and finally increasing consolidation later in the disease course.
Recognizing imaging patterns based on infection time course is paramount for not only understanding the pathophysiology of infection, but also for helping to predict patient progression and potential complication development.
“Future investigators may evaluate imaging findings in chronic patients. Such work could evaluate if long-term complications potentially arise,” the authors wrote.
LISTEN to Update on Coronavirus (COVID-19) February 19 Podcast by Radiology Editor David A. Bluemke, M.D., here.
For more information from the Radiological Society of North America (RSNA): Special Focus: COVID-19.
Additional References on the Novel Coronavirus:
1. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing: Radiology. https://doi.org/10.1148/radiol.2020200343. Accessed Feb. 14, 2020
2. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia: Radiology. https://doi.org/10.1148/radiol.2020200370. Accessed Feb. 14, 2020
3. U.S. Food and Drug Administration: https://www.fda.gov/news-events/press-announcements/fda-takes-significant-step-coronavirus-response-efforts-issues-emergency-use-authorization-first?utm_campaign=020420_PR_FDA%20Issues%20EUA%20for%20First%202019%20Novel%20Coronavirus%20Diagnostic&utm_medium=email&utm_source=Eloqua. Accessed Feb. 14, 2020.
4. Public Health News Alert: CMS Develops New Code for Coronavirus Lab Test. https://www.cms.gov/. Accessed Feb. 14, 2020.