Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review

Abstract

Coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, has rapidly swept around the world just within a month, causing global public health emergency. In diagnosis, chest computed tomography (CT) manifestations can supplement parts of limitations of real-time reverse transcription polymerase chain reaction (RT-PCR) assay. Based on a comprehensive literature review and the experience in the frontline, we aim to review the typical and relatively atypical CT manifestations with representative COVID-19 cases at our hospital, and hope to strengthen the recognition of these features with radiologists and help them make a quick and accurate diagnosis.Key Points• Ground glass opacities, consolidation, reticular pattern, and crazy paving pattern are typical CT manifestations of COVID-19.• Emerging atypical CT manifestations, including airway changes, pleural changes, fibrosis, nodules, etc., were demonstrated in COVID-19 patients.• CT manifestations may associate with the progression and prognosis of COVID-19.

Keywords: Coronavirus infections; Pneumonia; Tomography, X-ray computed.

Conflict of interest statement

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Figures

Fig. 1

a A 35-year-old male COVID-19 patient presenting fever and headache for 1 day. CT scan shows a pure ground glass opacity in the right lower lobe (red frame). b A 47-year-old male COVID-19 patient presenting fever for 7 days. CT scan shows consolidation in the right lobe subpleural area (red frame)

Fig. 2

a A 34-year-old female COVID-19 patient presenting fever with dry cough for 2 days. CT scan shows slight reticular pattern in the left lower lobe and subpleural area (red frame). b An 81-year-old female COVID-19 patient presenting fever with cough for 7 days. CT scan shows reticular pattern superimposed on the background of GGO, resembling the sign of crazy paving stones in the right middle lobe (red frame)

Fig. 3

a A 48-year-old male COVID-19 patient presenting fever for 5 days. CT scan shows bilateral GGO in the lower lobe (red frames) and air bronchogram (white arrow) in the left subpleural area. b A 66-year-old male COVID-19 patient presenting fever with cough for 7 days. CT scan shows reticular pattern in the subpleural areas of the bilateral lower lobe, GGO, and bronchial wall thickening (white arrow) in the right middle lobe

Fig. 4

a An 80-year-old female COVID-19 patient presenting fever for 7 days. CT scan shows left pleural thickening (white arrows). b A 43-year-old female COVID-19 patient presenting fever and chills for 5 days. CT scan shows subpleural lines (white arrows) in bilateral lower lobes. c A 66-year-old female COVID-19 patient presenting cough and myalgia for 7 days. CT scan shows bilateral GGO and fibrous stripes (white arrows) in the left lower lobe. d A 35-year-old male COVID-19 patient presenting fever and headache for 1 day. CT scan shows a large area of GGO (red frame) in the right upper lobe with multiple small vascular enlargement (white arrows)

Fig. 5

a A 49-year-old male COVID-19 patient presenting fever with diarrhea for 3 days. CT scan shows a patchy GGO (red frame) with an air bubble sign (white arrow) in the apicoposterior segment of the upper left lobe. b A 76-year-old female COVID-19 patient presenting fever with cough for 4 days. CT scan shows an irregular nodule (white arrow) in the posterior segment of the right upper lobe. c A 46-year-old male COVID-19 patient presenting fever with dry cough for 5 days. CT scan shows a solid nodule surrounded by a ground glass halo in the lateral segment of the right middle lobe (red frame). d A 66-year-old woman confirmed with COVID-19 presenting fever and myalgia for 7 days. CT scan shows a reversed halo sign (red frame) in the posterior basal segment of the right lower lobe

Fig. 6

A 49-year-old female COVID-19 patient presenting chest pain for 14 days. CT scan shows enlargement of mediastinal lymph nodes (asterisks)