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Chinese Journal of Diagnostics(Electronic Edition) ›› 2020, Vol. 08 ›› Issue (03): 180-185. doi: 10.3877/cma.j.issn.2095-655X.2020.03.008

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Manifestations of the initial chest CT and dynamic changes in patients with common Corona Virus Disease 2019

Wenheng Qin1, Yueqin Chen1, Zhengtong Wang1, Xiaolong Liu1, Wei Liu2, Zhongsheng Zhang3, Zhanguo Sun1,()   

  1. 1. Department of Medical Imaging, Affiliated Hospital of Jining Medical University, Jining 272029, China
    2. Department of Medical Imaging, The Fourth People′s Hospital of Jining, Jining 272031, China
    3. Department of Medical Imaging, The Second People′s Hospital of Jining, Jining 272049, China
  • Received:2020-04-12 Online:2020-08-26 Published:2020-08-26
  • Contact: Zhanguo Sun
  • About author:
    Corresponding author: Sun Zhanguo, Email:

Abstract:

Objective

To investigate the characteristics of the initial chest CT findings and their dynamic changes in patients with common Corona Virus Disease 2019 (COVID-19).

Methods

Forty-one patients diagnosed with common COVID-19 in Jining from January 24, 2020 to March 8, 2020 were collected. The CT morphological characteristics, distribution characteristics and dynamic changes of the lesions and the total severity score of patients with lung infection were analyzed retrospectively.

Results

One hundred and eighty-one lesions were detected in 41 patients. One hundred and twenty-four lesions (68.51%) presented with pure ground glass opacity (GGO), 51 lesions (28.18%) with mixed GGO and consolidation, and 6 lesions (3.31%) with complete consolidation. Morphology of 103 lesions (56.91%) appeared as round-shaped, 57 lesions (31.49%) as band-shaped, and 21 lesions (11.60%) as wedge-shaped. Crazy paving signs were shown in 47 lesions (25.97%), air bronchogram signs in 46 lesions (25.41%), and blood vessels dilatation in 68 lesions (37.57%). In 41 cases, 12 cases (29.27%) showed unilateral involvement and 29 cases (70.73%) showed bilateral involvement. Patients with 1, 2, 3, 4, and 5 lobes involvement were found in 10 cases (24.39%), 7 cases (17.07%), 8 cases (19.51%), 7 cases (17.07%), and 9 cases (21.95%), respectively. According to the lobe distribution of lesions, the upper left lobe, the left lower lobe, the right upper lobe, the right middle lobe, and the right lower lobe accounted for 31(17.13%), 43(23.76%), 26(14.36%), 25(13.81%), and 56 (30.94%), respectively. For CT dynamic observation, comparing the 11th to 15th days of the course with the 2nd to 5th and 6th to 10th days, the total number of lesions (143, 178, 165) and the number of pure GGO [56(39.61%), 101(56.74%), 68(41.21%)] showed a downward trend, the number of mixed GGO and consolidation [81(56.64%), 68(38.20%), 89(53.94%)] showed a gradual increase, there were significant differences in the 3 CT reexaminations(χ2=12.46, 13.26, all P<0.01). Total severity score at the initial and subsequent 3 CT scans evaluations were 4.00(2.50, 7.00), 4.00(2.00, 7.50), 3.00(2.00, 7.00), 2.00(1.00, 4.00)points, respectively. The score difference between the 6th to 10th days and the 11th to 15th days of the course [2.00(1.00, 2.50)points] was greater than the difference between the first CT and the 2nd to 5th days of the course [1.00(0.00, 1.00)points], and also greater than the difference between the 2nd to 5th days and 6th to 10th days of the cause [1.00(0.00, 1.00)points], the differences were statistically significant (H=21.16, P<0.01).

Conclusion

COVID-19 patients have certain chest CT characteristics, which are helpful for early clinical diagnosis and dynamic assessment.

Key words: 2019 novel coronavirus, Corona Virus Disease 2019, Tomography, X-ray computed, Lung, Diagnosis

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