Imaging Profile of the COVID-19 Infection: Radiologic Findings and Literature Review

Ng, Ming-Yen; Lee, Elaine YP; Yang, Jin; Yang, Fangfang; Li, Xia; Wang, Hongxia; Lui, Macy Mei-sze; Lo, Christine Shing-Yen; Leung, Barry; Khong, Pek-Lan; Hui, Christopher Kim-Ming; Yuen, Kwok-yung; Kuo, Michael David

BACKGROUND: COVID-19 (formerly known as the 2019 novel coronavirus [2019-nCoV]) has rapidly spread in mainland China and into multiple countries worldwide. The radiographic profile of this infection continues to evolve as more cases present beyond the epicenter of Wuhan, China. PURPOSE: We present 21 COVID-19 cases from two Chinese centers with CT and chest radiograph (CXR) findings, as well as follow-up imaging in 5 cases. MATERIALS AND METHODS: Retrospective study in Shenzhen and Hong Kong. Patients with COVID-19 infection were included. A systematic review of the published literature on COVID-19 infection’s radiological features. RESULTS: The predominant imaging pattern is of ground-glass opacification with occasional consolidation in the peripheries. Pleural effusions and lymphadenopathy were absent in all cases. Patients demonstrate evolution of the ground-glass opacities into consolidation, and subsequent resolution of the airspaces changes. Ground-glass and consolidative opacities visible on CT are sometimes undetectable on chest radiographs, suggesting that CT is a more sensitive imaging modality for investigation. The systematic review identified 4 other studies confirming the findings of bilateral and peripheral ground glass with or without consolidation as the predominant finding on CT chest examinations. CONCLUSION: The COVID-19 infection pulmonary manifestation is predominantly characterized by ground-glass opacification with occasional consolidation on CT. Radiographic findings in patients presenting in Shenzhen and Hong Kong are in keeping with 4 previous publications from other sites. The 2019 novel coronavirus (2019-nCoV), initially reported in Wuhan, China, has been declared a global health emergency. CT has been used on a massive scale to help identify and investigate suspected or confirmed cases of COVID-19. We present the findings of 21 confirmed COVID-19 infection in Shenzhen and Hong Kong, China. We found that the most common findings on chest CT were bilateral ground-glass opacities with or without consolidation in the lung periphery. Pleural effusions and lymphadenopathy were absent in all patients. A systematic review was undertaken to summarize the 4 previous publications on the imaging findings of this emerging infection in a total of 233 patients. Ground glass with or without consolidation were the most common findings in all publications, in alignment with our own findings.