PubMed Journals: AJR Am J Roentgenol

  Source:		PMID: 32130038

    		AJR Am J Roentgenol. 2020 Mar 4:1-7. doi:
     		10.2214/AJR.20.22954. [Epub ahead of print]

			Coronavirus Disease 2019 (COVID-19): Role of
			Chest CT in Diagnosis and Management.

			Li Y(1), Xia L(1).

			Author Information
			(1) Department of Radiology, Tongji Hospital,
			Huazhong University of Science and Technology,
			1095 Jiefang Ave, Wuhan, Hubei 430030,

			OBJECTIVE. The objective of our study was to
			determine the misdiagnosis rate of radiologists
			for coronavirus disease 2019 (COVID-19) and
			evaluate the performance of chest CT in the
			diagnosis and management of COVID-19. The
			CT features of COVID-19 are reported and
			compared with the CT features of other viruses
			to familiarize radiologists with possible CT
			patterns. MATERIALS AND METHODS. This
			study included the first 51 patients with a
			diagnosis of COVID-19 infection confirmed by
			nucleic acid testing (23 women and 28 men;
			age range, 26-83 years) and two patients with
			adenovirus (one woman and one man; ages, 58
			and 66 years). We reviewed the clinical
			information, CT images, and corresponding
			image reports of these 53 patients. The CT
			images included images from 99 chest CT
			examinations, including initial and follow-up CT
			studies. We compared the image reports of the
			initial CT study with the laboratory test results
			and identified CT patterns suggestive of viral
			infection. RESULTS. COVID-19 was
			misdiagnosed as a common infection at the
			initial CT study in two inpatients with underlying
			disease and COVID-19. Viral pneumonia was
			correctly diagnosed at the initial CT study in the
			remaining 49 patients with COVID-19 and two
			patients with adenovirus. These patients were
			isolated and obtained treatment. Ground-glass
			opacities (GGOs) and consolidation with or
			without vascular enlargement, interlobular
			septal thickening, and air bronchogram sign are
			common CT features of COVID-19. The The
			"reversed halo" sign and pulmonary nodules
			with a halo sign are uncommon CT features.
			The CT findings of COVID-19 overlap with the
			CT findings of adenovirus infection. There are
			differences as well as similarities in the CT
			features of COVID-19 compared with those of
			the severe acute respiratory syndrome.
			CONCLUSION. We found that chest CT had a
			low rate of missed diagnosis of COVID-19
			(3.9%, 2/51) and may be useful as a standard
			method for the rapid diagnosis of COVID-19 to
			optimize the management of patients.
			However, CT is still limited for identifying
			specific viruses and distinguishing between

			DOI: 10.2214/AJR.20.22954 PMID: 32130038

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