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Chest CT Findings in Coronavirus Disease 2019 (COVID-19):
Relationship to Duration of Infection
Autores: Adam Bernheim, MD • Xueyan Mei, MS • Mingqian Huang, MD • Yang Yang, PhD • Zahi A. Fayad, PhD • Ning Zhang, MD • Kaiyue Diao, MD • Bin Lin, MD • Xiqi Zhu, MD • Kunwei Li, MD • Shaolin Li, MD • Hong Shan, MD • Adam Jacobi, MD • Michael Chung, MD
Objetivo:
describir los hallazgos de imagen clave en los estudios de RM estructural de las demen- cias de origen neurodegenerativo más frecuentes: enfermedad de Alzheimer, demencia vascular, demencia de cuerpos de Lewy, variantes de la demencia frontotemporal, parálisis supranu- clear progresiva, variantes de la atrofia multisistémica, parkinson-demencia y degeneración corticobasal.
Conclusión:
El papel de la resonancia magnética hoy en día ya no está limitado a excluir causas subyacentes de deterioro cognitivo, sino que puede mostrar patrones de atrofia y otros datos con un alto valor predictivo para determinadas demencias que, aunque no son específicos ni únicos de cada patología, pueden ayudar a confirmar una sospecha diagnóstica o a identificar inicios tempranos de determinados procesos. Por ello es importante que los radiólogos conozcan los hallazgos típicos de las demencias más frecuentes.
Palabras clave: Resonancia magnética; Atrofia; Demencia; Enfermedad de Alzheimer; Parálisis supranuclear progresiva; Demencia vascular; Atrofia multisistémica; Enfermedad de Parkinson; Demencia frontotemporal
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In this retrospective study, chest CT scans from 121 symptomatic patients infected with coronavirus disease 2019 (COVID-19) from four centers in China from January 18, 2020, to February 2, 2020, were reviewed for common CT findings in relationship to the time between symptom onset and the initial CT scan (ie, early, 0–2 days [36 patients]; intermediate, 3–5 days [33 patients]; late, 6–12 days [25 patients]). The hallmarks of COVID-19 infection on images were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20 of the 36 patients (56%) imaged in the early phase had a normal CT scan. With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, crazy-paving pattern, and the reverse halo sign. Bilateral lung involvement was observed in 10 of the 36 early patients (28%), 25 of the 33 intermediate patients (76%), and 22 of the 25 late patients (88%).
Key Results: The hallmark CT manifestations of coronavirus disease 2019 (COVID-19) include bilateral and peripheral ground-glass and consolidative pulmonary opacities, sometimes with a rounded morphology and peripheral lung distribution. n As the time between onset of symptoms and initial chest CT increases, some CT findings are observed with increasing frequency, including consolidation, bilateral and peripheral lung disease, greater total lung involvement, linear opacities, and the appearance of a crazy-paving pattern and reverse halo sign. n Certain chest CT findings, including pleural effusions, lymphadenopathy, pulmonary nodules, and lung cavitation, are characteristically absent, and more than half of patients imaged quickly after symptom onset have a normal CT scan.
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