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A Comparison of CT Manifestations between Coronavirus Disease 2019 (COVID-19) and Other Types of Viral Pneumonia

Author(s):

Haixia Mao, Xiaoshan Li, Xiaoming Lin, Lijuan Zhou, Xiuping Zhang, Yang Cao, Yilun Jiang, Hongwei Chen, Xiangming Fang* and Lan Gu  

Abstract:


Background: Though imaging manifestations of COVID-19 and other types of viral pneumonia are similar, their clinical treatment methods differ. Accurate, non-invasive diagnostic methods using CT imaging can help developing an optimal therapeutic regimen for both conditions.

Objectives: To compare the initial CT imaging features in COVID-19 with those in other types of viral pneumonia.

Methods: Clinical and imaging data of 51 patients with COVID-19 and 69 with other types of viral pneumonia were retrospectively studied. All significant imaging features (Youden index >0.3) were included for constituting the combined criteria for COVID-19 diagnosis, composed of two or more imaging features with a parallel model. McNemar's chi-square test or Fisher's exact test was used to compare the validity indices (sensitivity and specificity) among various criteria.

Results: Ground glass opacities (GGO) dominated density, peripheral distribution, unilateral lung, clear margin of lesion, rounded morphology, long axis parallel to the pleura, vascular thickening, and crazy-paving pattern were more common in COVID-19 (p <0.05). Consolidation-dominated density, both central and peripheral distribution, bilateral lung, indistinct margin of lesion, tree-in-bud pattern, mediastinal or hilar lymphadenectasis, pleural effusion, and pleural thickening were more common in other types of viral pneumonia (p < 0.05). GGO-dominated density or long axis parallel to the pleura (with the highest sensitivity), and GGO-dominated density or long axis parallel to the pleura or vascular thickening (with the highest specificity) are good combined criteria of COVID-19.

Conclusion: The initial CT imaging features are helpful for differential diagnosis between COVID-19 and other types of viral pneumonia.

Keywords:

coronavirus disease 2019, tomography, X-ray computed, other types of viral pneumonia, Ground glass Opacities, differential diagnosis, manifestation

Affiliation:

Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Department of Lung Transplantation Center, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Department of Radiology, Wuxi Fifth People's Hospital, Wuxi, Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Department of Radiology, Wuxi Huishan District People’ s Hospital, Wuxi, Department of Radiology, Wuxi Xiishan District People’ s Hospital, Wuxi, Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, Department of Radiology, Wuxi Fifth People's Hospital, Wuxi



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