Imaging manifestations and differential diagnosis of novel coronavirus pneumonia

Abstract

Abstract: Objective To investigate the early manifestations of the novel coronavirus pneumonia on chest CT, and to distinguish it from the clinical and imaging features of the previous outbreak of viral pneumonia. Methods Retrospective analysis was performed on 33 suspected cases of novel coronavirus pneumonia admitted to Zhongnan Hospital of Wuhan University, and their clinical and imaging data was analyzed. Review and summarize the literature of previous outbreak of viral pneumonia for differential diagnosis.Results Chest CT of the suspected cases of the novel coronavirus pneumonia mainly showed ground-glass opacity, mixed ground-glass opacity,latticed opacity, consolidation, and showing patchy or lump-like shape. The lesions were widely distributed, involving three lobes of two lungs and above. Patients with pleural effusion and mediastinal lymph node enlargement are rare. Conclusion The chest CT of the novel coronavirus pneumonia has certain characteristics, but it is difficult to distinguish from other viral pneumonia. Combining clinical epidemiological data, clinical manifestations and laboratory tests, viral pneumonia can be differentiated.

Key words: Novel coronavirus pneumonia, Viral pneumonia, Imaging features, Differential diagnosis

Song Lu, Zeng Yingting, Gong Xiaoming, Zhang Xiaochun, Lu Zhiyan. Imaging manifestations and differential diagnosis of novel coronavirus pneumonia[J]. Electronic Journal of Emerging Infectious Diseases, 2020, 5(2): 83-86.

References

[1] World Health Organization. Novel coronavirus-China.2020[EB/OL]. https://www.who.int/csr/don/12 january 2020 novel coronavirus china/en/.
[2] Chan JF, Yuan S, Kok K, et al.A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster[J]. Lancet, 2020, 395(10223):514-523.
[3] 国家卫生健康委. 关于印发新型冠状病毒肺炎诊疗方案(试行第四版)的通知[EB/OL]. http://www.nhc.gov.cn/xcs/yqfkdt/202001/4294563ed35b43209b31739bd0785e67.shtml.
[4] Huang C, Wang Y, Li X, et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223):497-506.
[5] 钟南山. 传染性非典型肺炎(SARS)诊疗方案[J]. 中华医学杂志, 2003, 83(19):1731-1752.
[6] Wong KT, Antonio GE, Hui DSC, et al.Thin-section CT of severe acute respiratory syndrome: evaluation of 73 patients exposed to or with the disease1[J]. Radiology, 2003, 228(2): 395-400.
[7] Ooi GC, Khong PL, Müller NL, et al.Severe acute respiratory syndrome: temporal lung changes at thin-section CT in 30 patients[J]. Radiology, 2004, 230(3): 836-844.
[8] 苏冠琴,于铁链,张云亭. SARS与细菌性肺炎不同病期的CT表现及动态分析[J]. 临床放射学杂志,2005(3):221-224.
[9] 刘春红,马大庆. SARS的影像学表现[J]. 中华放射学杂志, 2003, 37(7):654-655.
[10] Wong KT, Antonio GE, Hui DSC, et al.Severe acute respiratory syndrome: radiographic appearances and pattern of progression in 138 patients[J]. Radiology, 2003, 228(2): 401-406.
[11] 李航,鲁植艳. 美国近期严重流感疫情引发的思考[J]. 新发传染病电子杂志,2018,3(1):5-7.
[12] 刘国兵,吴光耀. 新型甲型H1N1流感胸部影像学表现[J]. 临床放射学杂志,2010,29(2):277-279.
[13] 杨燕,郑继坤,孟娴,等. 甲型H1N1流感肺炎的多层螺旋CT表现及动态变化观察[J]. 实用医学影像杂志,2016,17(4):325-327.
[14] 邓莹莹,陆普选,刘映霞,等. 甲型H1N1流感肺炎的胸部CT表现及动态变化特点[J]. 中国医学影像技术,2010,26(6):1108-1111.
[15] Aviram G, Bar-Shai A, Sosna J, et al.H1N1 Influenza: Initial Chest Radiographic Findings in Helping Predict Patient Outcome[J]. Radiology, 2010, 255(1):252-259.
[16] 王雪元,胡粟,毛新峰,等. H7N9亚型人禽流感的胸部CT早期表现[J]. 临床放射学杂志,2014,33(4):628-630.
[17] 宋传涛,王兆华. 人感染H7N9禽流感胸部影像学表现:2例报告并文献复习[J]. 医学影像学杂志,2013,23(9):1399-1402.
[18] 邹家基,邹子仪,史小平,等. CT影像诊断人感染H7N9禽流感和甲型H1N1流感重症肺炎的对比[J]. 临床医学,2016,36(9):89-91.
[19] 辛小燕,常莹,孙晓敏,等. 甲型H7N9病毒性肺炎的胸部影像学表现[J]. 医学影像学杂志,2015,25(4):637-640.
[20] 吴炅,孔俊沣,何泽清,等. 人感染H7N9禽流感病毒性肺炎的胸部X线与CT影像学表现及特征分析[J]. 医学影像学杂志,2019,29(5):770-774.
[21] 施睿峰,施纯子,马倩,等. 临床影像学在人感染H7N9禽流感诊治中的价值[J]. 新发传染病电子杂志,2016,1(1):50-52.
[22] 龚晓明,鲁植艳. 急性脑炎的MRI研究进展[J]. 新发传染病电子杂志,2019,4(4):240-243.