Vascular enlargement and bronchiolectasis: Two important CT manifestations in Coronavirus Disease 2019 (COVID-19) and clinicopathologic analysis

DOI: 10.14800/ics.1168

Abstract

Coronavirus disease 2019 (COVID-19) is a novel infectious disease that spreads rapidly around the world and endangers global public health. Because of the lack of specificity of previously identified CT images, such as peripheral and subpleural ground glass opacities, early diagnosis is still a big challenge for radiologists. How to improve the accuracy of diagnosis and make diagnosis as early as possible is a problem concerned by the medical field. This article reports two important CT manifestations in COVID-19 patients, and investigates the pathogenesis and clinical significance of them. Single or multiple CT scans in COVID-19 patients confirmed at our hospital were retrospectively analyzed. The presence of vascular enlargement sign and bronchiolectasis sign on CT images were evaluated with the help of sophisticated post-processing techniques. A total of 14 patients (6 men and 8 women; mean ± standard deviation age: 41.51 ± 20.98 years) with 34 CT series were included. Vascular enlargement sign at a distribution of interior or the edge of pulmonary lesions was observed in all CT series (34/34, 100%). Bronchiolectasis sign was observed in 30 CT series (88%), with 4 series (4/7, 57.1%) in early stage, 16 series (16/16, 100%) in progressive stage, 5 series (5/5, 100%) in severe stage and 9 series (9/9, 100%) in absorption stage. The occurrence of bronchiolectasis sign in COVID-19 patients was significantly different between early stage and non-early stage (P=0.005). This study suggests that the vascular enlargement sign and bronchiolectasis sign are two important CT features in COVID-19 patients and may be of great significance in early diagnosis and guiding treatment decisions.