RADIOLOGICAL FEATURES OF COVID-19

 

1. CXR & CT THORAX IMAGES OF COVID-19 FROM SINGAPORE

 

 

 

2. RADIOLOGICAL SOCIETY OF NORTH AMERICA EXPERT CONSENSUS STATEMENT ON REPORTING CHEST CT FINDINGS RELATED TO COVID-19

 

Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA Published: 25 March 2020

https://pubs.rsna.org/doi/pdf/10.1148/ryct.2020200152

 

3.1 CHEST CT FINDINGS IN CORONAVIRUS DISEASE-19 (COVID-19): RELATIONSHIP TO DURATION OF INFECTION

 

RADIOLOGY Published: 20 February 2020

In this retrospective study, chest CTs of 121 symptomatic patients infected with coronavirus disease-19 (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 (i.e. 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 imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20/36 (56%) of early patients had a normal CT. 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 10/36 early patients (28%), 25/33 intermediate patients (76%), and 22/25 late patients (88%).

https://pubs.rsna.org/doi/10.1148/radiol.2020200463

 

3.2 IMAGING PROFILE OF THE COVID-19 INFECTION: RADIOLOGIC FINDINGS AND LITERATURE REVIEW

 

RADIOLOGY Published: 13 February 2020

The predominant imaging pattern is of ground-glass opacification with occasional consolidation in the peripheries. Pleural effusions and lymphadenopathy were absent in all cases. Patients demonstrate evolution of the ground-glass opacities into consolidation, and subsequent resolution of the airspaces changes. Ground-glass and consolidative opacities visible on CT are sometimes undetectable on chest radiographs, suggesting that CT is a more sensitive imaging modality for investigation. The systematic review identified 4 other studies confirming the findings of bilateral and peripheral ground glass with or without consolidation as the predominant finding on CT chest examinations.

https://doi.org/10.1148/ryct.2020200034

 

3.3 CLINICAL FEATURES OF PATIENTS INFECTED WITH 2019 NOVEL CORONAVIRUS IN WUHAN, CHINA

 

THE LANCET Published: 24 January 2020

All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.

https://doi.org/10.1016/S0140-6736(20)30183-5

 

3.4 COVID-19 IN SINGAPORE—CURRENT EXPERIENCE CRITICAL GLOBAL ISSUES THAT REQUIRE ATTENTION AND ACTION

 

JAMA Published: 20 February 2020

Editorial on the COVID experience in Singapore by Chief Health Scientist MOH, Prof Tan Chorh Chuan.

 

https://jamanetwork.com/journals/jama/fullarticle/2761890

 

3.5 CT IMAGING FEATURES OF 2019 NOVEL CORONAVIRUS (2019-NCOV)

 

RADIOLOGY Published: 4 February 2020

In this retrospective case series, chest CT scans of 21 symptomatic patients from China infected with the 2019 novel coronavirus (2019-nCoV) were reviewed, with emphasis on identifying and characterizing the most common findings. Typical CT findings included bilateral pulmonary parenchymal ground-glass and consolidative pulmonary opacities, sometimes with a rounded morphology and a peripheral lung distribution. Notably, lung cavitation, discrete pulmonary nodules, pleural effusions, and lymphadenopathy were absent. Follow-up imaging in a subset of patients during the study time window often demonstrated mild or moderate progression of disease, as manifested by increasing extent and density of lung opacities..

https://doi.org/10.1148/radiol.2020200230

 

3.6 CLINICAL CHARACTERISTICS OF 138 HOSPITALIZED PATIENTS WITH 2019 NOVEL CORONAVIRUS-INFECTED PNEUMONIA IN WUHAN, CHINA

 

JAMA Published: 7 February 2020

Question What are the clinical characteristics of hospitalized patients with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China? Findings In this single-center case series involving 138 patients with NCIP, 26% of patients required admission to the intensive care unit and 4.3% died. Presumed human-to-human hospital-associated transmission of 2019-nCoV was suspected in 41% of patients. .

 

https://jamanetwork.com/journals/jama/fullarticle/2761044

 

3.7 TIME COURSE OF LUNG CHANGES ON CHEST CT DURING RECOVERY FROM 2019 NOVEL CORONAVIRUS (COVID-19) PNEUMONIA

 

RADIOLOGY Published: 13 February 2020

Key Results:

  • In patients who recovered from COVID-19 pneumonia, initial lung findings on chest CT were small subpleural ground glass opacities (GGO) that grew larger with crazy-paving pattern and consolidation.
  • Lung involvement increased to consolidation up to two weeks after disease onset.
  • After two weeks, the lesions were gradually absorbed leaving extensive GGO and subpleural parenchymal bands.

https://doi.org/10.1148/radiol.2020200370

 

3.8 CHEST IMAGING APPEARANCE OF COVID-19 INFECTION

 

RADIOLOGY Published: 13 February 2020

Key Results:

  • It is important for all radiologists to be aware of the imaging spectrum of the disease and contribute to effective surveillance and response measures.
  • Ground-glass opacities and consolidation can demonstrate an organizing pneumonia pattern.
  • Cavitation can also occur in areas of airspace disease.

https://doi.org/10.1148/ryct.2020200028

 

3.9 COVID-19 INFECTION PRESENTING WITH CT HALO SIGN

 

RADIOLOGY Published: 12 February 2020

A recent case series (3) identified involvement of multiple lobes and predominance of ground-glass opacities as radiologic hallmarks of the outbreak of COVID-19 pneumonia on CT. The CT halo sign has been classically described in hemorrhagic nodules, typically seen in angioinvasive fungal infections, hypervascular metastases, and vasculitides; however, viral infections and organizing pneumonia are known differential causes for the halo sign (4). The present case highlights CT pattern that can be found within the spectrum of radiologic presentations of COVID-19 pneumonia..

https://doi.org/10.1148/ryct.2020200026

 

 

MANAGEMENT & RECONFIGURATION OF RADIOLOGY DEPARTMENTS & IMAGING CENTRES

 

1. RADIOLOGY DEPARTMENT PREPAREDNESS FOR COVID-19: RADIOLOGY SCIENTIFIC EXPERT PANEL

 

Radiology Published: 16 March 2020

https://pubs.rsna.org/doi/pdf/10.1148/radiol.2020200988

 

2. OLD THREAT, NEW ENEMY: IS YOUR INTERVENTIONAL RADIOLOGY SERVICE READY FOR THE CORONAVIRUS DISEASE 2019?

 

CVIR Published: 26 February 2020

https://doi.org/10.1007/s00270-020-02440-6

 

3. DEJA VU OR JAMAIS VU? HOW THE SEVERE ACUTE RESPIRATORY SYNDROME EXPERIENCE INFLUENCED A SINGAPORE RADIOLOGY DEPARTMENT'S RESPONSE TO THE CORONAVIRUS DISEASE (COVID-19) EPIDEMIC

 

AJR Published: 2020

https://www.ajronline.org/doi/full/10.2214/AJR.20.22927

 

4. IS YOUR INTERVENTIONAL RADIOLOGY SERVICE READY FOR SARS? THE SINGAPORE EXPERIENCE

 

CVIR Published: 2003

https://doi.org/10.1007/s00270-003-0143-5

 

5. SEVERE ACUTE RESPIRATORY SYNDROME: MANAGEMENT AND RECONFIGURATION OF A RADIOLOGY DEPARTMENT IN AN INFECTIOUS DISEASE SITUATION

 

RADIOLOGY Published: 2003

https://doi.org/10.1148/radiol.2291030789

 

6. HIDING IN THE BUNKER: CHALLENGES FOR A RADIATION ONCOLOGY DEPARTMENT OPERATING IN THE SEVERE ACUTE RESPIRATORY SYNDROME OUTBREAK

 

AUSTRALASIAN RADIOLOGY Published: 2003

https://doi.org/10.1046/j.0004-8461.2003.01165.x

 

7. WORKFLOW CHANGES IN NUCLEAR MEDICINE DURING COVID-19

 

 

8. SUMMARY OF SEGREGRATION & RE-CONFIGURATION OF RADIOLOGY DEPARTMENTS AND IMAGING CENTRES DURING COVID-19

 

 

PERSONAL PROTECTION AND INFECTION CONTROL MEASURES

 

1. RECOMMENDED USE OF PERSONAL PROTECTIVE EQUIPMENT IN DORSCON YELLOW AND ORANGE

 

 

2. ENVIRONMENTAL CLEANING GUIDELINES FOR COVID-19 EXPOSURE

 

https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines

 

 

3. INFECTION CONTROL MEASURES FOR COVID-19 EXPOSURE

 

 

UPDATES OF CASE DEFINITIONS, CIRCULARS AND PROTOCOLS

 

1. VIRAL PNEUMONIA OF UNKNOWN CAUSE IN WUHAN CITY, CHINA

 

MOH CIRCULAR 04/2020 Published: 2 January 2020

 

2. SUSPECT CASE DEFINITION FOR CORONAVIRUS DISEASE 2019 (COVID-19)

 

MOH CIRCULAR 65/2020 Published: 9 March 2020

 

3. MANAGEMENT OF SUSPECTED PNEUMONIA PATIENT AND INFECTION CONTROL MEASURES FOR X-RAY LABORATORIES

 

MH 50:30-17 Published: 21 February 2020

 

PERSONAL ANCEDOTES FROM THE FRONTLINE, REPORTING ROOM AND PROCEDURE SUITE

 

REFLECTIONS ON COVID-19

 

No. Name PDF
1 Dr Chew Yi Cong
2 Dr How Guo Yuan
3 Dr Tricia Kuah Zhi Ling
4 CGH

 

 

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