Radiology: Cardiothoracic Imaging
Radiological Society of North America
image
COVID-19 Infection Presenting with CT Halo Sign
Volume: 2, Issue: 1
DOI 10.1148/ryct.2020200026
  • PDF   
  • XML   
  •       

Table of Contents

Highlights

Notes

Li, Zeng, Liu, and Yu: COVID-19 Infection Presenting with CT Halo Sign

A 27-year-old woman who worked in Wuhan, China presented to the hospital with a 4-day history of fever and cough. At admission, her body temperature was elevated to 38.5°C (101.3°F) and coarse breath sounds were heard during auscultation. Laboratory studies showed leucopenia, and positive sputum analysis using real-time reverse transcriptase fluorescence polymerase chain reaction confirmed infection by COVID-19 (formerly known as 2019 novel coronavirus [2019-nCoV]) (1,2). Noncontrast chest CTs obtained at admission and after 4 days of hospitalization (Figure) showed a right upper lobe nodule with ground-glass halo, which increased in size between studies, concurrently with the deterioration of clinical symptoms.

Nonenhanced axial chest CT images in a 27-year-old woman. A, Image shows a solid nodule (*) surrounded by a ground-glass halo in the posterior right upper lobe segment (arrows). B, Image at the same level as in A, obtained 4 days after, shows increase in size of the solid nodule (*), with development of small peripheral air bronchograms.
Nonenhanced axial chest CT images in a 27-year-old woman. A, Image shows a solid nodule (*) surrounded by a ground-glass halo in the posterior right upper lobe segment (arrows). B, Image at the same level as in A, obtained 4 days after, shows increase in size of the solid nodule (*), with development of small peripheral air bronchograms.

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.

Notes

This study was supported by the Anhui Natural Science Foundation (20200410702003)
Disclosures of Conflicts of Interest: : X.L. disclosed no relevant relationships. X.Z. disclosed no relevant relationships. B.L. disclosed no relevant relationships. Y.Y. disclosed no relevant relationships.

References

1. 

Zhu N, Zhang D, Wang W, et al. . A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020 Jan 24. doi: 10.1056/ NEJMoa2001017. [Epub ahead of print]

2. 

Huang C, Wang Y, Li X, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 [Epub ahead of print].

3. 

Lei J, Li J, Qi X. . CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology , pp.2020 (in press).

4. 

Pinto PS. . The CT halo sign. Radiology 2004;230(1):, pp.10910.

https://www.researchpad.co/tools/openurl?pubtype=article&doi=10.1148/ryct.2020200026&title=COVID-19 Infection Presenting with CT Halo Sign&author=Xiaohu Li,Xiaosong Zeng,Bin Liu,Yongqiang Yu,&keyword=&subject=Images in Cardiothoracic Imaging,Pulmonary Imaging,