Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210, United States. mina.makary@osumc.edu
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Table 3 Four most common imaging modalities used in the diagnosis and management of coronavirus disease-2019 and their unique features/findings characterized by organ system
Characteristic Features of COVID-19 by Imaging Modality
2GGOs and reticular opacities; consolidations; 3crazy paving pattern; multifocal and bilateral in a peripheral, sub-pleural, and posterior distribution
Interstitial reticular and reticulonodular patterns; alveolar hazy pulmonary opacities (equivalent to GGOs on CT); consolidations; multifocal & bilateral in a peripheral, sub-pleural, and posterior distribution
Table 4 Two main standardized reporting systems used for coronavirus disease-2019 compared by their characteristic features
Standardized CT Imaging Reporting Systems for COVID-19
Characteristics of the Reporting System
Coronavirus Disease 2019 Reporting and Data System[118]-Dutch Radiological Society
Consensus Statement on Reporting Chest CT Findings for COVID-19-Radiological Society of North America[120]
Type of Reporting System
Quantitative
Qualitative
Components & Relationship Between Both Reporting Systems
0 = inadequate or suboptimal imaging
No equivalent
1 = very low suspicion for COVID-19 with findings of non-infectious etiology
Negative for pneumonia = no CT features to suggest pneumonia
2 = low suspicion of COVID-19 with infectious findings not typical for COVID-19
Atypical appearance = absence of typical or indeterminate features & the presence of lobar or segmental consolidation, but no GGOs or centrilobular nodules
3 = equivocal scan with common findings of COVID-19
No equivalent
4 = high suspicion of COVID-19 with typical features that overlap with other viral pneumonias
Indeterminate appearance = absence of typical features and the presence of multifocal, diffuse, or unilateral GGOs with or without consolidation in a non-specific distribution
5 = very high suspicion of COVID-19 with typical findings of disease in typical locations
Typical appearance = peripheral and bilateral GGOs with or without consolidations/crazy paving pattern
6 = RT-PCR positive COVID-19
No equivalent
Inter-observer agreement
Absolute agreement between 68.2% of observers; > 80% observer agreement on COVID-19 being low to very low or high to very high