Early differential diagnosis between COVID-19 and mycoplasma pneumonia with chest CT scan.
10.3785/j.issn.1008-9292.2020.07.04
- Author:
Xianluo HUO
1
;
Xiaohua XUE
2
;
Shuhui YUAN
3
;
Dianchun ZHANG
4
;
Qing'e GAO
5
;
Tao GONG
6
Author Information
1. Department of CT, Zibo First Hospital, Zibo 255200, Shandong Province, China.
2. Department of Respiratory and Critical Care, Zibo First Hospital, Zibo 255200, Shandong Province, China.
3. Department of Blood Screening Test, Jinan Blood Center, Jinan 250021, China.
4. Department of Radiology, Lanshan People's Hospital, Linyi 276002, Shandong Province, China.
5. Department of Infection, Fourth People's Hospital of Zibo City, Zibo 255000, Shandong Province, China.
6. Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250021, China.
- Publication Type:Journal Article
- Keywords:
Computed tomography;
Coronavirus disease 2019;
Crazy-paving sign;
Mycoplasma pneumoniae;
Tree-bud sign
- MeSH:
Adult;
Betacoronavirus;
Clinical Laboratory Techniques;
standards;
Coronavirus Infections;
diagnosis;
diagnostic imaging;
Diagnosis, Differential;
Humans;
Lung;
diagnostic imaging;
Pandemics;
Pneumonia, Mycoplasma;
diagnostic imaging;
Pneumonia, Viral;
diagnostic imaging;
Tomography, X-Ray Computed
- From:
Journal of Zhejiang University. Medical sciences
2020;49(4):468-473
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To early differentiate between coronavirus disease 2019 (COVID-19) and adult mycoplasma pneumonia with chest CT scan.
METHODS:Twenty-six patients with COVID-19 and 21 patients with adult mycoplasma pneumonia confirmed with RT-PCR test were enrolled from Zibo First Hospital and Lanshan People's Hospital during December 1st 2019 and March 14th 2020. The early chest CT manifestations were analyzed and compared between the two groups.
RESULTS:The interstitial changes with ground glass density shadow (GGO) were similar in two groups during first chest CT examination (>0.05). There were more lung lobes involved on the first chest CT in COVID-19 patients, which were mostly distributed in the dorsal outer zone (23/26, 88.5%), and nearly half of them (12/26, 46.2%) were accompanied by crazy-paving sign; while the lesions in adult mycoplasma pneumonia patients were mostly distributed along the bronchi, and the bronchial wall was thickened (19/21, 90.5%), accompanied with tree buds / fog signs (19/21, 90.5%). The above CT signs were significantly different between the two kinds of pneumonia (all <0.01). COVID-19 had a longer course compared with mycoplasma pneumonia, the disease peaks of COVID-19 patients was on day (10.5±3.8), while the disease on CT was almost absorbed on day (7.9±2.2) in adult mycoplasma pneumonia. The length of hospital stay in COVID-19 patients was significantly longer than that of mycoplasma pneumonia patients [(19.5±4.3) d vs (7.9±2.2) d, <0.01].
CONCLUSIONS:The lesions of adult mycoplasma pneumonia are mostly distributed along the bronchi with tree buds/fog signs, while the lesions of COVID-19 are mainly distributed in the dorsal outer zone accompanied by crazy-paving sign, which can early distinguish two diseases.
