Chest CT Diagnostic classification system: Classical COVID
The British Society of Thoracic Imaging (BSTI) guidelines (attached below) have outlined features that define Classical COVID:
Lower lobe predominant, peripheral predominant, multiple, usually bilateral foci of GGO, Plus or minus the following:
- Crazy-paving
- Peripheral consolidation
- Air bronchograms
- Reverse halo/ perilobular pattern (organising pneumonia pattern)
Radiological Society of North America (RSNA) guidelines (attached below) have outlined features that define Typical COVID:
- Peripheral, bilateral, GGO with or without consolidation or visible intralobular lines (“crazy-paving”)
- Multifocal GGO of rounded morphology with or without consolidation or visible intralobular lines (“crazy-paving”)
- Reverse halo sign or other findings of organizing pneumonia
The RSNA have also provided some guidance on structuring CT reports for Typical COVID:
“Commonly reported imaging features of (COVID-19) pneumonia are present. Other processes such as influenza pneumonia and organizing pneumonia, as can be seen with drug toxicity and connective tissue disease, can cause a similar imaging pattern.”
Chest CT Diagnostic classification system: Classical COVID
The British Society of Thoracic Imaging (BSTI) guidelines (attached below) have outlined features that define Classical COVID:
Lower lobe predominant, peripheral predominant, multiple, usually bilateral foci of GGO, Plus or minus the following:
- Crazy-paving
- Peripheral consolidation
- Air bronchograms
- Reverse halo/ perilobular pattern (organising pneumonia pattern)
Radiological Society of North America (RSNA) guidelines (attached below) have outlined features that define Typical COVID:
- Peripheral, bilateral, GGO with or without consolidation or visible intralobular lines (“crazy-paving”)
- Multifocal GGO of rounded morphology with or without consolidation or visible intralobular lines (“crazy-paving”)
- Reverse halo sign or other findings of organizing pneumonia
The RSNA have also provided some guidance on structuring CT reports for Typical COVID:
“Commonly reported imaging features of (COVID-19) pneumonia are present. Other processes such as influenza pneumonia and organizing pneumonia, as can be seen with drug toxicity and connective tissue disease, can cause a similar imaging pattern.”
Resources
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Thoracic Imaging in COVID-19 Infection (BSTI)
Guidance for the Reporting Radiologist British Society of Thoracic Imaging
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RSNA Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19
The goal of this expert consensus is to help radiologists recognize findings of COVID-19 pneumonia and aid their communication with other healthcare providers, assisting management of patients during this pandemic.
