Remarkable vessel enlargement within lung consolidation in COVID-19 compared to AH1N1 pneumonia: A retrospective study in Italy
Andrea Bianco,
Tullio Valente,
Fabio Perrotta,
Elvira Stellato,
Luca Brunese,
Brad J. Wood,
Gianpaolo Carrafiello,
Roberto Parrella,
Luigi Aronne,
Matilde Boccia,
Francesco Lassandro,
Giulia Lassandro,
Gaetano Rea,
Filippo Scialò
Affiliations
Andrea Bianco
Department of Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy; COViD Unit PNL Vanvitelli, Hospital Monaldi, A.O. R.N. dei Colli, Naples, Il Italy
Tullio Valente
Department of Radiology, Monaldi Hospital, A.O.R.N. dei Colli, Naples, Italy
Fabio Perrotta
Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
Elvira Stellato
Postgraduate School of Diagnostic and Interventional Radiology, University of Milan, Milan, Italy; Corresponding author.
Luca Brunese
Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
Brad J. Wood
Center for Interventional Oncology, Radiology and Imaging Science, National Institutes of Health, Bethesda, USA
Gianpaolo Carrafiello
Radiology Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
Roberto Parrella
Department of Infectious Diseases, COVID Unit D. Cotugno Hospital, A.O.R.N. dei Colli, Naples, Italy
Luigi Aronne
Department of Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
Matilde Boccia
Department of Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
Francesco Lassandro
Department of Radiology, Monaldi Hospital, A.O.R.N. dei Colli, Naples, Italy
Giulia Lassandro
Department of Radiology, Monaldi Hospital, A.O.R.N. dei Colli, Naples, Italy
Gaetano Rea
Department of Radiology, Monaldi Hospital, A.O.R.N. dei Colli, Naples, Italy
Filippo Scialò
COVID Unit Vanvitelli University of Campania Luigi Vanvitelli, Naples, Italy
Purpose: To investigate the early CT findings in COVID-19 pneumonia as compared to influenza A virus H1N1 (AH1N1), with focus on vascular enlargement within consolidation or ground glass opacity (GGO) areas. Methods: 50 patients with COVID-19 pneumonia were retrospectively compared to 50 patients with AH1N1 pneumonia diagnosed during the 2009 pandemic. Two radiologists reviewed chest CT scans independently and blindly, with discordance resolved by consensus. Dilated or tortuous vessels within hyperdense lesions were recorded. Results: COVID-19 pneumonia presented with bilateral (96%), peripheral areas of GGO (22%), consolidation (4%) or combined GGO-consolidation (74%). The vascular enlargement sign in COVID-19 pneumonia was much more commonly present in COVID-19 (45/50, 90%) versus AH1N1 pneumonia (12/50, 24%) (p < 0.001). Vascular enlargement was more often present in lower lobes with a peripheral distribution. Conclusions: Vascular enlargement in consolidative/GGO areas may represent a reasonably common early CT marker in COVID-19 patients and is of uncertain etiology. Although speculative, theoretical mechanisms could potentially reflect acute inflammatory changes, pulmonary endothelial activation, or acute stasis. Further studies are necessary to verify specificity and to study if prognostic for clinical outcomes.
