Target-shaped combined halo and reversed-halo sign, an atypical chest CT finding in COVID-19

Shaghaghi, Shiva; Daskareh, Mahyar; Irannejad, Mona; Shaghaghi, Mohammadreza; Kamel, Ihab R.

doi:10.1016/j.clinimag.2020.06.038

Cited by 26 publications

(32 citation statements)

References 10 publications

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“…In our study, bull’s eye sign accounted to 1.3% of the cases. Only few case reports on COVID-19 with bull’s eye sign has been made in the literature [ 13 – 15 ]. It has been theorized that they represent regions of organizing pneumonia, with perilobular involvement and a tendency to be located peripherally within the lung parenchyma [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Spectrum of atypical pulmonary manifestations of COVID-19 on computed tomography

Gurumurthy

Das

Hiremath

et al. 2021

Egypt J Radiol Nucl Med

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Background The typical CT manifestations of COVID-19 pneumonia include ground-glass opacity (GGO) with or without consolidation and superimposed interlobular septal thickening. These are often rounded in morphology and frequently bilateral, multilobar, posterior, peripheral, and basilar in distribution. The various atypical CT features of COVID-19 are seldom described in the literature. The study aims to enumerate the atypical pulmonary CT features in patients with COVID-19 pneumonia in correlation with the disease severity. Results A total of 298 confirmed cases of COVID-19 pneumonia with positive reverse transcription polymerase chain reaction (RT-PCR) who underwent chest CT scans were retrospectively evaluated. The cohort included 234 (78.5%) men and 64 (21.5%) women and the mean age was 53.48 ± 15.74 years. The most common presenting symptoms were fever [n = 197 (66.1%)] and cough [n = 139 (46.6%)]. Out of 298 cases of COVID-19 pneumonia, 218 cases (73.1%) showed typical CT features while 63 cases (21.1%) showed atypical CT features with concurrent classical findings and the remaining 17 cases (5.8%) were normal. Among the atypical CT features, the most common was pulmonary cysts [n = 27 (9%)]. The other features in the order of frequency included pleural effusion [n = 17 (5.7%)], nodules [n = 13 (4.3%)], bull’s eye/target sign[n = 4 (1.3%)], cavitation [n = 3 (1.0%)], spontaneous pneumothorax [n = 2 (0.6%)], hilar lymphadenopathy [n = 2 (0.6%)], spontaneous pneumo-mediastinum with subcutaneous emphysema [n = 1 (0.3%)], Halo sign [n = 1 (0.3%)], empyema [n = 1 (0.3%)] and necrotizing pneumonia with abscess [n = 1 (0.3%)]. Conclusion CT imaging features of COVID-19 pneumonia while in a vast majority of cases is classical, atypical diverse patterns are also encountered. A comprehensive knowledge of various atypical presentations on imaging plays an important role in the early diagnosis and management of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Spectrum of atypical pulmonary manifestations of COVID-19 on computed tomography

Gurumurthy

Das

Hiremath

et al. 2021

Egypt J Radiol Nucl Med

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“…Halo sign has rather been observed, in the context of more typical CT findings, as multiple and bilateral lesions, sometimes associated with reverse CT halo sign. 6 Halo-sign is non-specific and histopathologically usually represents alveolar edema and hemorrhage. 7 Although different from the bullseye sign, the lesion we presented showed connection to the vascular system too, as suggested from a pulmonary vein branch reaching it.…”

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confidence: 99%

“…Halo sign has rather been observed, in the context of more typical CT findings, as multiple and bilateral lesions, sometimes associated with reverse CT halo sign. 6 …”

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confidence: 99%

Single, unilateral halo sign in COVID-19 pneumonia

Agrò

Flor

2021

Clinical Imaging

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Highlights Radiologists should know the atypical CT findings of COVID-19 pneumonia as well as the typical ones A single focal halo-sign lesion has never been described before as manifestation of COVID-19 pneumonia CT halo-sign could represent a consequence of thrombotic damage of pulmonary microcirculation In the setting of asymptomatic patients, unilateral single halo-sign should alert to the possibility of COVID-19 pneumonia

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“…In a series of nearly simultaneous studies, 2 - 5 the target sign has been described as a new CT finding in patients with COVID-19, consisting of central nodular opacity surrounded by a dense peripheral rim. The sign has variously been termed the target sign, 2 , 4 the “double halo” sign, 3 and the “bullseye” sign. 5 However, the target sign appears to be the most appropriate and widely accepted term to describe it 2 , 4 , 6 because of its peculiar appearance, similar to that of a shooting target.…”

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confidence: 99%

“…The sign has variously been termed the target sign, 2 , 4 the “double halo” sign, 3 and the “bullseye” sign. 5 However, the target sign appears to be the most appropriate and widely accepted term to describe it 2 , 4 , 6 because of its peculiar appearance, similar to that of a shooting target.…”

mentioning

confidence: 99%