"This initial observation led to substantial excitement around the potential usefulness of chest CTs for the early detection of COVID-19," Cham told MedPage Today. Matthew Cham, MD, of the University of Washington in Seattle, said there was initial hope as one study determined that CT can show ground-glass opacities during the first few days of COVID infection, when PCR testing may be especially susceptible to false negatives. Yet chest CT has not panned out as an official diagnostic tool for COVID-19. "In many cases we saw ground-glass opacities" and those patients were subsequently diagnosed with COVID-19, he said. For instance, patients who had gastrointestinal issues but no respiratory symptoms were sent for abdominal CT, which catches the bottom of the lungs. They also had many cases where COVID-19 wasn't initially suspected but was detected incidentally. "It substantiated and confirmed what we were seeing in the Chinese patients." "Before long, we had cases here in our hospital in New York, and it turned out to be the same pattern," he said. Soon after their study published, New York's coronavirus case count started to rise, and Bernheim's team saw those features borne out in their own practice. And flu doesn't have these round, circular shapes." It would be more in the middle parts of the lungs. "Patients with flu can have ground-glass opacities, but they won't be in that distribution. "Influenza or other pneumonias don't often have that pattern," he said. "There are a lot of diseases that can cause ground-glass opacities, but in COVID-19, there's a distinct distribution, a preference for certain parts of the lung," chiefly in the lower lobes and periphery, and it appears multifocally and bilaterally, Bernheim said.ĬOVID-related ground-glass opacities also have a very round shape that's "really unusual compared with other ground-glass opacities," he said. "Clinical context matters for interpreting these findings," said Javad Azadi, MD, of Johns Hopkins University in Baltimore. They come in different shapes, sizes, quantities, and locations, and they can indicate many different underlying pathologies - including other viral infections, chronic lung disease, fibrosis, other inflammatory conditions, and cancers. "We see so often in chest imaging," Guo told MedPage Today. Chest radiologists adopted it in the 1980s, with a first appearance in the Fleischner Society Glossary of Terms for Thoracic Radiology in 1984. The term has its origins in the way old movies shot their flashback scenes, through a ground-glass lens that gave the film a hazy appearance, Guo said. Essentially, a ground-glass opacity describes the " shades of grey" in between a normal lung scan and one from an extremely diseased lung that shows up nearly all white because it's full of puss or fluid, said Henry Guo, MD, PhD, of Stanford University in Palo Alto, California.
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