{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:43:43Z","timestamp":1787769823546,"version":"build-2784847793"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>First, to investigate the added diagnostic value of chest computed tomography (CT) for evaluating COVID\u201019 in symptomatic children by comparing chest CT findings with chest radiographic findings, and second, to identify the imaging signs and patterns on CT associated with COVID\u201019 pneumonia in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>From March 2020 to December 2020, 56 consecutive children (33 males and 23 girls; mean age\u2009\u00b1\u2009<jats:italic>SD<\/jats:italic>, 14.8\u2009\u00b1\u20095.0 years; range, 9 months\u201318 years) with mild to moderate symptom and laboratory confirmed COVID\u201019 (based on Centers for Disease Control criteria) underwent both chest radiography and chest CT on the same day within the first 2 days of initial presentation to the hospital. Two experienced radiologists independently evaluated chest radiographs and chest CT studies for thoracic abnormalities. The findings from chest radiography and chest CT were compared to evaluate the added diagnostic value of chest CT for affecting patient management. Interobserver agreement was measured with Cohen's <jats:italic>\u03ba<\/jats:italic> statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven (19.6%) of 56 patients had abnormal chest radiographic findings, including ground\u2010glass opacity (GGO) in 5\/11 (45.4%) and combined GGO and consolidation in 6\/11 (54.5%). On chest CT, 26 (46.4%) of 56 patients had abnormal CT findings, including combined GGO and consolidation in 19\/26 (73.1%), GGO in 6\/26 (23.1%), and consolidation in 1\/26 (3.8%). Chest CT detected all thoracic abnormalities seen on chest radiography in 11\/26 (42.3%) cases. In 15\/26 (57.7%), chest CT detected lung abnormalities that were not observed on chest radiography, which included GGO and consolidation in 9\/15 (60%), GGO in 5\/15 (33.3%), and consolidation in 1\/15 (6.6%) cases. These additional CT findings did not affect patient management. In addition, chest CT detected radiological signs and patterns, including the halo sign, reversed halo sign, crazy paving pattern, and tree\u2010in\u2010bud pattern. There was almost perfect interobserver agreement between the two reviewers for detecting findings on both chest radiographs (<jats:italic>\u03ba<\/jats:italic>, 0.89, <jats:italic>p<\/jats:italic>\u2009=\u2009.001) and chest CT (<jats:italic>\u03ba<\/jats:italic>, 0.96, <jats:italic>p<\/jats:italic>\u2009=\u2009.001) studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chest CT detected lung abnormalities, including GGO and\/or consolidation, that were not observed on chest radiography in more than half of symptomatic pediatric patients with COVID\u201019 pneumonia. However, these additional CT findings did not affect patient management. Therefore, CT is not clinically indicated for the initial evaluation of mild to moderately symptomatic pediatric patients with COVID\u201019 pneumonia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25313","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T20:53:55Z","timestamp":1614286435000},"page":"1409-1418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Comparison of chest radiography and chest CT for evaluation of pediatric COVID\u201019 pneumonia: Does CT add diagnostic value?"],"prefix":"10.1002","volume":"56","author":[{"given":"Karuna M.","family":"Das","sequence":"first","affiliation":[{"name":"Department of Radiology CMHS, UAEU  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal A.","family":"Alkoteesh","sequence":"additional","affiliation":[{"name":"Clinical Imaging Institute Al Ain Hospital  Al Ain United Arab Emirates"},{"name":"Department of Radiology Twam Hospital  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumaa","family":"Al Kaabi","sequence":"additional","affiliation":[{"name":"Department of Medicine CMHS, UAEU  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taleb","family":"Al Mansoori","sequence":"additional","affiliation":[{"name":"Department of Radiology CMHS, UAEU  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbey J.","family":"Winant","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajvir","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Paraswani","sequence":"additional","affiliation":[{"name":"Department of Radiology LLH Hospital, VPS Healthcare  Abu Dhabi United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizwan","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Radiology Twam Hospital  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsadeg M.","family":"Sharif","sequence":"additional","affiliation":[{"name":"Child Health Institute Al Ain Hospital  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazala B.","family":"Balhaj","sequence":"additional","affiliation":[{"name":"Child Health Institute Al Ain Hospital  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-4920","authenticated-orcid":false,"given":"Edward Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001316"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_6_4_1","article-title":"Perceived impact of COVID\u201019 on pediatric radiology departments around the world: WFPI COVID\u201019 Task Force survey results from 6 continents\u00a0[published online ahead of print September 17, 2020]","author":"Foust AM","journal-title":"Radiology Cardiothorac Imaging"},{"key":"e_1_2_6_5_1","unstructured":"Worldometer. COVID\u201019 CORONAVIRUS PANDEMIC; 2021.https:\/\/www.worldometers.info\/coronavirus\/. Accessed February 7 2021."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0702"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30198-5"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104377"},{"key":"e_1_2_6_9_1","article-title":"COVID\u201019 in 7780 pediatric patients: a systemic review\u00a0[published online ahead of print June 26, 2020]","author":"Hoang A","journal-title":"EClinicalMedicine"},{"issue":"20","key":"e_1_2_6_10_1","first-page":"1","article-title":"Coronavirus infections in children including COVID\u201019: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children","volume":"20","author":"Zimmerman P","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24870"},{"key":"e_1_2_6_12_1","first-page":"1","article-title":"CT features of coronavirus disease (COVID\u201019) in 30 pediatric patients","volume":"21","author":"Steinberger S","year":"2020","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06860-3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0000000000000565"},{"key":"e_1_2_6_15_1","article-title":"Thoracic imaging findings of multisystem inflammatory syndrome in children (MIS\u2010C) associated with COVID\u201019: what radiologists need to know now\u00a0[published online ahead of print July 30, 2020]","author":"Winant AJ","journal-title":"Radiol\u00a0Cardiothorac\u00a0Imaging"},{"key":"e_1_2_6_16_1","first-page":"1","article-title":"Pediatric SARS, H1N1, MERS, EVLAI, and now coronavirus disease (COVID\u201019) pneumonia: what radiologists need to know","volume":"30","author":"Foust AM","year":"2020","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24718"},{"key":"e_1_2_6_18_1","unstructured":"Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID\u201019). Overview of testing for SARS\u2010CoV\u20102; 2020.https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/testing-overview.html. Accessed February 7 2021."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2462070712"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.09092083"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.176.1.2353097"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2282011860"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_6_24_1","article-title":"Differences in clinical and imaging presentation of pediatric patients with COVID\u201019 in comparison with adults\u00a0[published online ahead of print\u00a0April 6, 2020]","author":"Chen A","journal-title":"Radiol\u00a0Cardiothorac\u00a0Imaging"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.108972"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2361041278"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020200463"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-020-01237-4"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.20.22959"},{"key":"e_1_2_6_30_1","unstructured":"American College of Radiology. ACR Recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID\u201019 infection; 2020.https:\/\/www.acr.org\/Advocacy-and-Economics\/ACR-Position-Statements\/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection. Accessed February 7 2021."},{"key":"e_1_2_6_31_1","article-title":"International expert consensus statement on chest imaging in pediatric COVID\u201019 patient management: imaging study reporting and imaging study recommendations [published online ahead of print\u00a0April 23, 2020]","author":"Foust AM","journal-title":"Radiol\u00a0Cardiothorac\u00a0Imaging"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12644"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2015.05.030"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcl.2013.04.007"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.25313","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.25313","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.25313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T00:53:35Z","timestamp":1693616015000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.25313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,25]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1002\/ppul.25313"],"URL":"https:\/\/doi.org\/10.1002\/ppul.25313","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,25]]},"assertion":[{"value":"2021-01-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}