Presentation
Low-grade fever, myalgia and dry cough. Positive COVID-19 RT-PCR. Labs revealed lymphocytopaenia and raised inflammatory biomarkers. Imaging performed 11 days after onset of symptoms, when patient developed worsening shortness of breath.
Patient Data
There is a peripheral subpleural area of an incomplete rim of consolidation in the posterior segment of the right lower lobe, surrounding a central region of ground glass opacities, consistent with the "reverse halo sign" (best appreciated on the coronal MPR) associated with enlarged subsegmental vascular branches.
A few other areas of ill-defined consolidation are also seen in the right lower lobe.
Tiny ill-defined subpleural ground glass opacities in both upper lobes.
Selected axial and coronal reconstructed images show the reverse halo sign in this patient with COVID-19 pneumonia.
Case Discussion
The reverse halo sign is not a commonly encountered CT finding in patients with COVID-19 pneumonia. Although, some studies have proposed that it can be a useful finding in distinguishing COVID-19 from other non-COVID related pneumonias, where it is even more rare.
In COVID-19, the reverse halo sign has been found to prefer a peripheral lower lobe distribution.
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