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新型冠状病毒肺炎患者的CT表现及动态变化

Dynamic Changes of CT Findings in Pneumonia Patients with Coronavirus Disease 19

  • 摘要:
      目的  总结现阶段新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者的各种CT肺部表现,为该病的早期诊断提供辅助诊断依据。
      方法  搜集四川大学华西医院确诊为COVID-19的23例患者的临床资料及CT图像,对其主要CT表现进行回顾性分析,总结各阶段COVID-19患者CT征象特点。
      结果  在23例患者中,病变同时累及双肺的患者占56.5%(13/23),沿支气管血管束分布的患者占69.6%(16/23),分布于双肺外带的患者占65.2%(15/23),累及左/右肺下叶基底部的患者占82.6%(19/23),CT表现为纯磨玻璃密度影者占82.6%(19/23),磨玻璃密度伴实性密度影者占30.4%(7/23),呈现网格状改变的占26.1%(6/23);病变进展期病灶数量增多的患者占54.6%(6/11),病灶范围扩大的患者占63.6%(7/11),病变密度增高的患者占63.6%(7/11);缓解期病灶数量减少的患者占25.0%(4/16),病灶范围缩小的患者占81.3%(13/16),病灶密度减低的患者占62.5%(10/16),出现纤维灶的患者占37.5%(6/16)。对CT进展组(n=11)和缓解组(n=5)患者临床特征进行分析,差异无统计学意义。
      结论  CT检查作为COVID-19的重要诊断检查方法,在患者有流行病学史并且在CT上伴有肺炎征象的情况下,相较于病毒核酸检测,有利于疾病的快速诊断。

     

    Abstract:
      Objective  The chest CT findings of the pneumonia patients with coronavirus disease 19 (COVID-19) were summarized to provide an auxiliary diagnostic basis for the early detection of infected patients.
      Methods  Clinical data and CT images of 23 patients diagnosed with COVID-19 in West China Hospital of Sichuan University were retrospectively collected, and the chest CT findings were summarized and analyzed.
      Result  Of the 23 patients, 56.5% (13/23) had bilateral disease, 69.6% (16/23) had lesions distributed along the bronchovascular bundle, 65.2% (15/23) had lesions distributed periphery, 82.6% (19/23) involved in the basal segment of lower lobe, 82.6% (19/23) had ground-glass opacities, 30.4% (7/23) had ground-glass opacities with consolidation, 26.1% (6/23) had reticular changes. In the stage of disease progression, 54.6% (6/11) had an increased number of lesions, and 63.6% (7/11) had the scope of lesions enlarged and density increased. In the remission stage, 25.0% (4/16) had reduced number of lesions, 81.3% (13/16) had scope of lesions reduced, 62.5% (10/16) had density of lesions decreased, and 37.5% (6/16) had fibrosis.
      Conclusions  As an important diagnostic examination method for COVID-19, CT is conducive to the rapid diagnosis of the disease in patients with epidemiological history.

     

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