2019冠状病毒病患者首次CT影像学特征  

First CT characteristic appearance of patients with coronavirus disease 2019

作　　者：聂唯[1] 冯智超[1] 冒晓文 容鹏飞[1] 王维[1] 梁琪[1] NIE Wei;FENG Zhichao;MAO Xiaowen;RONG Pengfei;WANG Wei;LIANG Qi(Department of Radiology,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Radiology,Central Hospital of Shaoyang,Shaoyang Hunan 422000,China)

机构地区：[1]中南大学湘雅三医院放射科,长沙410003 [2]邵阳市中心医院放射科,湖南邵阳422000

出　　处：《中南大学学报（医学版）》2020年第3期262-268,共7页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2016JJ3175)。

摘　　要：目的:分析2019冠状病毒病(coronavirus disease 2019,COVID-19)患者的首次胸部CT影像学表现,为COVID-19的及时诊断提供可靠依据。方法:回顾性收集两家医院收治的163例严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-Co V-2)阳性患者的资料,包括年龄、性别、临床表现、流行病学病史、实验室检查和胸部CT影像学结果。分析患者首次胸部CT影像学特征并探讨其与SARS-Co V-2核酸检测结果的关系。结果:163例COVID-19患者的首次CT检查结果显示92.02%的病例可见磨玻璃样影,76.69%见实性病灶,73.62%见混杂密度病灶;71.17%为多发病灶,86.50%累及多叶;53.37%出现支气管充气征,36.20%出现"铺路石"征,仅7.36%出现肺门、纵隔淋巴结肿大及胸腔积液。共有18例患者出现首次CT影像学表现与SARSCo V-2核酸检测结果不一致的现象。结论:COVID-19患者的首次CT影像学表现具有一定的特征,结合首次CT影像学特点及SARS-Co V-2核酸检测结果,必要时进行复查,能更精准地诊断COVID-19。Objective: To investigate imaging features of the coronavirus disease 2019(COVID-19),and to provide concrete evidences for diagnosis of COVID-19.Methods: Imaging data of the first chest CT examination and clinical data(age, sex,clinical history, epidemiological history, and laboratory tests) of 163 patients with COVID-19 from 2 hospitals were collected for retrospective analysis. Imaging features of the first chest CT examination and the correspondence between CT manifestations and the nucleic acid test results of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) were analyzed.Results: The first chest CT images of 163 COVID-19 patients showed that 92.02% of lesions were ground-glass opacity(GGO), 76.69% were consolidation, and 73.62% were GGO together with consolidation. Multiple lesions were found in 71.17% patients and multiple lobules in 86.50% patients. Lesions in 53.37% patients were found with bronchial inflation signs and those in 36.20% patients presented with"crazy paving"pattern, while only 7.36% were found with hilar node enlargement and pleural effusion. First CT findings of 18 patients were found to be inconsistent with the results of pathogen examination.Conclusion: COVID-19 patients showed specific features in the first chest CT examination. The combination of the first chest CT imaging features and SARS-Co V-2 nucleic acid test results as well as reexamination if necessary can help to make the diagnosis of SARS-Co V-2 infection accurately.

关 键 词：严重急性呼吸综合征冠状病毒2 2019冠状病毒病 计算机体层摄影 核酸检测 

分 类 号：R563.1[医药卫生—呼吸系统] R816.4[医药卫生—内科学]