新型冠状病毒肺炎首次胸部高分辨率CT表现分析  

Analysis of first chest high resolution CT features of COVID-19

作　　者：刘海峰 张东友[1] 阳义 龙斌[1] 尹龙 赵明[1] 彭勇 LIU Haifeng;ZHANG Dongyou;YANG Yi;LONG Bin;YIN Long;ZHAO Ming;PENG Yong(Department of Radiology,Wuhan Hospial of Traditional Chinese and Western Midicine,Wuhan 430030,China)

机构地区：[1]武汉市中西医结合医院放射科,湖北武汉430030

出　　处：《实用放射学杂志》2020年第3期353-355,451,共4页Journal of Practical Radiology

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)的首次胸部高分辨率CT(HRCT)影像表现。方法回顾性分析2020年1月3日至2020年1月24日经临床确诊的COVID-19患者102例首次胸部HRCT图像,对病灶数量、分布、形态及周围受累情况进行统计和分析。结果102例患者首次肺部HRCT均发现病灶,单侧肺分布11例(10.8%),双侧肺分布91例(89.2%);肺外周分布65例(63.7%),肺外周及中心同时分布37例(36.3%);1个病灶9例(8.8%),2个病灶6例(5.9%),多发病灶87例(85.3%);结节影13例(12.7%),磨玻璃影84例(82.4%),铺路石影9例(8.8%),纤维条索影或2种及以上形态病灶共存35例(34.3%);累及1个肺叶9例(8.8%),累及2个及2个以上肺叶93例(91.2%);纵隔淋巴结增大22例(21.6%,其中60岁以上患者18例,60岁以下患者4例),胸腔积液2例(2.0%),心包积液1例(1.0%),胸膜受累/增厚1例(1.0%)。60岁以上患者表现为多病灶,多形态,分布广,多肺叶受累,可伴有纵隔淋巴结增大。结论COVID-19患者首次胸部HRCT检查能发现肺部病灶,是首选的影像学检查方法,在COVID-19的早期诊断及鉴别诊断中有重要作用。Objective To analyze the first chest high resolution CT(HRCT)features of COVID-19.Methods 102 cases of the first chest HRCT images of COVID-19 patients confirmed clinically between January 3—24,2020 were analyzed retrospectively.Statistics and analysis of the number,distribution,morphology and surrounding involvement of lesions were presented.Results Lesions were found in the first lung HRCT of 102 patients,with unilateral lung distribution in 11 cases(10.8%),bilateral lung distribution in 91 cases(89.2%);peripheral distribution of the lung in 65 cases(63.7%),37 cases(36.3%)were distributed at the same time;9 cases(8.8%)showed 1 lesion,6 cases(5.9%)2 lesions,87 cases(85.3%)multiple lesions;13 cases were nodular shadows(12.7%),84 cases of ground glass shadow(82.4%),9 cases of pavi ng stone shadow(8.8%),35 cases(34.3%)of coexistence of fibrous cord shadow or 2 or more morphological lesions;lesions were showed in one lung lobe in 9 cases(8.8%),in two or more lung lobes in 93 cases(91.2%);enlarged mediastinal lymph nodes were found in 22 cases(21.6%,18 cases over 60 years old,4 cases under 60 years old),pleural effusions were showed in 2 cases(2.0%).pericardial effusion in 1 case(1.0%),and pleural involvement/thickening in 1 case(1.0%).Patients age over 60 years showed multiple lesions,multiple forms,wide distribution,multiple lung lobes involvement,and accompanied with enlarged mediastinal lymph nodes.Conclusion The first chest HRCT examination of patients with COVID-19 can detect lung lesions,which is the preferred imaging met hod,and plays an imports nt role in the early diagnosis and differential diagnosis of COVID-19.

关 键 词：新型冠状病毒肺炎 计算机体层成像 胸部 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]