新型冠状病毒肺炎32例临床表现及影像学特征初探  

Clinical and imaging features of 32 cases of corona virus disease 2019

作　　者：徐鹤 李淑华[2] 赵灿灿 高玉青 朱芸[2] 王小雷 张书海 徐佳玮 谢宗玉[2] XU He;LI Shu-hua;ZHAO Can-can;GAO Yu-qing;ZHU Yun;WANG Xiao-lei;ZHANG Shu-hai;XU Jia-wei;XIE Zong-yu(School of Graduate,Bengbu Medical College,Bengbu Anhui 233030;Department of Radiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;CT Room of Imaging Department,Lu′an People′s Hospital,Lu′an Anhui 237000,China)

机构地区：[1]蚌埠医学院研究生院,安徽蚌埠233030 [2]蚌埠医学院第一附属医院放射科,安徽蚌埠233004 [3]安徽省六安市人民医院影像科CT室,237000

出　　处：《蚌埠医学院学报》2020年第2期150-153,155,共5页Journal of Bengbu Medical College

摘　　要：目的:初步探讨新型冠状病毒肺炎的临床特点与影像学特征。方法:对临床已确诊为新型冠状病毒肺炎病人32例的临床资料和肺部高分辨率CT(HRCT)表现进行回顾性分析,并根据病变范围与类型将病人分为早期、进展期、重症期、转归期,对HRCT表现进行分析。结果:病人中男性多于女性(1.5∶1),多数病人有直接或间接的武汉人员接触史,临床以发热(84.3%)、咳嗽(59.4%)为主要表现,白细胞计数减低(62.5%)、淋巴细胞计数减少(65.6%)、C反应蛋白增高(71.9%)较为常见。HRCT表现以两肺发病多见(81.3%),主要分布于两肺中外带、胸膜下区(96.7%),最常见于左肺下叶(90.6%);形态多表现为斑片状(84.6%)和不规则形(76.9%);病灶以单纯磨玻璃影(80.3%)、磨玻璃阴影伴实变(62.5%)较为常见,还可呈完全实变(43.8%)、小叶间隔的增厚(71.9%)、支气管血管束的增粗(68.8%)、“铺路石”征(43.8%)、空泡/空腔影(28.1%)等,重症病人可发展为“白肺”(3.1%)。结论:新型冠状病毒肺炎的临床特点和影像表现具有一定特征性和参考价值,但诊断时仍需结合流行病学、实验室指标等综合考虑。Objective:To investigate the clinical and imaging features of the corona virus disease 2019(COVID-19).Methods:The clinical data and pulmonary high-resolution CT(HRCT)findings of 32 patients with clinically diagnosed COVID-19 were retrospectively analyzed.According to the range and type of lesions,the patients were divided into early stage,progressive stage,termination stage and severe stage,and their HRCT findings were analyzed.Results:There were more male patients than female patients(1.5∶1),and most patients had direct or indirect contact history with Wuhan personnel.Fever(84.3%)and cough(59.4%)were the main clinical manifestations,and lower leukocyte count(62.5%),lower lymphocyte count(65.6%)and higher C-reactive protein(71.9%)were common.HRCT findings showed that most lesions were in two lungs(81.3%),which mainly distributed in the middle and outer zone of the two lungs and the subpleural area(96.7%),and most commonly in the left lower lobe(90.6%).Most of the lesions were patchy(84.6%)and irregular(76.9%),the common lesions were ground-glass shadow(80.3%),ground-glass shadow with consolidation(62.5%),complete consolidation(43.8%),thickening of interlobular septum(71.9%),thickening of bronchovascular bundle(68.8%),paving stone sign(43.8%),vacuole/cavity shadow(28.1%)and so on,severe patients could develop"white lung"(3.1%).Conclusions:The clinical and imaging features of COVID-19 have certain characteristics and reference value,but it still needs to be considered comprehensively in combination with epidemiology and laboratory indicators.

关 键 词：新型冠状病毒肺炎 临床特征 高分辨率CT 

分 类 号：R563.1[医药卫生—呼吸系统]