新型冠状病毒肺炎筛查患者的临床及影像表现分析  

Clinical and imaging findings of novel coronavirus pneumonia screening patients

作　　者：陈光文[1] 李杭[1] 蒲红[1] CHEN Guang-wen;LI Hang;PU Hong(Department of Radiology,Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院放射科,四川成都610072

出　　处：《实用医院临床杂志》2020年第2期25-29,共5页Practical Journal of Clinical Medicine

摘　　要：目的探讨非湖北地区新型冠状病毒肺炎(COVID-19)筛查患者的临床及影像表现特点,进而分析影像诊断价值。方法回顾性分析66例有肺部阳性征象患者的临床信息及肺部HRCT资料。患者均行胸部CT平扫,并对原始图像进行薄层高分辨重建。两位放射科医师共同阅读HRCT图像,将肺部病变分为磨玻璃结节、磨玻璃片影、磨玻璃片影伴实变、实变影及实性结节影五大类,根据临床信息及影像表现作出相应诊断。结果66例患者中,仅9例有明确流行病学史,单纯发热48例、发热伴咳嗽12例、发热伴咳嗽、咳痰3例、有呼吸道症状无发热2例、无发热亦无呼吸道症状1例。确诊NCP 5例,其余被排除。影像表现:肺部病变表现为磨玻璃结节、磨玻璃片影、磨玻璃片影伴实变、实变影及实性结节影分别占7.6%(5/66)、27.3%(18/66)、48.5%(32/66)、13.6%(9/66)和3.0%(2/66)。诊断意见:5例确诊为“符合NCP”的患者肺部影像表现均为磨玻璃片影,其余被诊断为“不符合NCP”18例、“不除外NCP”17例、“疑似NCP”15例和“高度疑似NCP”11例。结论非湖北地区NCP筛查患者主要表现为发热和呼吸道症状,确诊患者影像表现典型,而部分排除病例存在NCP类似影像表现。Objective To investigate the clinical and imaging features of patients with novel coronavirus pneumonia(NCP)screened in non-Hubei regions,and to analyze the diagnostic value of imaging.Methods Clinical information and HRCT data of 66 patients with positive pulmonary signs were analyzed retrospectively.All patients underwent chest CT plain scan and thin-layer high-resolution reconstruction of the original image.Two radiologists read HRCT images together,and the lung lesions were divided into five categories:ground glass nodule,ground glass shadow,ground glass shadow with consolidation,consolidation shadow and solid nodule shadow.Diagnoses were made according to clinical information and image manifestations.Results Among the 66 patients,only 9 patients had a clear epidemiological history.Other clinical characteristics included simple fever(n=48),fever with cough(n=12),fever accompanied by cough and sputum(n=3),only respiratory symptoms without fever(n=2),and one patient had neither fever nor respiratory symptoms.At last,5 cases with NCP were confirmed and the rest were excluded.Image information:the above five types imaging manifestations of pulmonary lesions were 7.6%(5/66),27.3%(18/66),27.3%(32/66),13.6%(9/66),and 3.0%(2/66),respectively.Diagnostic opinions:all the pulmonary images of 5 patients diagnosed as"NCP"showed ground glass shadow.There were 18 cases diagnosed as"not conforming to NCP",17 as"excluding NCP",15 as"suspected NCP"and 11 as"highly suspected NCP".Conclusion NCP screening patients in non-Hubei areas mainly show fever and respiratory symptoms,and the imaging manifestations of confirmed patients are typical,while similar imaging manifestations of NCP are excluded in some cases.

关 键 词：病毒性肺炎 新型冠状病毒 计算机断层扫描 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统] R445.2[医药卫生—内科学]