22例新型冠状病毒肺炎治疗前后CT影像的动态表现分析  

Dynamic Analysis of CT Manifestations Before and After Treatment in 22 Cases of COVID-19

作　　者：周欣[1] 张婷婷[2] 张银 Zhou Xin;Zhang Tingting;Zhang Yin(Gastrointestinal Surgery,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Department of Radiology,The First People's Hospital of Yichang,People's Hospital,China Three Gorges University,Yichang 443000,China;Department of Radiology,The Third People's Hospital of Yichang,Third People's Hospital,China Three Gorges University,Yichang 443000,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]胃肠外科,湖北宜昌443003 [2]三峡大学人民医院[宜昌市第一人民医院]放射科,湖北宜昌443000 [3]三峡大学第三人民医院[宜昌市第三人民医院]放射科,湖北宜昌443000

出　　处：《巴楚医学》2020年第1期1-6,共6页Bachu Medical Journal

摘　　要：目的:分析新型冠状病毒肺炎(COVID-19)患者治疗前后的CT表现,为COVID-19的诊疗提供可靠的影像学依据。方法:本文回顾性分析了22例经病毒核酸检测阳性的COVID-19病例资料,对比患者治疗前后多次CT影像学表现,总结其CT影像动态变化特征。结果:COVID-19初诊CT表现为双肺胸膜下和支气管血管束周围磨玻璃密度影,大多为累及多个肺叶的多个病灶。第1、2、3次复查分别有81.81%、42.11%、50%的病例发生进展,4.55%、10.52%、8.33%的病例未见明显变化,13.64%、47.36%、41.67%病例好转。进展病例CT表现为磨玻璃密度病灶增大、融合、实变,出现“空气支气管征”,“铺路石征”,重症病例呈“白肺”表现。好转病例CT表现为磨玻璃密度病灶范围逐渐减少和消失,部分病例出现纤维条索灶。结论:CT可为COVID-19患者的疗效评估提供依据。Objective:To analyze the CT manifestations of patients with COVID-19 before and after treatment,in order to provide reliable imaging basis for the diagnosis and treatment of COVID-19.Methods:Twenty-two cases of COVID-19 that were positive for viral nucleic acid were analyzed retrospectively.The CT imaging features before and after treatment were compared and their CT dynamic characteristics were summarized.Results:The ground-glass density shadow in the subpleural and bronchial vascular bundles were found by CT scan at the first diagnosis of COVID-19,which were mostly performed as multiple lesions involving multiple lobes.The progressive cases were accounting for 81.81%,42.11%and 50%,the cases without changes were accounting for 4.55%,10.52%and 8.33%,and the improved cases were accounting for 13.64%,47.36%and 41.67%,at the first,second and third reexaminations using CT scan.The progressive cases displayed enlarged,fused,and consolidated lesions with ground-glass density,“air-bronchial signs”,“paving stones”,and even“white lungs”in severe cases.The improved cases showed that the ground-glass density lesions gradually reduced and disappeared,and the fibrous cord lesions appeared in some cases.Conclusion:CT could provide evidence for therapeutic effect evaluation in patients with COVID-19.

关 键 词：新型冠状病毒肺炎 CT影像动态变化 疗效评估 

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