新型冠状病毒肺炎130例CT分布特点及征象研究  

Novel coronavirus pneumonia(COVID-19)CT distribution and sign features

作　　者：吴婧[1] 冯连彩 冼新源[3] 强军[4] 张捷 毛勤香 孔淑凤 陈宇辰[1] 潘军平 Wu Jing;Feng Liancai;Xian Xinyuan;Qiang Jun;Zhang Jie;Mao Qinxiang;Kong Shufeng;Chen Yuchen;Pan Junping(Department of Radiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Respiratory,Rizhao Institute of Tuberculosis Prevention and Control,Rizhao 276800,China;Department of Radiology,Guigang combination of Chinese Traditional and Western Medicine Orthopedics Hospital,Guigang 537100 China;Department of Radiology,the First Affiliated Hospital,College of Clinical Medicine,Medical College of Henan University of Science and Technology,Luoyang 471003,China;The 908th Hospital of Chinese People′s Liberation Army Joint Logistic Support Force,Nanchang 330002,China;Department of Radiology,Guangxi province Longtan Hospital,Liuzhou 545003,China;Department of Imaging,Qujiang District People′s Hospital,Lung Imaging Alliance,Shaoguan512100,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)影像科,210006 [2]日照市结核病防治所呼吸内科,山东276800 [3]广西贵港市中西医结合骨科医院,537100 [4]河南科技大学临床医学院,河南科技大学第一附属医院影像中心,洛阳471003 [5]南昌市第908医院影像科,330002 [6]广西壮族自治区龙潭医院影像科,柳州545003 [7]韶关市曲江区人民医院影像科,广东512100

出　　处：《中华结核和呼吸杂志》2020年第4期321-326,共6页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨2019新型冠状病毒肺炎(COVID-19)影像学表现。方法根据纳入标准和排除标准收集2020年1月20日至2月5日来自全国多家医院确诊COVID-19病例130例,按分布特点进行分型,分析其影像学特征。结果(1)分布:单侧14例(10.7%),双侧116例(89.3%);胸膜下型(102例78.4%),小叶核心型99例(76.1%),弥漫型8例(6.1%);(2)数目:单发病灶9例(6.9%),多发病灶113例(86.9%),弥漫8例(6.1%);(3)密度:仅为磨玻璃影(GGO)70例(53.8%),GGO与实变影兼有60例(46.2%);(3)伴随征象:血管增粗100例(76.9%),胸膜平行征98例(75.3%),"细网格征"100例(76.9%),"晕征"13例(10%),"反晕征"6例(4.6%),3例胸腔积液(2.3%),2例肺气囊(1.5%)。未见空洞。35患者行CT复查,21例(60%)好转,14例(40%)加重。结论COVID-19影像学特点主要以胸膜下及小叶核心分布为主,两者均可融合成片,重症者发展为双肺弥漫;最有价值的特征是"胸膜平行征";恢复期表现为边缘收缩的实变影,支气管扩张,胸膜下线或纤维条索影。Objective To investigate the imaging findings of 2019 novel coronavirus pneumonia(COVID-19).Methods From January 20 to February 5,2020,a total of 130 patients diagnosed with COVID-19 from seven hospitals in China were collected.The imaging data were reviewed and analyzed in detail.Results(1)Distribution:the lesion detected in the lung unilaterally in 14 cases(10.7%)and bilaterally in 116 cases(89.3%).According to the distribution in the lobes of the lung,all cases could be classified into subpleural distribution(102 cases,78.4%),centrilobular distribution(99 cases,76.1%)and diffused distribution(8 cases,6.1%).(2)Number of lesions:single lesion 9 cases(6.9%);multiple lesions 113 cases(86.9%),diffuse lesions 8 cases(6.1%).(3)Imaging density:70 cases(53.8%)of ground-glass opacity(GGO),60 cases(46.2%)of GGO+consolidation.(4)Accompanying signs:100 cases(76.9%)with vascular thickening,98 cases(75.3%)with"pleural parallel sign";"intralobular septal thickening"in 100 cases(76.9%);"halo sign"in 13 cases(10%);"reversed-halo sign"in 6 cases(4.6%);pleural effusion in 3 cases(2.3%),and pneumatocele in 2 cases(1.5%);no case with pulmonary cavity.Among 35 patients that underwent follow-up CT,21 patients(60%)improved while 14(40%)exacerbated.Conclusions COVID-19 imaging characteristic mainly has subpleural,centrilobular and diffused distribution.The first two distributions can overlap or progress to diffused distribution.In the later period,it was mainly manifested as organizing pneumonia and fibrosis.The most valuable characteristic is the pleural parallel sign.

关 键 词：新型冠状病毒肺炎 放射摄影术 体层摄影术 X线计算机 

分 类 号：R816[医药卫生—放射医学] R563[医药卫生—临床医学]