新型冠状病毒肺炎肺部磨玻璃影鉴别诊断的研究  

The differential diagnosis of pulmonary ground-glass opacity during the epidemic of corona virus disease 2019

作　　者：聂姗[1] 姚志刚[1] 何馨[1] 王浩彦[1] 徐波[1] 王军[1] 李云霄[1] NIE Shan;YAO Zhigang;HE Xin;WANG Haoyan;XU Bo;WANG Jun;LI Yunxiao(Department of Respiratory,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院呼吸内科,100050

出　　处：《心肺血管病杂志》2020年第4期370-380,共11页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都卫生发展科研专项(2018-2-2024)。

摘　　要：目的:在新型冠状病毒肺炎(COVID-19)流行期间,正确认读胸部CT的磨玻璃影,以早期做出鉴别诊断。方法:回顾性分析我科2020年1月至2月,收治的影像学不除外COVID-19,新型冠状病毒核酸检测为阴性的8例患者,收集其临床资料(年龄、性别、临床病史、流行病学病史、实验室检查结果)及胸部CT的影像学资料。结果:8例患者中男性4例,女性4例,年龄17~73岁。8例患者均有咳嗽及呼吸困难症状,其中7例有发热。8例患者淋巴细胞绝对值、比例均明显降低,C反应蛋白均增高。胸部CT表现为磨玻璃密度病灶(8/8)、支气管血管束增粗(6/8)、小叶间隔增厚(5/8)、实变影(4/8)、空气支气管征(4/8)、铺路石征(3/8)、树芽征(1/8)、气体陷闭(1/8)表现。结论:对于流行病史不明确,胸部CT以磨玻璃样病变为著的病例,正确认识影像鉴别的关键点,利于早期明确诊断。Objective:To analyze the CT features of ground-glass opacity(GGO)in the lung and make early differential diagnosis of pulmonary diseases,during the epidemic of corona virus disease 2019(COVID-19).Methods:We made a retrospective analysis of the 8 patients with suspected COVID-19 by imaging diagnosis but confirmed negative with novel coronavirus(2019-nCoV)nucleic acid test,in our department from January to February,2020.We analyzed the clinical data(age,sex,clinical history,epidemiological history,and laboratory tests)and CT findings.Results:8 patients(4 men and 4 women)aged 17 to 73 years met the criteria.All the 8 patients had common symptoms included cough and dyspnea,of which 7 presented with fever;The count and ratio of lymphocyte decreased and CRP elevated in all the patients.The CT signs of the patients included GGO(8/8),thickened Bronchovascular bundle(6/8),thickened of interlobular septum(5/8),consolidation(4/8),air bronchogram(4/8),"crazy"paving pattern(3/8),tree-in-bud sign(1/8)and air trapping(1/8).Conclusions:When the patients have unclear Epidemiological history and the main lesions of lung were ground-glass opacity,to recognize the key point of differential diagnosis will be helpful for the early diagnosis.

关 键 词：新型冠状病毒肺炎 磨玻璃影 鉴别诊断 

分 类 号：R56[医药卫生—呼吸系统]