初诊普通型新型冠状病毒肺炎的肺部高分辨率CT表现与动态观察  

High-resolution CT imaging manifestations and dynamic analysis of newly diagnosed common COVID-19

作　　者：柏玉涵[1] 杨健[2] 彭红芬[1] 董进[1] 蒋玮丽[1] 刘海峰[1] 阳义[1] 何博 张东友[1] BAI Yuhan;YANG Jiang;PENG Hongfen;DONG Jin;JIANG Weili;LIU Haifeng;YANG Yi;HE Bo;ZHANG Dongyou(Department of Radiology,Wuhan first Hospital,Wuhan 430022,China;不详)

机构地区：[1]武汉市第一医院放射科,武汉430022 [2]武汉市第一医院消化内科,武汉430022

出　　处：《实用医学杂志》2020年第9期1131-1134,共4页The Journal of Practical Medicine

摘　　要：目的探讨临床初诊普通型新型冠状病毒肺炎(COVID-19)从首次检查至治愈出院时肺部病变的高分辨率CT(HRCT)表现及变化特点。方法回顾性分析2020年1月1日-2月20日武汉市第一医院60例确诊为普通型COVID-19的患者CT及临床资料,研究3次CT检查与临床表现的变化。结果60例确诊为COVID-19患者(其中男22例,女38例,平均年龄49岁),初诊CT单发病灶11例,多发49例,为胸膜下分布的磨玻璃影(GGO)、GGO伴"铺路石"征、GGO伴实变或几种共存。第二次CT检查45例(75%)明显进展,表现为原病灶范围扩大,数量增多或不变或"此消彼长"表现,其中42例实变增多;3例(5%)病灶范围变化不明显,实变增多;12例(20%)病灶吸收表现。9例(15%)患者影像与临床症状进展无明显对应关系。出院前1~3 d第3次CT显示,50例(83.33%)病灶不同程度吸收,8例(13.33%)病灶明显吸收,同时出现少许淡薄新发病灶,还有2例(3.33%)老年患者仍有残留未吸收病灶。结论胸部HRCT能客观反映COVID-19患者肺内病灶变化,与临床进展、转归有较好的一致性,对患者临床治疗及分层管理具有重要价值。Objective To observe the changes of HRCT manifestations in the chest of newly diagnosedclinical COVID-19 from the first diagnosis to the time of discharge in the hospital.Methods We retrospectivelyanalyzed CT and clinical data of 60 patients diagnosed with common COVID-19 from January 1 to February 20,2020 in Wuhan NO.1 Hospital,and studied the changes of three CT examinations and clinical manifestations.Results Sixty cases of COVID-19 were confirmed(including 22 males and 38 females,with an average age of 49 years).There were 11 cases with a single CT lesion at first diagnosis and 49 cases with multiple lesions.GGO with"paving stones"sign,GGO with consolidation or several types of coexistence.Forty-five cases(75%)of the sec-ond CT examination progressed markedly,with the scope of the original lesions expanding,the number increasingor unchanged,or the appearance of"trading off and taking turns",and 42 cases of consolidation increased;Theextent of lesions the change was not obvious in 3(5%)patients,and the consolidation increased;12 cases(20%)showed lesion absorption.Nine patients(15%)had no significant correlation with the progression of clinical symp-toms.The third CT scan 1-3 days before discharge showed that most of the lesions in 50(83.33%)were absorbedto varying degrees,8(13.33%)of the lesions were clearly absorbed,and a few new lesions appeared,and 2(3.33%))elderly patients still have unabsorbed lesions.Conclusion Chest HRCT can objectively reflect changesin COVID-19 pulmonary lesions,and has good consistency with clinical progress and outcomes.It has importantvalue for clinical treatment and hierarchical management of patients.

关 键 词：新型冠状病毒 肺炎 体层摄影术 X线计算机 

分 类 号：R825.6[医药卫生—临床医学] R816.4