新型冠状病毒肺炎患者的CT表现及动态变化  

Dynamic Changes of CT Findings in Pneumonia Patients with Coronavirus Disease 19

作　　者：方鑫 赵明 李爽 杨岚清[1] 伍兵[1] FANG Xin;ZHAO Ming;LI Shuang;YANG Lan-qing;WU Bing(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Gastroenterology and Hepatology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]四川大学华西医院消化内科,成都610041

出　　处：《四川大学学报（医学版）》2020年第3期422-427,共6页Journal of Sichuan University(Medical Sciences)

摘　　要：目的总结现阶段新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者的各种CT肺部表现,为该病的早期诊断提供辅助诊断依据。方法搜集四川大学华西医院确诊为COVID-19的23例患者的临床资料及CT图像,对其主要CT表现进行回顾性分析,总结各阶段COVID-19患者CT征象特点。结果在23例患者中,病变同时累及双肺的患者占56.5%(13/23),沿支气管血管束分布的患者占69.6%(16/23),分布于双肺外带的患者占65.2%(15/23),累及左/右肺下叶基底部的患者占82.6%(19/23),CT表现为纯磨玻璃密度影者占82.6%(19/23),磨玻璃密度伴实性密度影者占30.4%(7/23),呈现网格状改变的占26.1%(6/23);病变进展期病灶数量增多的患者占54.6%(6/11),病灶范围扩大的患者占63.6%(7/11),病变密度增高的患者占63.6%(7/11);缓解期病灶数量减少的患者占25.0%(4/16),病灶范围缩小的患者占81.3%(13/16),病灶密度减低的患者占62.5%(10/16),出现纤维灶的患者占37.5%(6/16)。对CT进展组(n=11)和缓解组(n=5)患者临床特征进行分析,差异无统计学意义。结论CT检查作为COVID-19的重要诊断检查方法,在患者有流行病学史并且在CT上伴有肺炎征象的情况下,相较于病毒核酸检测,有利于疾病的快速诊断。Objective The chest CT findings of the pneumonia patients with coronavirus disease 19(COVID-19)were summarized to provide an auxiliary diagnostic basis for the early detection of infected patients.Methods Clinical data and CT images of 23 patients diagnosed with COVID-19 in West China Hospital of Sichuan University were retrospectively collected,and the chest CT findings were summarized and analyzed.Result Of the 23 patients,56.5%(13/23)had bilateral disease,69.6%(16/23)had lesions distributed along the bronchovascular bundle,65.2%(15/23)had lesions distributed periphery,82.6%(19/23)involved in the basal segment of lower lobe,82.6%(19/23)had ground-glass opacities,30.4%(7/23)had ground-glass opacities with consolidation,26.1%(6/23)had reticular changes.In the stage of disease progression,54.6%(6/11)had an increased number of lesions,and 63.6%(7/11)had the scope of lesions enlarged and density increased.In the remission stage,25.0%(4/16)had reduced number of lesions,81.3%(13/16)had scope of lesions reduced,62.5%(10/16)had density of lesions decreased,and 37.5%(6/16)had fibrosis.Conclusions As an important diagnostic examination method for COVID-19,CT is conducive to the rapid diagnosis of the disease in patients with epidemiological history.

关 键 词：新型冠状病毒肺炎 诊断 CT表现 

分 类 号：R563.1[医药卫生—呼吸系统]