低剂量CT在妊娠合并新型冠状病毒肺炎中的应用价值  

The application value of low-dose CT scan in pregnant women with COVID-19

作　　者：李亮[1] 王莉[2] 曾菲菲 刘芳[1] 彭宙锋[1] 谢宝君[1] 刘昌盛[1] 查云飞[1] Li Liang;Wang Li;Zeng Feifei;Liu Fang;Peng Zhoufeng;Xie Baojun;Liu Changsheng;Zha Yunfei(Department of Radiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Infection Prevention and Control,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院放射科,430060 [2]武汉大学人民医院感染预防与控制办公室,430060

出　　处：《中华放射医学与防护杂志》2020年第5期333-337,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的探讨低剂量CT在妊娠合并新型冠状病毒肺炎(新冠肺炎)中的应用价值。方法回顾性分析2020年1月20日至2020年2月16日武汉大学人民医院12例经核酸检测确诊为妊娠合并新冠肺炎患者的低剂量CT应用及影像特点。由2位影像医师独立评价CT图像质量,采用5分法进行评分。以≥3分为临床诊断可接受。并记录CT辐射剂量,包括CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)及有效剂量(E)。由2名放射科医师共同观察肺部病变分布、形态、密度等特征及有无肺门、纵隔淋巴结肿大及胸膜改变。结果12例妊娠合并新冠肺炎患者中,咳嗽8例,发热4例,胸闷2例,呼吸困难、腹泻各1例。所有患者CT主观图像质量评分3~4分,平均3.46分,完全满足临床诊断要求。CTDIvol为1.13~4.31 mGy,平均3.02 mGy。DLP为34.48~75.29 mGy·cm,平均55.48 mGy·cm。E为0.48~1.05 mSv,平均0.78 mSv。胸部CT表现单肺病变5例,双肺病变7例。磨玻璃影1例,实变影1例,磨玻璃合并实变影7例,条索影1例,磨玻璃、实变及条索影共存2例。所有患者病情均得到有效控制。结论低剂量CT扫描在妊娠合并新冠肺炎中的应用是完全可行的,CT主要表现为双肺斑片状、片状磨玻璃合并实变影,积极有效治疗可完全康复,预后较好。Objective To explore the value of low-dose CT in pregnancy with COVID-19.Methods A retrospective analysis was performed on the clinical characteristics,laboratory tests,and chest CT findings of 12 pregnant women with COVID-19 diagnosed by nucleic acid testing in the Renmin Hospital of Wuhan University from January 20,2020 to February 16,2020.Two radiologists blinded to the reconstruction algorithm independently scored subjective image quality on a 5-point Likert scale.Image quality score≥3 was acceptable in clinics.The CT radiation doses were recorded,including CT volume dose index(CTDIvol),dose length product(DLP),and effective radiation dose(E).Two radiologists observed the distribution,shape,density,and other characteristics of lung lesions,and they also decided whether hilar,mediastinal lymphadenopathy,and pleural changed.Results A total of 12 pregnant women with COVID-19,8 had cough,4 had fever,2 had chest tightness,and 1 had dyspnea and diarrhea each.The CT image quality score of all patients was 3-4,with an average of 3.46,which fully met the clinical diagnosis requirements.The CTDIvol value was 1.13-4.31 mGy,with an average of 3.02 mGy.The DLP value was 34.48-75.29 mGy·cm,with an average of 55.48 mGy·cm.The Evalue was 0.48-1.05 mSv,with an average of 0.78 mSv.In all cases,chest CT examination showed abnormal manifestations after clinical symptoms,including unilateral lung lesions in 5 cases and bilateral lung lesions in 7 cases,1 case of ground-glass opacity,1 case of solidification,7 cases of ground-glass and consolidation,1 case of strip opacity,ground-glass,and consolidation and strip cable shadow coexisted in 2 cases. Conclusions The application of low-dose CT scan in pregnant women with COVID-19 is completelyfeasible. CT mainly manifested as bilateral lung patchy and flaky ground-glass opacity with consolidation.Active and effective treatment can help recover and improve prognosis.

关 键 词：辐射剂量 妊娠 新型冠状病毒肺炎 体层摄影术 X射线计算机 

分 类 号：R714.253[医药卫生—妇产科学] R816.91[医药卫生—临床医学]