肺部CT在新型冠状病毒感染性肺炎中的诊断价值  

The diagnostic value of chest CT scan in the diagnosis of pneumonia caused by 2019-novel coronavirus

作　　者：刘小玉 谢元亮[1] 张树桐[1] 江燕萍[1] 王翔[1] LIU Xiao-yu;XIE Yuan-liang;ZHANG Shu-tong(Medical Imaging Center,Wuhan Central Hospital, Wuhan 430014,China)

机构地区：[1]武汉市中心医院影像诊断科,武汉430014

出　　处：《放射学实践》2020年第4期433-436,共4页Radiologic Practice

摘　　要：目的:探讨薄层高分辨率肺部CT在新型冠状病毒肺炎(COVID-19)中的诊断价值。方法:回顾性分析2020年1月20日-2020年2月10日本院发热门诊收治的120例患者的CT图像、临床和实验室资料(白细胞计数,淋巴细胞计数,淋巴细胞百分数,C反应蛋白及SARS-CoV-2核酸检测结果),计算CT诊断新冠肺炎的敏感度、特异度、阳性和阴性预测值。结果:120例中男49例,女71例,年龄(50.7±17.1)岁;白细胞计数正常及减低者110例(91.7%);淋巴细胞百分数正常及减低者118例(98.3%);淋巴细胞计数正常及减低者120例(100%);C反应蛋白升高者67例(55.8%)。本组中最终确诊COVID-19患者91例,首次SARS-CoV-2核酸检测阳性81例,检出率为89.0%。120例患者中首次CT筛查诊断为新型冠状病毒肺炎104例,诊断敏感度、特异度、阳性和阴性预测值分别为96.7%、44.8%、84.6%和81.3%。结论:高分辨率薄层肺部CT检查能及时、敏感地检出病毒性肺炎,弥补部分新型冠状病毒肺炎患者首次核酸检测阴性的不足,使临床医师能及早对临床疑似病例采取隔离等处置措施,阻止疫情进一步扩散。Objective:The purpose was to evaluate the diagnostic value of high resolution chest CT in the diagnosis of pneumonia caused by novel coronavirus.Methods:CT images and clinical laboratory data(WBC count,lymphocyte count,lymphocyte percentage,c-reactive protein and SARS-CoV-2 nucleic acid test results)of 120 patients with fever admitted to our hospital from January 20,2020 to February 10,2020 were collected and analyzed retrospectively.The sensitivity,specificity,positive predictive value,negative predictive value of CT were calculated.Results:There were 49 males and 71 females,with an average age of(50.7±17.1)years.White blood cell count was normal and decreased in 110 cases(91.7%).The percentage of lymphocytes was normal and decreased in 118 cases(98.3%).Lymphocyte count was normal and decreased in 120 cases(100%);C-reactive protein was elevated in 67 cases(55.8%).Totally 91 patients were clinically diagnosed as COVID-19 by several SARS-CoV-2 nucleic acid tests,in which only 81 cases(89.0%)got positive results in the first nucleic acid test.104 cases were diagnosed as COVID-19 at the first CT examination,and 16 cases were negative.The sensitivity,specificity,positive predictive value,negative predictive value of CT scan were 96.7%,44.8%,84.6%and 81.3%,respectively.Conclusion:2019-novel coronavirus pneumonia can be timely and sensitively diagnosed by use of high resolution chest CT scan,which makes up for the deficiency of negative nucleic acid test for the first time in some patients,and enable clinicians to take measures such as isolation for suspected cases as early as possible,so as to prevent the further spread of the epidemic.

关 键 词：病毒性肺炎 2019新型冠状病毒 肺部 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563.1[医药卫生—放射医学]