重症新型冠状病毒肺炎患者胸部计算机断层成像表现及动态变化分析  

Chest computed tomography features and dynamic changes of severe corona virus disease 2019

作　　者：刘雪艳[1,2] 唐光孝 李春华 鲁雁秋[3] 杨佳 舒伟强[1] 戴欣 李咏梅[2] 吕圣秀[1] Liu Xueyan;Tang Guangxiao;Li Chunhua;Lu Yanqiu;Yang Jia;Shu Weiqiang;Dai Xin;Li Yongmei;Lyu Shengxiu(Department of Medical Imaging,Chongqing Public Health Medical Center,Chongqing 400036,China;Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Infectious Diseases,Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心医学影像科,400036 [2]重庆医科大学附属第一医院放射科,400016 [3]重庆市公共卫生医疗救治中心感染科,400036

出　　处：《中华传染病杂志》2020年第3期155-158,共4页Chinese Journal of Infectious Diseases

基　　金："十三五"国家科技重大专项(2018ZX10302104);重庆市卫生适宜技术推广项目(2018jstg031);重庆市重点项目(2019ZDXM012);重庆市委属单位能力提升计划项目(2019NLTS003);重庆市公共卫生医疗救治中心青年科研创新项目(2019QNKYXM07)。

摘　　要：目的:探讨重症新型冠状病毒肺炎患者的胸部计算机断层成像(computed tomography,CT)表现及动态变化特点。方法:收集2020年1月24日至2月6日重庆市公共卫生医疗救治中心收治的17例重症新型冠状病毒肺炎确诊患者的临床及CT检查资料,回顾性分析其首次胸部CT检查表现及诊疗中的影像学动态变化。结果:17例患者首次胸部CT检查表现示病变以周边优势分布16例;受累肺叶为3叶者2例,4叶者1例,5叶者14例;磨玻璃影17例,实变影10例,胸膜下线7例,充气支气管征象9例,小叶间隔增厚3例,支气管扩张2例,少许胸腔积液2例;淋巴结肿大3例,短径为1.0~1.2 cm。16例复查CT患者中,8例患者病灶呈持续性好转,8例患者病灶呈波动性变化。结论:重症新型冠状病毒肺炎患者的CT检查表现以磨玻璃影及实变影为主,呈周边优势分布。病变范围广泛,以5叶受累居多。淋巴结肿大或胸腔积液少见。动态监测胸部CT检查变化对该病的疗效评估具有一定价值。Objective To investigate the features of chest computed tomography(CT)imaging and dynamic changes of severe corona virus disease 2019(COVID-19).Methods The clinical and CT data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6,2020 were collected.The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.Results The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions,and two cases presented with three lobes involved,one case with four lobes involved and 14 cases with five lobes involved,and 17 cases presented with ground-glass opacities,ten cases with consolidation,seven cases with subpleural line,nine cases with air bronchogram,three cases with thickened lobular septum,two cases with bronchiectasis,two cases with pleural effusion,three cases with lymphadenopathy with the short diameter of 1.0-1.2 cm.Among 16 patients who underwent repeated CT examination,the lesions of eight patients showed continuous improvement,and those of the other eight patients showed fluctuating changes.Conclusions The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation,with the peripheral distribution.The range of lesions is wide,with five-lobe involvement mostly.Lymphadenopathy or pleural effusion is rare.Pynamic monitoring chest CT is useful for the evaluation for the therapeutic effects.

关 键 词：冠状病毒感染 肺炎 2019新型冠状病毒 新型冠状病毒肺炎 体层摄影术 X线计算机 

分 类 号：R512.99[医药卫生—内科学]