新型冠状病毒肺炎的高分辨率CT表现  

High resolution CT features of COVID-19

作　　者：王传彬 马培旗 张庆 赵剑宇 张南 程宜涛 袁玉山[2] 吴宗山[3] 周辉 王雅琴 凡平林 董江宁 WANG Chuanbin;MA Peiqi;ZHANG Qing;ZHAO Jianyu;ZHANG Nan;CHENG Yitao;YUAN Yushan;WU Zongshan;ZHOU Hui;WANG Yaqin;FAN Pinglin;DONG Jiangning(Department of Radiology,the First Affiliated Hos pital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230031,China;Department of Radiolog y,Fuyang People’s Hos pital,Fuyang,Anhui Province 236000,China;Department of Radiology,Lu’an People’s Hospital,Lu’an,Anhui Province 237005,China;Department of Radiology,Fengyang County People’s Hospital,Fengyang,Anhui Province 233100,China;Department of Radiology,Dingyuan County General Hospital,Dingyuan,Anhui Province 233200,China;Department of Radiology,Yingshang County People’s Hospital,Yingshang,Anhui Province 236200,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)西区影像科,安徽合肥230031 [2]阜阳市人民医院影像科,安徽阜阳236000 [3]六安市人民医院影像科,安徽六安237005 [4]凤阳县人民医院影像科,安徽凤阳233100 [5]定远县总医院影像科,安徽定远233200 [6]颍上县人民医院影像科,安徽颍上236200

出　　处：《实用放射学杂志》2020年第6期888-892,938,共6页Journal of Practical Radiology

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)的高分辨率CT征象。方法共入组20例严重急性呼吸综合征冠状病毒2号(SARS-CoV-2)核酸检测阳性病例,患者资料包括流行病学接触史、临床病史、实验室检查及治疗前首次高分辨率CT(HRCT)图像;参考相关文献及经验指南,回顾性分析其HRCT征象。结果本组20例COVID-19患者的首次HRCT检查结果均呈阳性(20/20,100%),与病毒核酸检测阳性之间具有较好的一致性;CT征象如下:单肺受累1例(1/20,5%),双肺受累19例(19/20,95%);单个肺叶受累1例(1/20,5%),2个及以上肺叶受累19例(19/20,95%);胸膜下病灶出现率100%(20/20),仅胸膜下分布3例(3/20,15%),胸膜下分布为主伴肺内弥漫性分布17例(17/20,85%);无仅呈团片状/不规则状者(0/20,0%),仅呈结节状/斑片状5例(5/20,25%),多种形态并存15例(15/20,75%);仅呈磨玻璃影16例(16/20,80%),以磨玻璃影为主伴局部实变4例(4/20,20%);病灶内见微血管影增粗18例(18/20,90%);病变内见“细网格影”、“空气支气管征”各12例(12/20,60%);此外,伴有“马赛克”征、“空泡/空洞”征及胸腔积液各1例(1/20,5%);无纵隔淋巴结肿大(0/20,0%)。结论COVID-19患者的首次HRCT检查具有极高的阳性率及较特征性的HRCT征象,结合流行病学接触史、临床表现及实验室检查有助于在核酸检测之前做出较准确的临床诊断。Objective To investigate the HRCT features of COVID-19.Methods A total of 20 severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)caused pneumonia patients diagnosed with positive results of nucleic acid testing(NAT)were enrolled,and patient information included epidemiological contact history,clinical history,laboratory examination and the first HRCT images before medical treatment.The HRCT signs were analyzed retrospectively with a review of relevant literature and guidelines.Results The first HRCT examination results of 20 patients infected with COVID-19 were all positive(20/20,100%),which was correlated well with the results of NAT.The CT signs were as follows:single lung involvement(1/20,5%),double lungs involvement(19/20,95%),single lobe involvement(1/20,5%),two or more lobes involvement(19/20,95%);incidence of subpleural lesions(20/20,100%),only subpleural distribution(3/20,15%),diffuse distribution(17/20,85%);onlylarge/irregularshapes(0/20,0%),only nodular/patchy shapes(5/20,25%),coexistence of various shapes(15/20,75%);only ground glass lesion(16/20,80%),ground glass with consolidation lesion(4/20,20%);thickening of microvascular(18/20,90%);“fine grid shadow”and“air bronchogram sign”(12/20,60%);“mosaic”sign,“vacuole/cavity”sign and pleural effusion(1/20,5%);mediastinal lymph nodes enlargement(0/20,0%).Conclusion The first HRCT examination results of COVID-19 show a relatively high positive rate and representative HRCT signs.With the combination of patients’epidemiological contact history,clinical manifestations and laboratory examinations,they are helpful for a much more accurate clinical diagnosis prior to NAT.

关 键 词：新型冠状病毒肺炎 计算机体层成像 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]