新型冠状病毒肺炎首次临床和CT特征价值分析  

The First Clinical and CT Value Analysis of COVID-19

作　　者：曾泥 何建华[1] 曾健 段绪琼 徐晓梅 谯捷 ZENG Ni;HE Jianhua;ZENG Jian;DUAN Xuqiong;XU Xiaomei;QIAO Jie(Department of Nuclear Medicine,Yongchuan Hospital Affiliated To Chongqing Medical University,Chongqing 402160,China;Department of Radiology,Yongchuan Hospital Affiliated To Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院核医学科,重庆402160 [2]重庆医科大学附属永川医院放射科,重庆402160

出　　处：《CT理论与应用研究（中英文）》2020年第4期416-423,共8页Computerized Tomography Theory and Applications

摘　　要：目的:分析2019新型冠状病毒肺炎(COVID-19)首次临床和CT特征价值。方法:回顾性分析90例临床确诊COVID-19患者的首诊症状、一般炎症指标和胸部CT,包括13例重型/危重型和77例轻型/普通型,并由两名经验丰富的影像诊断医师进行分析和比较。结果:相对于轻型/普通型COVID-19患者,重型/危重型最重要的临床特征为年龄较大,一般炎症指标上升,胸部CT显示肺部炎症指数(PII)更高。受试者工作特征曲线(ROC)显示C-反应蛋白(CRP)、PII区分重型/危重型和轻型/普通型COVID-19患者的灵敏度分别为69.2%、69.2%,特异度分别为83.1%、87.0%,曲面下面积(AUC)分别为0.775[95%CI(0.649,0.901);P=0.002]、0.770[95%CI(0.621,0.920);P=0.002],其联合的AUC为0.785[95%CI(0.644,0.927);P=0.001]。结论:重型/危重型和轻型/普通型COVID-19患者的临床症状、炎症指标和胸部CT特征具有显著性区别,结合年龄、CRP和PII的检查,有助于早期识别重型/危重型COVID-19和评估其预后。Objective:To analyze the value in the first clinical and chest CT features of Corona Virus Disease 2019(COVID-19).Methods:The first clinical symptoms、general inflammatory indicators and chest CT features of 90 patients with clinically diagnosed COVID-19 were retrospectively analyzed,which included 13 cases of severe/critical type and 77 cases of light/ordinary type.The results were analyzed and compared by two experienced radiologists.Results:Compared with the light/ordinary COVID-19 patients,the most important clinical characteristics of the severe/critical type were older age,general inflammatory indicators increased,and chest CT showed higher pulmonary inflammatory index(PII).The receiver operating characteristic curve(ROC)showed that the sensitivity of C-reactive protein(CRP)and PII to distinguish between severe/critical COVID-19 and light/ordinary COVID-19 was respectively 69.2%and 69.2%;The specificity was 83.1%and 87.0%,respectively;The Area Under Curve(AUC)were 0.775[95%CI(0.649,0.901);P=0.002]and 0.770[95%CI(0.621,0.920);P=0.002],respectively.The AUC of their association was 0.785[95%CI(0.644,0.927);P=0.001].Conclusion:Clinical symptoms,inflammatory indicators and chest CT features were significantly different between severe/critical COVID-19 and light/ordinary COVID-19 patients,and it is helpful for early identification of severe/critical COVID-19 and assessment of its prognosis when combined with age,PII and CRP.

关 键 词：新型冠状病毒肺炎 C-反应蛋白 CT 肺部炎症指数 

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