新型冠状病毒肺炎核酸检测阳转阴前后CT影像对比  

Comparative analysis of CT images acquired before and after coronavirus disease 2019 turning from positive to negative by nucleic acid testing

作　　者：朱芸仙 刘静[1] 任砚 吴敏昱 任荣[1] 朱怡[1] 姚文妍 李敏[1] Zhu Yunxian;Liu Jing;Ren Yan;Wu Minyu;Ren Rong;Zhu Yi;Yao Wenyan;Li Min(Department of Radiology,The Affiliated Infectious Diseases Hospital of Soochow University,The Fifth People's Hospital of Suzhou,Jiangsu Suzhou 215000,China)

机构地区：[1]苏州大学附属传染病医院,苏州市第五人民医院放射科,江苏苏州215000

出　　处：《新发传染病电子杂志》2020年第3期183-187,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：新型冠状病毒感染应急防治科技专项(SYS2020022)。

摘　　要：目的对比分析新型冠状病毒肺炎(COVID-19)患者核酸检测阳转阴前后的CT影像,探讨CT影像在临床诊疗中的价值。方法回顾性分析苏州大学附属传染病医院32例COVID-19核酸检测末次阳性前及首次转阴后的胸部CT影像,对比观察其CT表现;并对病灶范围半定量评分,使用秩和检验分析组间差异。根据《新型冠状病毒肺炎影像学诊断指南(2020第一版)》判断32例核酸首次转阴后CT影像是否进入转归期。结果32例COVID-19核酸阳转阴前后的CT影像均表现为病毒性肺炎,病灶以双侧、非对称性、胸膜下分布为主。在核酸首次转阴后,24例(75.00%)病灶范围减少,7例(21.87%)增加,1例(3.13%)变化不明显;13例(40.63%)病灶密度减低,12例(37.50%)增高,7例(21.88%)变化不明显。核酸阳转阴前后的网格征、支气管空气征、血管增粗分别为87.50%/84.38%、96.88%/87.50%、46.88%/34.38%。核酸首次转阴后肺内总体病灶范围较末次阳性时减小,核酸阳转阴前后的病灶范围半定量评分差异具有统计学意义(P<0.05)。对核酸首次转阴后CT影像进行诊断,27例(84.38%)进入转归期。结论COVID-19患者核酸检测阳转阴性前后CT表现存在一定差异,核酸首次转阴后的CT影像多诊断为转归期,能够帮助临床进行诊疗效果的评价。Objective To compare and analyze the CT images of patients with coronavirus disease 2019(COVID-19)before and after their nucleic acid detection results turning from positive to negative,and to evaluate the value of CT in clinical diagnosis and treatment.Methods In this retrospective analysis,32 cases of COVID-19 from the Affiliated Infectious Diseases Hospital of Soochow University were enrolled.Chest CT images were acquired before the last positive nucleic acid test and after the first negative test.The imaging findings of the two timepoints were compared and observed,and a semi-quantitative scoring system was used to quantitatively estimate the extent of lesion in each lung lobe,using rank sum test.According to the"Guidelines for Imaging Diagnosis of New Coronavirus Pneumonia(First Edition 2020)",whether the CT images of 32 cases entered the absorption stage after the first negative nucleic acid test were determined.Results The CT images of 32 cases of COVID-19 during the transition from positive to negative in nucleic acid detection results all showed signs of viral pneumonia.The lesions were mainly bilateral,asymmetric,and subpleural distribution.After the nucleic acid test result turned negative for the first time,the lesion was decreased in extent in 24 cases(75.00%),increased in 7 cases(21.87%),and showed no overt change in 1 case(3.13%);The lesion density was decreased in 13 cases(40.63%),increased in 12 cases(37.50%)and showed no overt change in 7 cases(21.88%).The occurrence of intralobular septal thickening,air bronchogram sign,and enlarged vasculature sign before the last positive nucleic acid test and after the first negative test were 87.50%vs 84.38%,96.88%vs 87.50%,46.88%vs 34.38%.Compared with the lesion extent before the last positive nucleic acid test,the overall lesion extent after the negative test were significantly decreased in the semi-quantitative scores of lesion extent(P<0.05).Based on CT images diagnosis after the nucleic acid test turned negative for the first time,and 27 cases(84.38%)

关 键 词：新型冠状病毒肺炎 核酸 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统]