苏州地区出院新型冠状病毒肺炎患者胸部CT表现及动态变化  

The dischorged pationts with corona virus disease-19 in suxhou:CT findings and dynamic analysis

作　　者：任砚 任荣[1] 刘荣荣 朱怡[1] 刘静[1] 李敏[1] REN Yan;REN Rong;LIU Rongrong;ZHU Yi;LIU Jing;LI Min(Department of Radiology,The Affiliated Infectious Diseases Hospital of Soochow University,The Fifth People's Hospital of Suzhou,Suzhou 215000,P.R.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：《医学影像学杂志》2020年第9期1632-1635,1647,共5页Journal of Medical Imaging

基　　金：江苏省苏州市科技发展计划项目(编号:SYS2020022);江苏省苏州卫生和计划生育委员会基金项目(编号:SZZX201508)。

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)患者的胸部CT表现及动态变化特征,以帮助诊断,评估疗效以及转归。方法回顾性分析22例我院治愈出院的COVID-19患者的影像资料,动态观察患者的早期、进展期和转归期胸部CT表现,并对病变分布、形态、密度进行记录和统计分析,应用SPSS17.0统计软件对肺叶受累程度在三期之间的差异进行分析。结果早期(初次就诊时):病变多位于外周或者胸膜下,以双侧肺受累多灶性磨玻璃影为主。进展期(入院4~6天):病变多以外周向中央进展,以双肺受累为主,病变形态多呈多叶多灶性,密度主要为磨玻璃影合并实变的混合型。转归期(入院≥10天):肺部病变范围均较前缩小,形态上仍以多叶多灶为主,实变明显减少,索条影明显增多。肺部病灶范围占全部肺叶比重进行评分显示各期差异均具有统计学意义(P<0.05)。本组病例中均无胸腔积液及淋巴结肿大。结论COVID-19胸部CT表现为分布多发、胸膜下多见,磨玻璃影、实变影为主,各期的病变分布、形态和密度会有不同变化,不同分期的肺部病变范围占肺叶比重评分有差异。CT能够帮助COVID-19的诊断、观察肺内病变的动态变化,对临床诊疗具有重要价值。Objective To investigate the CT imaging features and dynamic changes of chest CT in patients with new type of coronavirus disease(COVID-19),so as to help diagnosis and to evaluate the efficacy and outcome.Methods We retrospectively analyed the imaging data of 22 patients with COVID-19 cured in the Fifth People's Hospital of Suzhou City,dynamic observation of CT images of patients at early,advanced and prognostic stages,and recorded and statistically analyed of the distribution,shape and density of lesions.Using SPSS 17.0 statistical software,we analyzed the difference between the three stages of lung lobe involvement.Results At the time of the first visit,most of the lesions were located in the periphery or under the pleura,with multifocal ground glass shadows in bilateral lung involvement.At the progressive period(4~6 days after admission),most lesions progressed to the periphery in the periphery,mainly involving bilateral lungs.The lesions were mostly multi-lobed and multifocal,and the density was mainly a mixed type of ground glass shadow and consolidation.At outcome period(≥10 days after admission),the lung lesions were all narrower than before,and the morphology was still dominated by multiple leaves and multiple foci.The consolidation was significantly reduced,and the cable shadow was significantly increased.The range of lung lesions in the proportion of all lung lobes was scored and showed that the differences between stages were statistically significant(P<0.05).None of the patients in this group had pleural effusion or lymphadenopathy.Conclusion Chest CT of COVID-19 mostly shows multiple distributions and subpleural manifestations,mainly ground glass shadows and solid shadows.The distribution,morphology and density of lesions in different stages vary,and the proportion of lung lesions in pulmonary lobe in different stages varied.CT images can help diagnose COVID-19 and observe the dynamic changes of pulmonary lesions,which is of great value for clinical diagnosis and treatment.

关 键 词：新型冠状病毒肺炎 影像学分析 体层摄影术 X线计算机 

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