新型冠状病毒肺炎的胸部CT特征  

Chest CT Features of COVID-19

作　　者：蒋玮丽[1] 龙斌[1] 柏玉涵[1] 张蔚[1] 张东友[1] JIANG Weili;LONG Bin;BAI Yuhan;ZHANG Wei;ZHANG Dongyou(Department of Radiology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院放射科,湖北武汉430022

出　　处：《中国医学影像学杂志》2020年第11期817-819,824,共4页Chinese Journal of Medical Imaging

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)的胸部CT特征。资料与方法回顾性纳入临床确诊的87例COVID-19,其中54例随诊复查CT 1~2次,分析其首次胸部CT图像及复查图像特点。结果 87例COVID-19患者中,胸部CT表现为磨玻璃状影56例(64.4%),结节影9例(10.3%),实变影8例(9.2%),2种或以上形态混合型14例(16.1%),支气管血管束增粗53例(60.9%),空气支气管征43例(49.4%),小叶间隔增厚31例(35.6%)。COVID-19早期CT主要表现为磨玻璃状影,病灶以双下肺外带胸膜下分布为主;进展期病灶增多伴实变,可累及双肺多叶,此期中表现为铺路石征13例(14.9%)、晕征7例(8.0%)、反晕征8例(9.2%);重症期双肺呈弥漫分布病灶,甚至呈"白肺"表现;恢复期肺部病灶吸收,可伴有纤维灶形成。结论 COVID-19的胸部CT表现具有一定的特点,结合影像分期有助于早期诊断及治疗评估。Purpose To investigate the chest CT features of COVID-19.Materials and Methods Eighty-seven patients with clinically diagnosed COVID-19 were retrospectively enrolled in this study.Among them,54 cases were followed up for 1 to 2 CT scans,the characteristics of their first chest CT images and follow-up images were analyzed.Results For 87 patients,56 cases(64.4%)showed ground glass opacity,9 cases(10.3%)showed nodular lesions,8 cases(9.2%)showed consolidation,14 cases(16.1%)showed coexisting lesions of two or more forms.53 cases(60.9%)showed enlarged bronchial vascular bundles,43 cases(49.4%)showed air bronchogram.The interlobular septal thickening was observed in 31 cases(35.6%).The main CT features were ground glass opacity in early stages of COVID-19,double lower lung subpleural mainly.The lesions expand and with consolidation in progressive stages,involving multiple lobules in double lungs.13 cases(14.9%)manifested as“paving stone sign”,7 cases(8.0%)with“halo sign”,and 8 cases(9.2%)with“reverse-halo sign”in this stage.In severe cases,the diffuse distribution lesions were observed,even showed“white lungs”.The lung lesions were absorbed and fibrosis lesions could be observed during recovery stage.Conclusion Chest CT features of COVID-19 patients have certain characteristics,combining with imaging staging are helpful for the early diagnosis and evaluation of treatment.

关 键 词：新型冠状病毒肺炎 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统] R445.3[医药卫生—内科学]