26例新型冠状病毒肺炎的胸部HRCT表现与其预后的相关性探讨  

Correlation between CT findings and Outcomes in 26 Patients with Coronavirus Disease-19(COVID-19)

作　　者：赖海辉[1,2] 黄旭东 雷强[3] 黄柏锋[4] Lai Haihuil;Huang Xudong;Lei Qiang;Huang Bofeng(Huizhou First People’s Hospital,Huizhou,Guangdong 516001;Huizhou Medical Research Institute,Huizhou,Guangdong 516001;The First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510120;Huizhou Central People’s Hospital,Huizhou,Guangdong 516001)

机构地区：[1]惠州市第一人民医院,广东惠州516001 [2]惠州市医学研究所,广东惠州516001 [3]广州医科大学附属第一医院,广东广州510120 [4]惠州市中心人民医院,广东惠州516001

出　　处：《现代医用影像学》2020年第12期2355-2358,共4页Modern Medical Imageology

摘　　要：目的:分析新型冠状病毒肺炎(COVID-19)的首诊胸部CT特征与其临床预后的相关性。方法:回顾性分析COVID-19的首诊胸部CT表现并进行评分,包括磨玻璃影、铺路石征、实变和纤维化,其中每个肺叶受累评分为0-5分,CT总分范围为0-25分。结果:26例COVID-19患者中,临床治愈20例和死亡6例。磨玻璃影14例,磨玻璃影并实变12例,铺路石征20例及纤维化5例,分布上以胸膜下(21/26,81%)和下叶(23/26,88%)为主。临床治愈组中1例(1/20,5%)和死亡组中4例(4/6,67%)表现为肺部弥漫性病变(p=0.005)。死亡组的CT总分明显高于临床治愈组(17.2±7.8和7.5±4.9,p=0.014)。结论:COVID-19的首诊胸部CT主要表现为下叶和胸膜下分布的磨玻璃影或磨玻璃影并实变。首诊胸部CT对COVID-19患者的预后有一定的临床预测价值。Purpose:To retrospectively analyze initial chest CT findings in COVID-19 pneumonia and to identify features associated with prognosis.Methods:Initial chest CT examinations of COVID-19 for ground-glass opacity,crazy-paving pattern,consolidation and fibrosis were scored and the total CT score was the sum of lung involvement(5 lobes,score 0-5 for each lobe,range,0 none,25 maximum)was determined.Results:Twenty-six patients(20 recovered well and 6 died)with confirmed COVID-19 pneumonia were evaluated.14 patients had ground-glass opacity,12 had ground-glass and consolidation in combination,20 patients had crazy-paving pattern and 5 patients had fibrosis.The majority of patients had subpleural lesions(21/26,81%)and lower(23/26,88%)lung lobes involvement.4(4/6,67%)patients death group and only 1 patient recovery group had diffuse lesions(p=0.005).In death group,the total CT score was higher than that of the recovery group(17.2±7.8 versus 7.5±4.9,p=0.014).Conclusion:The initial CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation,with peripheral lower lobe preference.Chest CT has certain clinical value in predicting the prognosis of COVID-19.

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] R816.4[医药卫生—内科学]