新型冠状病毒肺炎早期超高分辨率CT的影像表现及随访  

Ultra-High-Resolution CT Imaging and Follow-Up of Early-Stage Novel Coronavirus Pneumonia

作　　者：冯志鹏[1] 林禹 张有彬 王金岸[1] 康江河[1] Feng Zhipeng;Lin Yu;Zhang Youbin;Wang Jin’an;Kang Jianghe(Department of Radiology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361000)

机构地区：[1]厦门大学附属中山医院影像科,福建厦门361000

出　　处：《现代医用影像学》2021年第2期219-223,共5页Modern Medical Imageology

摘　　要：目的:探讨新型冠状病毒肺炎早期超高分辨率CT影像及随访的影像变化。方法:回顾性分析我院自2020年1月24日至2月6日确诊的11例新型冠状病毒肺炎患者的171个病灶,分析病灶的分布、形态、密度、内部及周边特征等影像学表现,并采用人工智能方法对11例患者早期CT随访的磨玻璃影及实变影标准化体积进行定量分析和比较。结果:114(67%)个病灶位于胸膜下区及肺外带区,35(20%)个沿支气管血管分布,22(13%)个病灶位于肺中内带。159(93%)个病灶为小叶/小斑片影。138(81%)个病灶表现为纯磨玻璃影,27(16%)个为混合磨玻璃影,6(4%)个为实变影。64(37%)个病灶内血管增粗,57(33%)个小叶间隔增厚,69(40%)个小叶内间隔增厚,33(19%)个可见含气支气管影,25(15%)个胸膜增厚和粘连,22(13%)个胸膜下病灶可见透亮区影。早期CT随访显示磨玻璃影(p=0.003)和实变影标准化体积(p=0.003)显著增加。结论:新型冠状病毒肺炎早期超高分辨率CT表现为沿胸膜下/外周分布的多发小叶性/小斑片状纯磨玻璃斑片影,常伴病灶内血管增粗和小叶内/小叶间隔增厚等表现;早期复查磨玻璃影及实变影病灶明显增多、增大、融合。具有一定的特征性影像表现,结合流行病学及临床表现,有助于疑似病例的早期诊断。Objective:To explore the ultra-high-resolution CT imaging and follow-up imaging changes ofearly-stage new coronavirus pneumonia.Methods:We retrospectively analyzed 171 lesions from 11 patients that were diagnosed with novel coronavirus pneumonia in our hospital from 24 th January to 6 th February 2020.The normalized total volumes of ground-glass opacities(GGOs)and consolidationsfrom 11 patients were calculated and compared during the radiologicalfollow-up by artificial-intelligence-basedmethods.Results:114(67%)lesions were identified in the subpleural and extrapulmonary areas,35(20%)lesions were distributed along the bronchial vessels,and 22(13%)lesions were found in the middle and inner lung areas.159(93%)lesions were multiple lobular/small patches.138(81%)lesions were pure ground-glass opacities,27(16%)were mixed ground-glass opacities,and 6(4%)were consolidation.64(37%)lesions were seen with thickening of blood vessels,57(33%)lesions with thickening of interlobular septum,69(40%)lesions with thickening of intralobularseptum,33(19%)lesions with air bronchogram,25(15%)lesions with thickening and adhesion of pleura,and 22(13%)lesions with subpleural lucent area.Normalized volumes of pulmonary GGOs(p=0.003)and consolidations(p=0.003)significantly increased during the follow-up.Conclusion:The ultra-high-resolution CTfindings of early-stagenovel coronavirus pneumonia are characterized by multiple lobular/small patches pure ground-glass opacities shadow along the pleura and its periphery area,accompanied by thickening of blood vessels and inter/intralobular septa.The lesions of GGOs and consolidation were significantly increased,enlarged and fused during the early-phase follow-up.The combination of these imaging characteristics with epidemiology and clinical manifestations is helpful for the early diagnosis among suspected cases.

关 键 词：冠状病毒 肺炎 体层摄影术 人工智能 

分 类 号：R816.4[医药卫生—放射医学] R563.1[医药卫生—临床医学]