COVID-19患者胸部CT表现特点及其演变规律  

Chest CT Features of COVID-19 and Its Evolution

作　　者：沈晶[1] 于晶[1] 鄢英男 桑亚荣[2] 鞠蓉晖[3] 潘龙 李桂泽 李欣[6] 伍建林[1] SHEN Jing;YU Jing;YAN Yingnan;SANG Yarong;JU Ronghui;PAN Long;LI Guize;LI Xin;WU Jianlin(Department of Radiology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Radiology,Huludao Central Hospital,Huludao 125000,China;Department of Radiology,Anshan Hospital of the First Affiliated Hospital of China Medical University,Anshan 114000,China;The Third People's Hospital of Xinyang,Xinyang 464000,China;Enliang Hospital of Tai'an County,Anshan 114100,China;Department of Radiology,Tangshan Workers’Hospital,Tangshan 063000,China)

机构地区：[1]大连大学附属中山医院放射科,辽宁大连116001 [2]葫芦岛市中心医院放射科,辽宁葫芦岛125000 [3]中国医科大学附属第一医院鞍山医院影像中心,辽宁鞍山114000 [4]信阳市第三人民医院,河南信阳464000 [5]台安县恩良医院,辽宁鞍山114100 [6]唐山工人医院放射科,河北唐山063000

出　　处：《CT理论与应用研究（中英文）》2021年第2期199-207,共9页Computerized Tomography Theory and Applications

摘　　要：目的:旨在分析COVID-19患者胸部CT表现特点及其演变规律。方法:回顾性分析总结52例经核酸检测确诊COVID-19患者的首次与治疗后胸部CT表现特点,包括病变部位、分布、密度及伴随征象等;以及经治疗后COVID-19肺部病变CT征象的动态变化。结果:52例患者中,2例为轻型,胸部CT为阴性,其余50例患者(43例普通型及7例重型)首次胸部CT检查为阳性。45例(45/50,90.00%)患者首次CT均发现双肺多发磨玻璃密度影(GGO),其中30例(30/50,60.00%)为GGO伴部分实变,15例(15/50,30.00%)为纯磨玻璃密度影(pGGO),多见于肺野外周胸膜下区;仅5例(5/50,10.00%)首次CT表现为肺内实变,病变大多呈斑片状、多发性、多叶性。病变内增粗血管征占74.00%(37/50),空气支气管征占52.00%(26/50),病变周围“晕征”占54%(27/50),小叶间隔增厚形成的“铺路石征”占36.00%(18/50)。25例患者经2~10 d治疗后,胸部CT结果显示14例(56.00%)GGO不同程度吸收、密度变淡;11例(44.00%)密度增高转归为实变等。结论:COVID-19胸部CT具有一定特点,首次多表现为双肺外周多发斑片状GGO伴或不伴肺实变,多伴“铺路石征”、空气支气管征及增粗血管征等。治疗后肺部病变变化较快,可吸收缩小、密度变淡或出现变实、纤维化等,上述特点有助于临床早期诊断和实时评估疗效。Objective:To analyze the chest CT features of COVID-19 and its evolution.Method:Retrospectively analyze the chest CT features of 52 cases of COVID-19,including location,distribution,density and others.The CT features after treatment of COVID-19 were also analyzed.Results:Within 52 patients,the CT of 2 light type patients was negative,the other 50 patients(43 common and 7 severe types)were positive for the first time CT scan.45 patients(45/50,90.00%)had multiple GGOs in both lungs,of which 30 patients(30/50,60.00%)showed as partial consolidation and 15 patients(15/50,30.00%)showed as pure GGO(pGGO),the lesions mainly distributed in the peripheral area of the lungs;only 5 patients(5/50,10.00%)showed as consolidation.Most of the lesions were patchy,multiple and leafy distributed.About 74.00%(37/50)cases showed thickening blood vessels,52.00%(26/50)cases showed air bronchus sign,54.00%(27/50)cases showed halo sign and 36.00%(18/50)cases showed paving stone sign.25 cases accepted CT scan after treatment(2~10 d),GGO lesions showed partial absorption in 14 cases(56.00%),density and lesions increased in 11 cases(44.00%).Conclusion:The main chest CT features of COVID-19 were multiple patchy GGO with or without pulmonary consolidation in the peripheral areas of lungs,which may be accompanied with thickening blood vessels,air bronchus sign and"paving stone sign".After treatment,the lesions of lungs can be absorbed,the density decreased,or the lesions can become consolidation,fibrosis and so on.Based on the above recognition of CT signs,it is helpful for clinicians to make early diagnosis and timely evaluation of COVID-19 therapeutic effect.

关 键 词：新冠肺炎 CT 空气支气管征 铺路石征 

分 类 号：R814[医药卫生—影像医学与核医学]