新型冠状病毒肺炎短期影像学随访研究  

A Short Term Follow-up Study of CT Imaging in Corona Virus Disease 2019(COVID-19)

作　　者：赵胜超 黄增发 丁义 杨培 谢元亮[1] 王翔[1] ZHAO Shengchao;HUANG Zengfa;DING Yi(Department of Radiology,The Central Hospital of Wuhan,Wuhan,Hubei Province 430014,P.R.China)

机构地区：[1]武汉市中心医院影像科,430014

出　　处：《临床放射学杂志》2021年第1期50-54,共5页Journal of Clinical Radiology

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)的CT表现及短期影像学变化。方法搜集64例COVID-19住院患者行高分辨率CT(HRCT)动态观察,所有患者均在发病5天内就诊,患者在发病时、入院后、出院前均行CT检查,每例患者最少检查3次,最多检查7次,第一次CT检查时间至最后一次检查时间间隔13~30天。结果早期CT表现:单发病灶30例,占比46.9%(30/64),其中磨玻璃病灶29例(包括极淡薄磨玻璃影3例),实性结节伴晕征1例;多发磨玻璃病灶8例,占比12.5%(8/64);弥漫性分布磨玻璃病灶26例,占比40.6%(26/64)。进展期CT表现:多发或弥漫性分布磨玻璃结节或伴有实变影,有60例表现为跨肺叶的病灶分布,占比93.8%(60/64)。45例患者病灶累及范围在发病10天内达到峰值,占比70.3%(45/64)。60例患者肺内渗出性病灶在16~30天吸收,占比93.8%(60/64),3例患者病情进展,转入专科医院继续治疗,1例患者死亡。结论HRCT可清楚显示COVID-19病灶的形态、密度及范围,可用于疾病的早期诊断及动态观察,COVID-19有一定的影像学演变特点。Objective To investigate the CT manifestations and short-term imaging changes of 2019 novel coronavirus pneumonia(COVID-19).Methods High-resolution computed tomography(HRCT)dynamic observations were performed on 64 COVID-19 hospitalized patients.All patients were seen within 5 days of onset.CT examination was performed at the time of onset afteradmission and before discharge.Each patient had at least 3 checks and up to 7 times.The interval between the first CT examination and the last examination was 13-30 days.Results Early CT showed 30 cases with a single lesion,accounting for 46.9%(30/64),of which 29 cases were ground-glass opacities(including 3 cases with very thin ground-glassopacities),and 1 case showed a solid nodule with halo sign.Eight cases had multiple ground-glasslesions accounting for 12.5%(8/64).Twenty-six cases haddiffusely distributedground-glasslesions accounting for 40.6%(26/64).In advanced CT,CT showed multiple or diffuse ground glass nodules accompanied with consolidation.In 60 cases,the involvement of lesion was distributed across pulmonary lobes,accounting for 93.8%(60/64).The range of lesion involvement in 45 patients reached a peak within 10 days of onset,accounting for 70.3%(45/64).Exudative lesions in the lungs of 60 patients were absorbed in 16-30 days,accounting for 93.8%(60/64).Three patients progressed to the specialist hospital for further treatment and one patient died.Conclusion HRCT can clearly show the shape,density and scope of COVID-19 lesions andit can as well be used for early diagnosis and dynamic observation of diseases.COVID-19 has certain imaging evolution characteristics.

关 键 词：新型冠状病毒肺炎 体层摄影术 X线计算机 随访研究 

分 类 号：R563.1[医药卫生—呼吸系统]