新型冠状病毒奥密克戎变异株感染者胸部CT表现及动态变化  

Imaging Features and Dynamic Changes of Chest CT in Patients Infected with SARS-CoV-2 Omicron Variants

作　　者：陈辉 张紫欣 陈七一 李晶晶 吕志彬 薛明 陈佳敏 谢汝明 关春爽 CHEN Hui;ZHANG Zixin;CHEN Qiyi;LI Jingjing;LYU Zhibin;XUE Ming;CHEN Jiamin;XIE Ruming;GUAN Chunshuang(Department of Radiology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Pathology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院放射科,北京100015 [2]首都医科大学附属北京地坛医院病理科,北京100015

出　　处：《CT理论与应用研究（中英文）》2023年第3期313-322,共10页Computerized Tomography Theory and Applications

基　　金：基于胸部CT影像用于COVID-19肺内病变自动量化评估模型的优化研究(2020-TG-001)。

摘　　要：目的:探讨新型冠状病毒奥密克戎(Omicron)变异株感染者胸部CT表现及短期动态变化。方法:纳入2022年11月至2023年1月在首都医科大学附属北京地坛医院确诊的200例新型冠状病毒Omicron变异株感染者,根据临床分型分为轻型组、中型组和重型/危重型组,回顾性分析其临床、实验室和胸部CT资料。结果:200例新型冠状病毒Omicron变异株感染者中,临床表现以发热、咳嗽咳痰、咽痛、乏力为主。轻型组与中型组之间、轻型组与重型/危重型组之间外周血白细胞计数值比较差异有统计学意义。轻型组与中型组之间、轻型组与重型/危重型组之间红细胞沉降率值比较差异有统计学意义。轻型组病变以胸膜下分布为主(53.6%),中型组(77.9%)和重型/危重型组(88.9%)病变以混合型分布为主。铺路石征在轻型组和重型/危重型组之间、轻型组和中型组之间差异有统计学意义。支气管充气征在3组之间差异均有统计学意义。发病与首次胸部CT不同间隔时间内磨玻璃密度影(GGO)的出现频率均最高,间隔时间大于4 d的患者肺内GGO伴实变/实变、支气管充气征的比例逐渐增加。铺路石征在间隔时间5~9 d内出现比例最高(95.4%),之后比例下降。间隔时间≥14 d的患者肺内索条影出现频率、胸膜增厚及胸腔积液的比例增加。GGO、GGO伴铺路石征、GGO伴实变或实变和索条出现的中位时间为4 d(2 d,7 d)、9 d(7 d,11 d),13 d(10 d,16 d)和16 d(13 d,19 d)。结论:胸部CT能够反映新型冠状病毒Omicron变异株感染者病变分布、病变形态和动态影像发展和转归,有助于临床治疗决策的制定和疗效评价。Objective:To investigate the chest CT findings and dynamic changes in patients infected with SARS-CoV-2 Omicron variants.Methods:200 patients infected with SARS-CoV-2 Omicron variants were collected in Beijing Ditan Hospital,Capital Medical University from November 2022 to January 2023.These patients were divided into mild group,moderate group and severe/critical group according to the clinical classification.All patients’clinical,laboratory and chest CT data were retrospectively analyzed.Results:Among 200 cases infected with SARS-CoV-2 omicron variant,the main clinical manifestations were fever,cough,sore throat and fatigue.There was a statistically significant difference in white blood cell count between the mild group and the medium group,and between the mild group and the severe/critical group.There were significant differences in erythrocyte sedimentation rate between mild and moderate groups,and between mild and severe/critical groups.Most of the lesions in mild group were subpleural(53.6%),while most of the lesions in moderate group(77.9%)and severe/critical group(88.9%)were mixed.The crazy-paving sign was statistically significant between the mild and severe/critical groups,and between the mild and moderate groups.There were significant differences in air bronchogram sign between the mild and the severe/critical groups,the mild and severe/critical groups,and the mild and moderate groups.The frequency of Ground Glass Opacity(GGO)was the highest at different intervals between the onset and the first chest CT.The proportion of GGO with consolidation/consolidation and air bronchogram sign gradually increased when the interval was more than 4 days.The proportion of GGO with consolidation/consolidation and air bronchogram sign gradually increased when the interval was more than 4 days.The highest proportion(95.4%)of crazy-paving sign appeared within the interval of 5-9 days,after which the proportion decreased.The frequency of irregular linear opacities,the proportion of pleural thickening and pleural effusio

关 键 词：新型冠状病毒感染 奥密克戎变异株 胸部 计算机断层扫描 核酸检测 

分 类 号：R814[医药卫生—影像医学与核医学] R563.1[医药卫生—放射医学]