重型新型冠状病毒感染的临床与CT特征  

Characteristics of Clinical and Imaging Features of Severe Coronavirus Disease 2019

作　　者：张怡梦 刘梦珂 张晓杰 郝琪 张妍 李兴鹏 张明霞[1] 刘晓燕[2] 王仁贵[1,2] ZHANG Yimeng;LIU Mengke;ZHANG Xiaojie;HAO Qi;ZHANG Yan;LI Xingpeng;ZHANG Mingxia;LIU Xiaoyan;WANG Rengui(Department of Radiology,Beijing Shijitan Hospital of Capital Medical University,Beijing 100038,China;Department of Infectious Diseases,Beijing Shijitan Hospital of Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院放射科,北京100038 [2]首都医科大学附属北京世纪坛医院感染科,北京100038

出　　处：《CT理论与应用研究（中英文）》2023年第5期579-585,I0002,共8页Computerized Tomography Theory and Applications

摘　　要：目的:探讨重型新型冠状病毒感染(COVID-19)的临床表现及胸部CT平扫的影像学特征。材料与方法:回顾性收集2022年11月至2023年1月确诊的重型COVID-19且胸部CT表现阳性的患者52例,所有患者自发病后1~14 d行胸部薄层平扫CT检查和有较完整的临床资料。根据患者发病与CT检查的时间间隔(<7 d和≥7 d)将患者各分为两组,比较两组患者的CT平扫影像学特征的差异性。结果:52例重型COVID-19患者中,年龄范围约53~97岁,中位年龄为80岁,男34例,女18例,且33例(63.5%)合并基础疾病,其中肺部疾病2例(3.8%),糖尿病6例(11.5%)、高血压18例(34.6%)、冠心病16例(30.8%)、脑血管疾病7例(13.5%)、恶性肿瘤4例(7.7%)、免疫疾病4例(7.7%);患者主要症状有发热44例(84.6%)、咳嗽43例(82.7%)、肌痛2例(3.8%)、咽痛19例(36.5%)、胸闷9例(17.3%)、腹泻2例(3.8%)、纳差3例(5.8%)。发病与CT检查时间间隔分组患者之间,病变累及部位、病变大小等CT表现特征差异有统计学意义。结论:重型COVID-19以老年男性多见,多合并基础疾病,CT特征为短期内多累及气管,发病时间较长者血管受累多见。Objective:To retrospectively investigate the clinical manifestations and imaging features of heavy novel coronavirus pneumonia(NCP).Materials and methods:Fifty-two patients with positive chest computed tomography(CT)manifestations and a confirmed diagnosis of COVID-19 in the Infection Unit from November 2022 to January 2023 were included in our study.All patients underwent chest thin-section CT examination and had more complete clinical data from 1 to 14 days after onset.Patients were divided into two groups based on the time interval between onset and CT examination(<7 and≥7 days),and the differences in CT performance characteristics between the two groups were compared.Results:Among the 52 patients with severe COVID-19,the age range was approximately 53 to 97 years,with a median age of 80 years in 4 men and 18 women.Thirty-three patients(63.5%)with underlying diseases were combined,including 2(3.8%)with pulmonary disease,6(11.5%)with diabetes mellitus,18(34.6%)with hypertension,16(30.8%)with coronary heart disease,and 7(13.5%)with cerebrovascular disease.The main symptoms of patients included fever in 44(84.6%),cough in 43(82.7%),myalgia in 2(3.8%),sore throat in 19(36.5%),chest tightness in 9(17.3%),diarrhea in 2(3.8%),and poor appetite in 3(5.8%).The differences in lesion involvement and lesion size were statistically significant between patients grouped at the time interval between onset and CT examination.Conclusions:Severe COVID-19 is more common in older adult males,mostly combined with underlying disease.CT features include more airway involvement in the short term,and bloodway involvement is more common in those with longer onset.

关 键 词：体层摄影术 X线计算机 新型冠状病毒肺炎 

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]