糖尿病患者肺部新型冠状病毒感染HRCT特点  

High-resolution Computed Tomography(HRCT)Characteristics of Coronavirus Disease 2019(COVID-19)in Patients with Diabetes

作　　者：梁玉红 钟溪溪 姚新群 黄诗淇 骆丽安 吕亚萍[1] LIANG Yuhong;ZHONG Xixi;YAO Xinqun;HUANG Shiqi;LUO Lian;LYU Yaping(Department of Radiology,Liuzhou Municipal Liutie Central Hospital,Liuzhou 545007,China;Siemens Healthineers Ltd,Guangzhou 510080,China)

机构地区：[1]广西柳州市柳铁中心医院放射科,广西柳州545007 [2]西门子医疗系统有限公司广州分公司,广州510080

出　　处：《CT理论与应用研究（中英文）》2023年第5期659-665,共7页Computerized Tomography Theory and Applications

摘　　要：目的:探讨糖尿病患者肺部新型冠状病毒感染(COVID-19)HRCT特点。材料与方法:收集2022年12月14日至2023年1月10日确诊COVID-19且胸部CT表现异常的患者584例,男359例、女225例,年龄范围60~99岁,平均年龄(76±9)岁。其中合并糖尿病225例,非糖尿病359例;比较糖尿病患者COVID-19胸部HRCT与非糖尿病患者COVID-19胸部HRCT表现不同;定义发病与CT检查时间间隔<7d为急性期,363例入组患者,分析急性期糖尿病组与非糖尿病组新型冠状病毒肺炎(COVID-19)HRCT特点。结果:糖尿病患者COVID-19胸部感染与非糖尿病患者COVID-19胸部感染两组肺内病变在发病部位、分布、形态及伴随征象差异无统计学意义。两组病变在密度(细网格、病变密度不均匀)及病变边缘(病变边缘模糊)差异有统计学意义。无糖尿病组的肺部影像网格、不均匀和模糊征象显著高于有糖尿病组。其中细网格影:糖尿病组54例(24%),非糖尿病组127例(35.38%);密度不均匀:糖尿病组181例(80.44%),非糖尿病组313例(87.19%);边缘模糊:糖尿病组205例(91.11%),非糖尿病组344(95.82%)。急性期糖尿病组患者肺内网格影明显少于非糖尿病组患者,糖尿病组35例(24.65%),非糖尿病组82例(37.10%),差异有统计学意义。结论:糖尿病患者肺部新型冠状病毒感染(COVID-19)胸部HRCT病变渗出为主、密度均匀、边缘清晰,较非糖尿病组间质改变不明显。Objective:To explore the characteristics of high-resolution computed tomography(HRCT)in diabetes complicated with coronavirus disease 2019(COVID-19)-associated pneumonia.Materials and Methods:This study included 584 patients(359 males and 225 females),aged between 60~99 years old(mean,(76±9)years),with positive chest computed tomography(CT)findings and diagnosed with COVID-19 in our hospital from December 14,2022,to January 10,2023.Of these,225 patients were diabetic and 359 were non-diabetic.The features of the chest HRCT from patients with diabetes mellitus complicated with COVID-19 and those without diabetes mellitus complicated with COVID-19 were compared.Moreover,363 patients in the acute stage of COVID-19(defined as the time interval between onset and CT examination<7 days)were selected for subgroup analysis,and the HRCT characteristics of COVID-19 between the diabetes group and the non-diabetic group in the acute stage.Results:The location,distribution,morphology,and concomitant signs of pulmonary lesions between the two groups of patients with COVID-19 did not differ significantly.Conversely,statistically significant differences in density(fine mesh,uneven density)and lesion margin(fuzzy lesion margin)were detected.In particular,the grid,uneven,and fuzzy signs on lung imaging were significantly higher in the non-diabetic group than that in the diabetic group.Additionally,54 patients(24%)in the diabetic group and 127 patients(35.38%)in the non-diabetic group demonstrated fine mesh shadows.There were 181 patients(80.44%)in the diabetic group and 313 patients(87.19%)in the non-diabetic group with uneven density.Furthermore,205 patients(91.11%)in the diabetic group and 344 patients(95.82%)in the non-diabetic group had blurred edges.There was significantly less pulmonary grid shadowing in the acute subgroup with diabetes(35,24.65%)than in the acute subgroup without diabetes(82,37.10%).Conclusion:The features of chest HRCT in patients with diabetes mellitus and COVID-19 are mainly exudation,uniform density,and

关 键 词：计算机断层扫描 高分辨率 新型冠状病毒感染 糖尿病 

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]