新型冠状病毒感染的CT影像特点及演变规律  

Characteristics and Evolution of Computed Tomography Images in Coronavirus Disease 2019 Pneumonia

作　　者：刘蓉辉[1] 何磊[1] 叶玉芳[1] 张淑倩[1] 陈英敏[1] LIU Ronghui✉;HE Lei;YE Yufang;ZHANG Shuqian;CHEN Yingmin(Department of Medical Imaging,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院医学影像科,石家庄050051

出　　处：《CT理论与应用研究（中英文）》2023年第5期695-701,共7页Computerized Tomography Theory and Applications

摘　　要：目的:分析不同时期新型冠状病毒感染的CT影像特点及演变规律。方法:回顾性分析2022年12月至2023年1月期间113例河北省人民医院确诊COVID-19患者不同时期的CT征象,观察其变化趋势。32例患者行1次CT检查,41例行CT检查2次,20例行CT检查3次,15例行CT检查4次,5例行CT检查5次。本组113例患者共行CT检查259次。其中早期(新冠感染7 d以内)32例患者CT检查32次,进展期(新冠感染8~30 d)74例患者CT检查87次,转归期(新冠感染12~57 d)89例患者CT检查140次。分析患者每次CT特点。结果:早期CT表现为磨玻璃密度影26次,实变+磨玻璃密度影6次。进展期磨玻璃密度影32次,实变+磨玻璃密度影55次。转归期48次磨玻璃密度影,90次实变+磨玻璃密度影。112例患者为多叶多发病灶,其中1例在转归期为单叶多发病灶。早期胸膜下分布13次,支气管血管束周围+胸膜下分布19次。进展期胸膜下分布24次,支气管血管束周围+胸膜下分布63次。转归期胸膜下分布48次,2次完全吸收好转,支气管血管束周围+胸膜下分布90次。早期磨玻璃密度影内小叶间隔增粗32次,病灶内血管增粗32次。进展期病灶内小叶间隔增粗85次,病灶内血管增粗87次。转归期小叶间隔增粗5次,病灶内血管增粗1次,48次伴条索影。早期1次支气管气充气征,进展期6次胸腔积液,6次支气管充气征,3次肺气肿,转归期2次支气管充气征,1次胸腔积液。结论:不同时期新冠肺炎患者的CT影像特点有所差别,了解其演变规律对指导临床治疗至关重要。Objective:To analyze the computed tomography(CT)imaging features and evolution of different stages of coronavirus disease 2019(COVID-19).Methods:A retrospective analysis was conducted on the CT images of 113 patients diagnosed with COVID-19 at Hebei Provincial People's Hospital between December 2022 and January 2023 to observe the trends of imaging changes.Results:All 113 patients were clinically diagnosed with COVID-19.Among these,32,41,20,15,and five patients underwent CT examination once,twice,three times,four times,and five times,respectively.A total of 259 CT examinations were performed in this group of 113 patients.Among them,32 were early-stage(within 7 days of COVID-19 infection)examinations,87 were progression-stage CT examinations,and 140 were recovery-stage CT examinations.Analysis of the imaging features of each CT examination of the patients was performed to identify the imaging features and evolution rules of COVID-19.Among the 32 examinations performed in 32patients with early-stage disease(within 7 days of COVID-19 infection),26 cases showed ground-glass density shadows and six cases additionally showed solid nodules.In the progression stage(8~30 days after COVID-19 infection),among the 87 CT examinations in 74 patients,62,11,and one patient underwent examinations one,two,and three times,respectively.The 87 examinations revealed there 32 cases with ground-glass density shadows and 55 cases with additional solid nodules.In the recovery stage(12~57 days after COVID-19 infection),89 patients underwent 140 CT examinations.Among these,48,32,eight,and one patient underwent CT examinations once,twice,three times,and four times,respectively.Among the 140 CT examinations,48 cases showed ground-glass density shadows,while 90 cases additionally showed solid nodules.Moreover,112 patients had multiple lesions in multiple lobes,with only one case having multiple lesions in a single lobe.Regarding the distributions,in the early stage,13 cases had subpleural distributions and 19 cases had peribronchovascular and

关 键 词：CT 新型冠状病毒肺炎 影像特点 变化趋势 

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]