胸部CT对新型冠状病毒感染病人多器官受累的随访研究  

Multisystem involvement in patients with COVID-19 based on chest CT:a follow-up study

作　　者：安冉 颜颖 魏巍[2] 魏璇 杨正汉[1] 王振常[1] AN Ran;YAN Ying;WEI Wei;WEI Xuan;YANG Zhenghan;WANG Zhenchang(Department of Radiology,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China;Department of Science and Technology,Beijing Friendship Hospital Affiliated to Capital Medical University)

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]首都医科大学附属北京友谊医院科技处

出　　处：《国际医学放射学杂志》2024年第2期165-171,共7页International Journal of Medical Radiology

基　　金：国家自然科学基金项目(62141110)。

摘　　要：目的探究新型冠状病毒感染(COVID-19)病人胸部CT随访影像中肺部病灶体积、甲状腺、脾、大血管、骨骼及腹部脂肪的变化。方法回顾性纳入33例确诊为COVID-19的病人,男22例,女11例,平均年龄(47.1±15.0)岁。收集基线及随访(≥10个月)胸部CT的影像资料,测量全肺病灶体积,甲状腺左、右叶面积和平均密度,肺动脉主干直径、升主动脉主干直径、下腔静脉短径、腹主动脉短径、下腔静脉短径/腹主动脉短径,脾厚径、脾最长径、脾的平均密度,腹部皮下脂肪面积、腹腔内脂肪面积、肝脏平均脂肪,胸椎平均密度。比较基线及随访影像中上述参数的变化。采用组内相关系数(ICC)分析2名医师测量数据的一致性。采用配对样本t检验或配对样本的Wilcoxon符号秩和检验比较基线与随访影像中各项测量数据的差异。结果2名观察者测量基线和随访影像中大血管、甲状腺、脾、骨骼和腹部脂肪各项指标的一致性均较好(均ICC>0.80)。相比于基线影像,随访中肺病灶体积占比减小;升主动脉主干直径增大;甲状腺面积增加,甲状腺平均密度减低;脾厚径、脾最长径减小,脾平均密度减低(均P<0.05)。基线和随访影像上各部位其余CT特征比较的差异均无统计学意义(均P>0.05)。结论急性COVID-19是一种累及多器官的疾病,病人多器官均会发生结构性改变。Objective To investigate the changes of COVID-19 patients in lung lesion volume,thyroid,spleen,macrovascular,bone,and abdominal fat on chest CT images during follow-up.Methods Thirty-three patients of COVID-19(22 males and 11 females,mean age of 47.1±15.0 years)were retrospectively included.Chest CT scans were performed at baseline time and at 10 months later,measuring the volume of whole lung lesions,areas and mean densities of the bilateral lobes of thyroid gland,diameter of the main trunk of pulmonary artery,diameter of the main trunk of ascending aorta,short diameter of inferior vena cava,short diameter of the abdominal aorta,short diameter of inferior vena cava/short diameter abdominal aorta,thick diameter of spleen,longest diameter of spleen,mean density of the spleen,abdominal subcutaneous fat area,intra-abdominal fat area,mean liver fat,and mean density of thoracic spine.The above parameters between the baseline time and follow-up were compared using the paired-samples t-test or the Wilcoxon signed rank sum test.The intraclass correlation coefficient(ICC)was used to analyze the agreement between the 2 radiologists’measurements.Results The agreements were good(mean ICC>0.80)between the 2 observers’measurements of the macrovascular,thyroid,splenic,skeletal,and abdominal fat indices at the baseline time and follow-up.Comparing with the baseline data,the patients showed a decrease in the percentage of lung lesion volume,an increase in the diameter of the ascending aortic trunk,an increase in the thyroid area and a decrease in the mean thyroid density,a decrease in the spleen thickness and longest diameter,and a decrease in the mean density of the spleen at follow-up(all P<0.05).The remaining CT characteristics did not differ statistically between the baseline and follow-up measurements(all P>0.05).Conclusion Acute COVID-19,a disease affecting multiple organs,could cause structural alterations across various systems to the patients.

关 键 词：新型冠状病毒感染 体层摄影术 X线计算机 胸部 多器官受累 

分 类 号：R816.41[医药卫生—放射医学] R814.42[医药卫生—临床医学]