83例新型冠状病毒肺炎病例CT图像定量分析

Quantification of CT images in 83 cases of COVID-19

目的全自动人工智能(AI)系统定量分析新型冠状病毒肺炎(COVID-19)病例胸部CT图像,为判断COVID-19病例重症转化和早期临床干预提供依据。方法选择2020年1月23日—2月14日武汉市武昌医院收治的83例COVID-19确诊病例为研究对象。收集病例临床资料,参考《新型冠状病毒肺炎诊疗方案(试行第七版)》将病例纳入普通组和重症组,利用胸部CT图像的全自动AI系统定量化图像参数,比较两组病例的CT影像学特征。结果普通组46例,重症组37例,年龄分别为(62.68±13.69)岁和(50.52±12.45)岁。重症组和普通组病例总肺部病变百分比[M(Q_(R))]分别为19.80%(21.69%)和9.78%(13.24%),总肺病变体积分别为622.87(1145.73)cm^(3)和333.55(401.77)cm^(3),右下叶病变体积分别为205.73(246.95)cm^(3)和126.02(164.21)cm^(3),肺CT值在-300~-200 Hu时的左肺体积分别为26.50(21.20)cm^(3)和21.43(13.11)cm^(3),右肺体积分别为38.02(48.78)cm^(3)和26.92(18.04)cm^(3),差异均有统计学意义(P<0.05)。疾病症状出现后第10~16 d肺部病变体积达到高峰。结论COVID-19重症病例肺病变体积较大,尤其是右下肺,应在疾病症状出现后第10~16 d加强监测,为临床重症转化提出早期预警。

Objective To quantitatively analyze the chest computerized tomography(CT)images of coronavirus disease 2019(COVID-19)cases by automatic artificial intelligence(AI)system,so as to provide the basis for the prediction of severe cases and early clinical intervention.Methods Eighty-three confirmed cases of COVID-19 from January 23 to February 14,2020 in Wuchang Hospital of Wuhan were selected and the clinical data were collected.According to the diagnosis and treatment Plan of COVID-19(seventh trial),the patients were divided into an ordinary group and a severe group.The parameters of chest CT images were quantified by the automatic AI system,and the CT imaging features of two groups were compared.Results There were 46 cases in the ordinary group and 37 cases in the severe group,with the age of(62.68±13.69)years and(50.52±12.45)years,respectively.The percentages of total pulmonary lesions,the lesion volume of bilateral lungs,the lesion volume of right lower lung,the left lung volume and the right lung volume from-300 to-200 Hu[median(inter-quartile range)]were 19.80%(21.69%),622.87(1145.73)cm^(3),205.73(246.95)cm^(3),26.50(21.20)cm^(3)and 38.02(48.78)cm^(3)in the severe group,which were significantly different from 9.78%(13.24%),333.55(401.77)cm^(3),126.02(164.21)cm^(3),21.43(13.11)cm^(3)and 26.92(18.04)cm^(3)in the ordinary group(P<0.05).The volume of pulmonary lesions reached the peak from 10 to 16 days after infection.Conclusion The lung lesions in severe cases of COVID-19 are large,especially in the right lower lung,and need to be closely monitored from 10 to 16 days after infection for early warning of severe cases.