新型冠状病毒肺炎与细菌性肺炎的胸部CT特征比较

Chest CT features comparison between COVID-19 and bacterial pneumonia

目的:通过对新型冠状病毒肺炎(COVID-19)与细菌性肺炎患者的胸部CT影像特点进行对比分析,提高对COVID-19患者的影像诊断水平。方法:回顾性分析2020年1月16日-2月18日的42例COVID-19病例CT资料,并与2017年11月27日-2020年2月6日收集的36例细菌性肺炎病例CT资料进行比较。结果:COVID-19发生于双侧肺叶的占比为73. 8%,明显高于细菌性肺炎的41. 7%(P<0. 01)。COVID-19出现磨玻璃影(95. 2%)、网格影(31. 0%)及铺路石征(26. 2%)的占比显著高于细菌性肺炎(分别为77. 8%、8. 3%和0,均为P<0. 05);而出现实变(35. 7%)、小叶中心结节或树芽征(9. 5%)的占比低于细菌性肺炎(分别为66. 7%和47. 2%,均为P<0. 05)。结论:COVID-19患者磨玻璃影、网格影和铺路石样外观等CT表现出现的概率明显高于细菌性肺炎,而出现实变影、小叶中心结节及树芽征等CT表现明显少于细菌性肺炎。

Objective: To improve the imaging diagnosis of novel coronavirus disease 2019(COVID-19) by comparing the chest CT imaging characteristics between COVID-19 and bacterial pneumonia.Methods: CT data of 42 COVID-19 cases from January 16 to February 18, 2020 were retrospectively analyzed, and we also compared with the CT data of 36 cases of bacterial pneumonia collected from November 27, 2017 to February 6, 2020.Results: The incidence of bilateral lobes involvement in COVID-19 group was 73. 8%, which was significantly higher than that in bacterial pneumonia group(vs41. 7%, P<0. 01). The incidences of ground glass shadow(95. 2%), mesh shadow(31. 0%), and pavement sign(26. 2%) were significantly higher than those of bacterial pneumonia(77. 8%, 8. 3%and 0, respectively, all P<0. 05). The incidences of consolidation(35. 7%), and central lobular nodule or tree-bud signs(9. 5%) were lower than those of bacterial pneumonia(66. 7% and 47. 2%, respectively, both P<0. 05).Conclusion: In COVID-19 patients, more CT signs such as ground glass shadow, mesh shadow and paved appearance were found than in bacterial pneumonia ones, whereas the consolidation shadow, central lobular nodules and tree-bud signs were less common.