新型冠状病毒肺炎(COVID-19)临床影像学特征

Clinical and thin-section CT features of patients with the COVID-19 in Wuhan

中国武汉市不明原因肺炎是由一种新型冠状病毒(SARS-CoV-2)感染引起的,传染性强,人群普遍易感。临床症状以发热、干咳、乏力为主,严重者并发急性呼吸窘迫综合征。COVID-19的高分辨CT演变特点:①病灶呈多发性、双侧性分布,以胸膜下及两下肺沿支气管血管束分布多见。②早期以胸膜下斑片状、结节状、团状、节段或亚段性磨玻璃影(GGO)多见,常见血管充血增粗穿行,也可表现为GGO合并实变及纤维化;进展期病灶增多范围扩大,发展为双肺多叶受累的GGO与实变影,小叶间隔增厚及纤维化,也可呈"铺路石征",常见支气管充气征及血管穿行;重症期双肺弥漫性病变,呈"白肺",常见支气管充气征及血管穿行;吸收缓解期可见病灶范围缩小,伴较多纤维化病灶。CT演变特征可为早期诊断与鉴别、病情严重程度评估、及时防控、诊疗决策及治疗评估提供重要依据。

The recent outbreak of unknown original pneumonia cases in Wuhan,China,was caused by a novel beta-coronavirus,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Adults can easily get infected,and infants and children were also reported to be infected.Clinical manifestation mainly presents with fever,fatigue,dry cough,whereas some cases can progress to severe respiratory distress syndrome.The high resolution CT findings of COVID-19 were as follows:①Lesions were multiple and bilaterally distributed,and commonly located in subpleural and lower lobe of lung.②In early stages,chest CT showed multiple small ground glass infiltration,interstitial changes,and enlarged vascular lumens.Then they gradually progress to multiple ground glass infiltration in the lungs,and severe cases can have consolidation in the lobe.The lobular septum become thicken and fibrosis can also be seen,like"paving stone sign".The diffuse lung lesions can be seen in severe patients,some show as"white lungs".Bronchial inflation signs and blood vessel penetration sign are common.Fibrosis lesions can be seen during remission stage.The CT identification of the COVID-19 provides essential evidence for timely prevention,early diagnosis,severitydegree and treatment evaluation.