新型冠状病毒肺炎CT表现动态变化的初步探讨

Preliminary discussion for chest CT dynamic findings of COVID-19 patients

目的:探讨新型冠状病毒肺炎(简称新冠肺炎)胸部CT表现的动态变化过程。方法:回顾性分析26例新冠肺炎的年龄、性别、临床病史、流行病学病史及胸部CT资料。结果:26例中,普通型19例,其中2例表现为单个磨玻璃结节或双肺多个磨玻璃影,达到出院标准时结节或磨玻璃影未见明显改变;13例病变磨玻璃影多次检查均表现为逐渐吸收;4例磨玻璃影范围先扩大,并新增肺实变或磨玻璃病灶,后期病灶再逐渐吸收变淡。重型或危重型7例,表现为双肺弥漫性磨玻璃影;首次复查3例CT表现为病变轻度吸收,4例病灶较前增多、密度增高;继续复查肺内病灶均表现为少许吸收,且开始向纤维化转归,但达到出院标准时病变仅大部吸收或向纤维化陈旧病灶发展。结论:新冠肺炎的CT表现及其动态变化过程有一定的特征和规律,能对临床治疗效果及预后进行评价,并为研究新冠肺炎的病理机制提供影像依据。

Objective:To investigate the dynamic changes of chest CT imaging in patients with COVID-19.Methods:The age,sex,clinical history,epidemiological history and chest CT imaging data of 26 patients with COVID-19 were retrospectively analyzed.Results:There were 11 males and 15 females in COVID-19 patients,the age ranged from 1 month to 64 years old.Nineteen patients were common COVID-19.Among them,2 cases with single or multiple ground-glass shadows had no significant changes of CT images before discharge,13 patients with multiple ground-glass shadows showed gradual absorption on multiple examinations,4 cases with multiple ground-glass shadows showed shadow range expanded firstly,new lung consolidation or ground-glass lesions added,and the later lesions gradually absorbed.Seven patients with severe or critical COVID-19 showed diffuse characteristic ground-glass shadows of both lungs.Among them,3 cases showed slightly absorbed in the first reexamination,4 cases showed more lesions and higher density than before;in the reexaminations,all lesions showed a little absorption and began to turn to fibrosis;most of the lesions were absorbed or developed to old fibrosis lesions before charge.Conclusions:The imaging manifestation and dynamic change process of COVID-19 have certain characteristics and rules.It could not only evaluate the clinical treatment effect and prognosis,but also provide imaging comparison for the study of the pathological mechanism of COVID-19.