新型冠状病毒肺炎首次胸部高分辨率CT影像分析

Analysis of the initial chest high resolution CT manifestations of COVID-19

目的 探讨新型冠状病毒肺炎(COVID-19)首次胸部高分辨率CT(HRCT)影像表现。方法 回顾性分析2020年1月3日至25日武汉市中西医结合医院确诊的106例COVID-19患者的首次胸部HRCT图像,对病灶分布、形态及周围受累情况进行统计和分析。结果 106例COVID-19患者首次肺部HRCT均发现病灶,单侧肺分布11例(10.4%),双侧肺分布95例(89.6%);肺外周分布65例(61.3%),肺外周及中心同时分布41例(38.7%);1个病灶8例(7.5%),2个病灶5例(4.7%),多发病灶93例(87.8%);结节状病灶12例(11.3%),磨玻璃状病灶94例(88.7%),条索状病灶7例(6.6%),2种及以上形态共存病灶15例(14.2%);累及一个肺叶10例(9.4%),累及2个及以上肺叶96例(90.6%);纵隔淋巴结增大24例(22.6%)(>60岁患者19例,占79.2%),胸腔积液3例(2.8%),心包积液1例(0.9%),胸膜受累/增厚2例(1.9%)。>60岁患者多表现为多病灶,多形态,肺外周及中心同时分布,累及多个肺叶,纵隔淋巴结增大。结论 COVID-19患者首次胸部HRCT检查能发现肺部病灶,是首选的影像学检查方法,胸部HRCT扫描检查在NCP的早期诊断中有重要作用。

Objective To investigate the initial chest high resolution CT(HRCT)manifestations of the patients with COVID-19.Methods A retrospective analysis of the first chest HRCT images of 106 patients with COVID-19 was performed who were confirmed in our hospital from January 3 to 25,2020.Lesion distribution,morphology and surrounding involvement were analyzed.Results The lesions were found on all initial HRCT images of 106 patients,with unilateral lung distribution in 11 cases(10.4%)and bilateral lung distribution in other 95 cases(89.6%),peripheral distribution of lung in 65 cases(61.3%)and peripheral and central distribution in other 41 cases(38.7%).HRCT showed 8 cases(7.5%)with 1 lesion,5 cases(4.7%)with 2 lesions,and other 93 cases(87.8%)with multiple lesions.HRCT also showed the nodular lesions in 12 cases(11.3%),ground-glass opacities in 94 cases(88.7%),fibrous stripes in 7 cases(6.6%),and mixed lesions in 15 cases(14.2%).Only one lung lobe was involved in 10 cases(9.4%),while more than two lobes were involved in other 96 cases(90.6%).In addition,24 cases(22.6%)with enlarged mediastinal lymph nodes(over 60 years old in 19 cases,accounting for 79.2%),3 cases with pleural effusion(2.8%),1 case with pericardial effusion(0.9%),and 2 cases with pleural involvement/thickening(1.9%)were found.Patients over 60 years old mostly presented with multiple lesions,various appearances,peripheral and central distributions of lungs,involving multiple lobes,and enlarged mediastinal lymph nodes.Conclusions Lung COVID-19 lesions can be shown by the initial chest HRCT,which is the preferred imaging method.Thoracic HRCT scans play an important role in the early diagnosis of COVID-19.