儿童2019新型冠状病毒感染15例CT影像特征分析

Analysis of CT features of 15 children with 2019 novel coronavirus infection

目的探讨儿童2019新型冠状病毒感染的CT影像学特征。方法回顾性分析2020年1月16日至2月6日深圳市第三人民医院收治的15例2019新型冠状病毒感染患儿的临床资料及胸部CT影像资料。分析2019新型冠状病毒感染患儿CT影像肺部病变分布位置、病变形态等特征。结果15例患儿中男5例、女10例,年龄4~14岁,其中初诊发热者5例、无症状者10例;鼻拭子或咽拭子病毒核酸初诊检测均阳性。初诊胸部CT影像,6例未见病变;9例显示肺部炎症,其中小结节磨玻璃影7例、斑片磨玻璃影2例。治疗3~5 d复查,病毒核酸转阴6例,其中2例患儿胸部CT炎症较前吸收减少,3例患儿胸部CT仍未见病灶,1例无明显变化;病毒核酸仍阳性者9例,其中6例胸部CT炎症表现无明显变化,3例复查胸部CT新见炎症,均表现为小结节磨玻璃影。结论儿童感染2019新型冠状病毒临床症状不典型,其早期影像学多表现为小结节状磨玻璃影。对于儿童2019新型冠状病毒感染胸部CT及病毒核酸动态复查很重要。

Objective To explore imaging characteristics of children with 2019 novel coronavirus(2019-nCoV)infection.Methods A retrospective analysis was performed on clinical data and chest CT images of 15 children diagnosed with 2019-nCoV infection.They were admitted to the Third People's Hospital of Shenzhen from January 16 to February 6,2020.The distribution and morphology of pulmonary lesions on chest CT images were analyzed.Results Among the 15 children,5 were males and 10 females,aged from 4 to 14 years.Five of the 15 children were febrile and 10 were asymptomatic on the first visit.The first nasal or pharyngeal swab samples in all the 15 cases were positive for 2019-nCoV nucleic acid.For their first chest CT images,6 patients had no lesions,while 9 patients had pulmonary inflammatory lesions.Seven cases had small nodular ground glass opacities and 2 cases had speckled ground glass opacities.After 3 to 5 days of treatment,2019-nCoV nucleic acid in a second respiratory sample turned negative in 6 cases.Among them,chest CT images showed less lesions in 2 cases,no lesion in 3 cases,and no improvement in 1 case.The remaining 9 cases were still positive in a second nucleic acid test.Six patients showed similar chest CT inflammation,while 3 patients had new lesions,which were all small nodular ground glass opacities.Conclusions The early chest CT images of children with 2019-nCoV infection are mostly small nodular ground glass opacities.The clinical symptoms of children with 2019-nCoV infection are nonspecific.Dynamic reexamination of chest CT and nucleic acid are important.