新型冠状病毒肺炎的CT检查与核酸检测对比

Comparative analysis of COVID-19 with CT and nucleic acid detection

目的探讨计算机断层扫描(CT)与病毒核酸检测在2019新型冠状病毒肺炎(COVID-19)诊断及疗效评判中的应用价值。方法纳入南充市中心医院确诊并收治的18例COVID-19患者行。将患者核酸检测结果、CT检查结果及CT表现进行汇总,分析其在COVID-19诊断及疗效评判中的应用价值。结果18例确诊病例中,首诊核酸检测和胸部CT检查中,核酸阳性14例(71.78%),阴性4例;胸部CT有肺炎表现15例(83.33%),无肺炎表现3例,两者比较差异无统计学意义(P>0.05)。但第二次及第三次复查时,核酸检测阳性率与CT检查阳性率差异有统计学意义(P均<0.05)。核酸检测阳性病例中,均在胸部CT上有病毒肺炎表现。CT表现为胸膜下区域见片状、絮状、结节状的渗出影,往往以双下肺为主,病灶中以磨玻璃密度影(GGO)为主要表现,危重症者GGO大片融合及网格状改变,亦有典型的“白肺“征象。结论CT检查不仅在早期临床诊断中占有重要地位,在疗效的评判中也是不可替代的。因此有机的结合核酸检测及CT检查,普及胸部CT检查对COVID-19疑似患者的筛查,能够实现COVID-19防治的早发现,可有效的控制疫情的蔓延。

Objective To explore computed tomography(CT)and viral nucleic acid detection in the diagnosis and curative effect evaluation of 2019 new coronavirus pneumonia(COVID-19).Methods 18 patients with COVID-19 were selected.The results of nucleic acid detection,CT examination and CT manifestations were analyzed.Results In the 18 confirmed cases,the nucleic acid of throat swab and chest CT were detected.The positive result of nucleic acid detection was in 14 cases,while 4 cases were negative in the first detection.Similarly,15 cases with positive results and 3 cases with negative results for the first time of CT scan were found.In the nucleic acid positive cases,all cases had imaging features of pneumonia on CT.Flake,flocculent and nodular exudative shadows in the subpleural region imaging features of pneumonia were found in the image of CT,which distributed mainly in bilateral lower lungs.In the lesions,GGO is the main manifestation.In seriously ill patients,there are large fusion and grid like changes of GGO,as well as typical"white lung"signs.Conclusion CT not only plays an important role in early clinical diagnosis,but also in the evaluation of curative effect.Therefore,organic combination of nucleic acid detection and CT examination,and popularization of chest CT examination for the screening of suspected patients with COVID-19 can achieve the early detection,which will contribute to the control of COVID-19 epidemic.