新型冠状病毒肺炎治疗后转归CT影像表现

CT imaging findings after treatment of new coronavirus pneumonia

目的对比观察新型冠状病毒肺炎(COVID-19)治疗前后影像变化,探讨其转归影像表现。方法回顾性分析24例COVID-19患者临床、实验室及治疗前后影像资料。结果轻型1例,胸部CT影像未见异常,白细胞、淋巴细胞计数、C反应蛋白未见异常,临床以咳嗽为主,治疗后症状消失。普通型15例,病变累及单个肺叶或多个肺叶,中外带、磨玻璃影为主,临床表现为普通型肺炎,肺内病灶治疗后2例(13.3%)完全吸收,7例(46.6%)明显吸收,6例(40%)部分有吸收,临床症状消失或减轻,白细胞、淋巴细胞计数全部恢复正常,C反应蛋白仍升高的4例(26.7%)。重型8例,表现为双肺广泛分布的大片状实变影和/或磨玻璃密度影,临床表现为病情较重,治疗后明显吸收5例(62.5%),部分吸收3例(37.5%),临床症状减轻,白细胞、淋巴细胞计数全部恢复正常,C反应蛋白仍升高4例(50%)。结论COVID-19以磨玻璃密度影及斑片状阴影为主,部分实变,影像表现多样,治疗后普通型患者病灶多明显吸收,重型患者多残留间质纤维化,影像表现滞后于临床。

Objective To compare and observe the image changes before and after treatment of the new type of coronavirus pneumonia(COVID-19),and explore its outcome image performance.Methods The clinical,laboratory and pre-treatment imaging data of 24 NCP patients were analyzed retrospectively.Results There was no abnormality in chest CT image,white blood cells,lymphocyte count and C reactive protein in 1 mild case in whom the main clinical symptom was cough,and the symptoms disappeared after treatment.In 15 patients with common type,lung lesions involved a single lobe or multiple lobes,showing a main external band,grinding glass shadow,and clinical manifestations of common type pneumonia.After treatment,pulmonary lesions completely absorbed in 2 cases(13.3%),significantly absorbed in 7 cases(46.6%),and partially absorbed in 6 cases(40%)and clinical symptoms were disappeared or alleviated,as well as white blood cells and lymphocyte count were all returned to normal,but C reactive protein was still elevated in 4 cases(26.7%).Among 8 patients with severe disease,lung lesions in 5 cases(62.5%)were completely absorbed and 3 cases(37.5%)were partially absorbed after treatment.The clinical symptoms were relieved,the white blood cell and lymphocyte counts were returned to normal,and the C reactive protein remained elevated in 4 cases(50%).Conclusion Lung lesions of Covid-19 infection are mainly composed of ground glass density shadow and patchy shadow,some of them are consolidation and images are various.After treatment,the lesions in common type patients are obvious absorption.The lesions in heavy type patients show residual interstitial fibrosis,and the image is lagging behind clinical.