新型冠状病毒肺炎与社区获得性肺炎胸部CT的比较

Comparison of chest CT of COVID-19 and community-acquired pneumonia

目的:通过对新型冠状病毒肺炎(COVID-19)患者与社区获得性肺炎(community-acquired pneumonia,CAP)患者的胸部CT影像特点对比分析,总结COVID-19患者的影像学特点,从而提高对COVID-19患者的影像诊断水平。方法:回顾性分析2020年1月19日—2月27日68例COVID-19病例CT资料,与2018年10月27日—2020年2月27日收集的72例CAP病例CT资料进行比较。结果:COVID-19发生于双侧肺叶的占比为 76.5%,明显高于CAP的38.8%(P<0.01)。COVID-19出现磨玻璃影(95.6%)、铺路石征(26.5%)及网格影(30.9%)的构成比显著高于CAP(分别为 72.2%、1.4%和8.3%),而CAP中实变影(69.4%)、支气管充气征(58.3%)及树芽征或小叶中心结节(50.0%)的构成比显著高于COVID-19(分别为35.2%、23.5%和10.3%)(P<0.05)。结论:COVID-19患者胸部CT出现磨玻璃影、铺路石样和网格影样改变的概率明显高于CAP,而出现实变影、支气管充气征和树芽征及小叶中心结节等改变明显少于CAP。

Objective Through the comparative analysis of the chest CT image characteristics of COVID-19 patients and patients with community acquired pneumonia(CAP),the imaging characteristics of COVID-19 patients were summarized,so as to improve the imaging diagnosis level of COVID-19 patients.Method The CT data of 68 COVID-19 cases from January 19 to February 27,2020 were analyzed and compared with the CT data of 72 CAP cases collected from October 27,2018 to February 27,2020.Result The proportion of COVID-19 in bilateral lobes was 76.5%,significantly higher than that of CAP(38.8%)(P﹤0.01).The composition ratio of ground glass shadow(95.6%),pavement sign(26.5%)and mesh shadow(30.9%)in COVID-19 was significantly higher than that of CAP(72.2%,1.4%and 8.3%,respectively)(P﹤0.05).However,the composition ratios of consolidation shadow(69%),air bronchogram(58.3%),and tree-bud signs or central lobular nodule(50.0%)in CAP were significantly higher than that of COVID-19(35.2%,23.5%and 10.3%,respectively)(P﹤0.05).Conclusion The incidence of ground glass shadow,pavement sign and mesh shadow changes in chest CT of COVID-19 patients was significantly higher than that of CAP,while the incidence of consolidation shadow,air bronchogram and tree-bud signs or central lobular nodules were significantly less than that of CAP.