新型冠状病毒肺炎影像表现及鉴别诊断

Imaging manifestations and differential diagnosis of novel coronavirus pneumonia

目的探讨新型冠状病毒肺炎胸部CT的早期表现,并与以往流行的病毒性肺炎临床及影像特点进行鉴别。方法回顾性分析武汉大学中南医院收治的33例新型冠状病毒肺炎确诊病例的临床及影像资料。并结合以往流行的病毒性肺炎的相关文献资料,进行鉴别诊断。结果新型冠状病毒肺炎确诊病例胸部CT主要表现为磨玻璃影、混合磨玻璃影、网格影、实变影,呈斑片状或团块状。病灶广泛分布,累及两肺3个肺叶及以上者多见。合并胸腔积液及纵隔淋巴结肿大者较少。结论新型冠状病毒肺炎胸部CT具有一定特征性,但是与其他病毒性肺炎的胸部CT表现难以区分。结合临床流行病学资料、临床表现及实验室检查可以确诊。

Objective To investigate the early manifestations of the novel coronavirus pneumonia on chest CT,and to distinguish it from the clinical and imaging features of the previous outbreak of viral pneumonia.Methods Retrospective analysis was performed on 33 suspected cases of novel coronavirus pneumonia admitted to Zhongnan Hospital of Wuhan University,and their clinical and imaging data was analyzed.Review and summarize the literature of previous outbreak of viral pneumonia for differential diagnosis.Results Chest CT of the suspected cases of the novel coronavirus pneumonia mainly showed ground-glass opacity,mixed ground-glass opacity,latticed opacity,consolidation,and showing patchy or lump-like shape.The lesions were widely distributed,involving three lobes of two lungs and above.Patients with pleural effusion and mediastinal lymph node enlargement are rare.Conclusion The chest CT of the novel coronavirus pneumonia has certain characteristics,but it is difficult to distinguish from other viral pneumonia.Combining clinical epidemiological data,clinical manifestations and laboratory tests,viral pneumonia can be differentiated.