91例新型冠状病毒肺炎CT演变特征

Analysis of the evolution of CT presentations in 91 cases of COVID-19

目的:分析新型冠状病毒肺炎CT征象演变规律,进一步提高对该疾病的认识。方法:搜集91例核酸检测阳性新型冠状病毒肺炎患者普通型69例,重症型17例,危重型5例。年龄17~90岁,平均年龄50岁,男40例,女51例。回顾分析其CT征象发展与转归。结果:普通型患者经过3~26d(平均14d)进入消散期,其演变过程表现为早期→消散期(3例),早期→进展期→消散期(56例),早期→进展期→重症期→消散期(10例);重型患者经过8~27d(平均15d)进入消散期,其演变过程表现为早期→进展期→消散期(6例),早期→进展期→重症期→消散期(11例);危重型患者经过14~22d(平均18d)发展进入消散期,其演变过程均表现为早期→进展期→重症期→消散期(5例)。演变过程出现磨玻璃密度影(48例),实性/亚实性结节(13例),斑片实变影(75例),铺路石征(34例),纤维条索影(46例),胸膜下线(12例),支气管气象征(14例),支气管扩张(9例),血管增粗征(15例),淋巴结肿大(2例),胸膜增厚(17例)、胸腔积液(6例)12种CT征象。结论:新型冠状病毒肺炎演变过程表现为3种:①早期→消散期;②早期→进展期→消散期;③早期→进展期→重症期→消散期。CT为临床治疗提供重要依据。

Objective:To analyze the evolution of computerized tomography(CT)signs of coronavirus disease 2019(COVID-19)in order to further improve our understanding of the disease.Methods:The data of 91 patients in our hospital with positive nucleic acid tests for COVID-19 were reviewed,including 69 moderate cases,17 severe cases,and 5 critical cases.The patients ranged in age from 17~90 years,with a mean age of 50 years.There were 40 males and 51 females.The development and outcomes of the CT signs were retrospectively analyzed.Results:Patients with moderate cases improved to the resolving stage after 3~26 days(mean:14 days),with evolutionary processes of early stage→resolving stage(3 cases),early stage→progressive stage resolving stage(56 cases),and early stage→progressive stage→severe stage→resolving stage(10 cases).Patients with severe cases entered the resolving stage after 8~27 days(mean:15 days),with evolutionary processes of early stage→progressive stage→resolving stage(6 cases),and early stage→progressive stage→severe stage→resolving stage(11 cases).Patients with critical cases improved to the resolving stage after 14~22 days(mean:18 days),with an evolutionary process of early stage→progressive stage→severe stage→resolving stage(5 cases).During the evolutionary process,12 CT signs were revealed,including ground glass opacity(48 cases),solid/sub-solid nodule(13 cases),patchy consolidation(75 cases),crazy-paving sign(34 cases),fibrous cord shadow(46 cases),subpleural line(12 cases),air bronchogram sign(14 cases),bronchiectasis(9 cases),vascular thickening sign(15 cases),lymphadenopathy(2 cases),pleural thickening(17 cases),and pleural effusion(6 cases).Conclusions:The evolution of COVID-19 may proceed in 3 ways:①Early stage→resolving stage;②Early stage→progressive stage→resolving stage;③Early stage→progressive stage→severe stage→resolving stage,CT imaging can be an important reference for clinical treatment.