计算机断层扫描对新型冠状病毒肺炎的诊断要点及临床意义

Computed tomography in coronavirus disease 2019:diagnosis and clinical significance

目的探讨新型冠状病毒肺炎(COVID-19)确诊患者的CT特征及临床意义,提高对COVID-19影像学表现的认识。方法回顾性分析海军军医大学(第二军医大学)长海医院2020年1月25日至2月15日经病毒核酸检测确诊的7例COVID-19患者的胸部CT特征。男6例、女1例,年龄为(51.1±18.8)岁(29~75岁)。7例患者均行胸部CT平扫检查,由2名经验丰富的高年资影像诊断医师阅片,记录COVID-19病灶分布、病灶位置、病灶密度、累及肺叶数量,以及空气支气管征、纵隔淋巴结肿大、胸腔积液等表现。结果7例COVID-19患者从首次出现临床症状至CT检查时间为1~9 d,平均3.6 d。病灶分布于单肺1例、双肺6例;病灶累及肺野外中带5例、全肺野2例;病灶呈磨玻璃影4例、混合影3例;病灶累及≤2个肺叶4例、累及5个肺叶3例;1例有空气支气管征;7例均无纵隔淋巴结肿大和胸腔积液。结论COVID-19患者的CT影像表现具有一定的特征,对COVID-19的诊疗有重要临床意义,但确诊需结合患者流行病学史、临床症状和实验室指标。

Objective To investigate the computed tomography(CT)features of the coronavirus disease 2019(COVID-19)and the clinical significance,so as to improve our understanding of CT imaging of this disease.Methods The chest CT features of seven COVID-19 patients,who were diagnosed by virus nucleic acid test from Jan.25 to Feb.15,2020 in Changhai Hospital of Naval Medical University(Second Military Medical University),were analyzed retrospectively.There were six males and one female,aged(51.1±18.8)years(range 29-75 years).All the seven patients received chest CT plain scan examimation.The CT images were interpreted by two experienced senior radiologists,and the distribution,location and density of lesions,number of involved lobes,air bronchogram,mediastinal lymphadenopathy and pleural effusion were analyzed.Results The average time from onset of symptoms to CT examination was 3.6 d(range 1-9 d)in the seven COVID-19 patients.The lesions were distributed in single lung in one case and bilateral lungs in six cases.The lesions involved middle and lateral fields of lungs in five cases and the whole field of lungs in two cases.The lesions showed ground-glass opacity in four cases and mixed shadow in three cases.The lesions involved two or less lobes in four cases and five lobes in three cases.One case had air bronchogram.No mediastinal lymphadenopathy or pleural effusion were found.Conclusion COVID-19 patients have characteristic CT findings,which has important clinical significance for the diagnosis and treatment of COVID-19.However,the diagnosis should be confirmed based on the patient’s epidemic history,clinical symptoms and laboratory indicators.