COVID-19与早期肺癌磨玻璃样变的HRCT影像特征对比分析

Comparison of HRCT imaging features of ground glass opacity of COVID-19 and early-stage lung carcinoma

目的探讨COVID-19与早期肺癌磨玻璃样变的HRCT表现差异,规范疫情期间磨玻璃样变的诊治流程。方法2020年1月23日至2020年2月15日厦门大学附属第一医院收治的34例经检测新型冠状病毒核酸阳性确诊COVID-19患者作为观察组;2018年1月1日至2019年12月31日经厦门大学附属第一医院胸外科手术确诊为肺恶性肿瘤,且术前HRCT检查表现为纯磨玻璃病变,符合纳入标准的患者,采用数字表法随机抽取40例作为对照组;对比两组患者的HRCT特征,进行统计学分析。结果性别、年龄、病变是否伴有胸腔积液、病变位置是否位于外侧带差异无统计学意义;病变是否多灶起病、病变3天内是否发生明显变化、是否有网格征、是否有空泡征、边界是否清晰差异有统计学意义。结论COVID-19病情进展较快,早期肺癌多为惰性病灶,影像学动态检查是鉴别两者的重要依据。

Objective To investigate the difference of HRCT imaging features between COVID-19 and the ground-glass opacity(GGO)lesion of early-stage lung carcinoma,standardize the diagnosis and treatment process of ground-glass opacity(GGO)degeneration during the epidemic.Methods A total of 34 patients with diagnosed COVID-19 who confirmed by positive results of the new coronavirus nucleic acid test were collected as observation group 40 patients with pathologically diagnosed early-stage lung carcinoma whose preoperative HRCT examination showed pure ground glass lesions and received surgical intervention were recruited from the Department of Thoracic Surgery(The First Affiliated Hospital of Xiamen University)from January 2018 to December 2019 as the control group.The HRCT imaging features of these two groups of patients were compared and statistically analyzed.Results The HRCT imaging features of the new type of COVID-19 showed significant difference by characteristics of multiple lesions,lesion rapid variation within 3 days,reticular pattern,vacuolar sign and clear boundary compared to the GGO lesion of early-stage lung carcinoma(P<0.05).The chinical and imaging characteristic the sex,age,with pleural effusion or not and the lesion location showed no significant difference between these 2 groups(P>0.05).Conclusion Contrast with inert early lung carcinoma lesions,COVID-19 disease developed rapidly.Imaging dynamic examination can provide evidences to distinguish Novel Coronavirus Pneumonia and early-stage lung carcinoma.