新型冠状病毒肺炎患者治愈后肺部CT特点分析

CT characteristics of cured patients with COVID-19

目的:探讨新型冠状病毒肺炎(COVID-19)治愈后近期肺部CT变化特点。方法:回顾性分析2020年2月1日-3月14日云南省各定点医院收治的确诊并治愈的130例COVID-19患者的病例资料。所有患者在出院时均行肺部CT检查并在出院后2周返院复查。对比分析患者的两次肺部CT图像,观察病灶的数目、分布、形态及密度等特征的变化规律。结果:8例患者在出院时肺部CT无明显病灶,其余122例治愈患者肺部CT表现为不同程度的病灶存留,其中普通型104例、重型18例。出院时,普通型患者肺部病灶特点主要有多发89例(85.6%)、磨玻璃密度影(GGO)31例(29.8%)、实变影73例(70.2%)、小叶间隔增厚79例(76.0%)、纤维条索影98例(94.2%)、胸膜下线74例(71.2%)、病变内血管增粗19例(18.3%)和空气支气管征9例(8.7%);重型患者肺部病灶均为多发,磨玻璃密度影(GGO)17例(94.4%)、实变影10例(55.6%)、小叶间隔增厚15例(83.3%)、纤维条索影14例(77.8%)、胸膜下线6例(33.3%)、病变内血管增粗10例(55.6%)、空气支气管征4例(22.2%)。返院复查时,普通型患者肺部GGO 15例(14.4%)、实变影52例(50.0%)、小叶间隔增厚44例(42.3%)、纤维条索影77例(74.0%)、胸膜下线37例(35.6%)、病变内血管增粗9例(8.7%),较前均明显减少(all P<0.05);空气支气管征5例(4.8%),较前无明显改变(χ^2=1.583,P>0.05)。返院复查时,重型患者肺部病灶较前不同程度吸收、减少,但病灶性质较前无明显变化(P>0.05)。结论:COVID-19患者治愈后肺部CT表现具有一定特点及变化规律,能为临床评估患者疗效及预后提供参考依据。

Objective:The purpose of this study was to explore the short term characteristics of pulmonary CT findings in discharged patients with COVID-19.Methods:130 cured patients with COVID-19 at all the designated hospitals in Yunnan province were collected from 2020 February 1 to March 14.All patients who underwent pulmonary CT scans at discharge and 2 weeks follow-up were retrospectively analyzed.The number,distribution,morphology and density of the pulmonary lesions on the twice CT images were observed and compared.Results:There were no obvious lesions found in 8 cases at the time of discharge,and there were different lesions found in the other 122 cases including 104 with normal type and 18 with severe type.At the time of discharge,in common type group the main pulmonary findings included multiple lesions in 89 cases(85.6%),GGO in 31 cases(29.8%),consolidation in 73 cases(70.2%),thickened interlobular septa in 79 cases(76.0%),fibrosis in 98 cases(94.2%),subpleural lines in 74 cases(71.2%),thickened blood vessels in 19 cases(18.3%),and air bronchogram sign in 9 cases(8.7%);and in severe group,pulmonary findings were multiple lesions of different nature in all patients,and the other signs were GGO in 17 cases(94.4%),consolidation in 10 cases(55.6%),thickened interlobular septa in 15 cases(83.3%),fibrosis in 14 cases(77.8%),subpleural lines in 6 cases(33.3%),thickened blood vessels in 10 cases(55.6%),and air bronchogram sign in 4 cases(22.2%).At the follow-up scans,in common type group the pulmonary lesions were significantly reduced(P<0.05),including GGO in 15 cases(14.4%),consolidation in 52 cases(50.0%),thickened interlobular septa in 44 cases(42.3%),fibrosis in 77 cases(74.0%),subpleural lines in 37 cases(35.6%),and thickened blood vessels in 9 cases(8.7%);no obvious change was found in air bronchogram sign between the two CT examinations(χ^2=1.583,P>0.05).At the time of follow-up scans,in the severe group the pulmonary lesions were absorbed and decreased to different degrees than before,but there was no significant changes in the nature of the lesions(P>0.05).Conclusion:The CT findings of lung in COVID-19 patients have certain characteristics and change rules,which can provide reference for clinical evaluation of the curative effect and prognosis of the patients.