40例新型冠状病毒肺炎患者胸部CT表现

CT imaging analysis of 40 cases with Corona Virus Disease 2019

目的分析40例COVID-19患者的影像学表现,探讨胸部CT对该病早期诊断、预后评估的价值。方法回顾性分析2020年2月1日至3月3日济宁医学院附属医院和济宁市第四人民医院确诊的40例COVID-19患者的临床和影像学资料,总结其影像学特征。结果病灶单发12例(30%),多发28例(70%);单侧18例(45%),双侧22例(55%);单纯磨玻璃密度(GGO)32例(80%),完全实变1例(2.5%),GGO+实性混合密度7例(17.5%);分布模式为小叶核心型17例(42.5%),胸膜下型7例(17.5%),混合型13例(32.5%),弥漫型3例(7.5%)。伴随征象中血管增粗征17例(42.5%),胸膜平行征10例(25%),空气支气管征8例(20%),晕征7例(17.5%),反晕征1例(2.5%),铺路石征3例(7.5%)。吸收期病变残留纤维条索灶或胸膜下线的有14例(35%);病变完全消失未残留纤维条索灶的有20例(50%);以上2种形式均存在的有6例(15%)。有17例第2次CT复查有进展。结论COVID-19的胸部影像学表现具有一定的特征性,CT在其早期诊断及治疗、转归的效果评价中发挥重要作用。

Objective To analyze and summarize the CT imaging features of Corona Virus Disease 2019(COVID-19)patients and explore the value of chest CT in early diagnosis and prognosis assessment of the disease.Methods From February 1 to March 3,2020,the clinical and imaging data of COVID-19 patients diagnosed in the Affiliated Hospital of Jining Medical University and The Fourth People's Hospital of Jining were retrospectively collected and analyzed,to summarize their imaging characteristics.Results Single lesion 12 cases(30%),multiple lesions 28 cases(70%);the lesion detected in the lung unilaterally in 18 cases(45%)and bilaterally in 22 cases(55%);32 cases(80%)of ground-glass opacity(GGO),1 case(2.5%)of solid density,7cases(17.5%)of GGO+consolidation.Distribution patterns:centrilobular distribution(17 cases,42.5%),subpleural distribution(7 cases,17.5%),mixed distribution(13 cases,32.5%)and diffused distribution(3 cases,7.5%).Accompanying signs:17 cases(42.5%)with vascular thickening,10 cases(25%)with“pleural parallel sign”;“bronchial inflatable sign”in 8 cases(20%);“halo sign”in 7 cases(17.5%);“reversed-halo sign”in 1 case(2.5%);“paving stone sign”in 3 cases(7.5%).The features of chest CT in clinical outcomes are that lesions in the lung gradually fade and were completely absorbed without residual fibrous cord shadows(20 cases,50%);lesions were absorbed and accompanied by residual fibrous cord shadows(14 cases,35%).There were 6 cases(15%)with the above two forms.17 cases exacerbated in the second CT review.Conclusion COVID-19 patients have certain chest CT characteristics,which plays an important role in the early diagnosis,treatment and outcome evaluation.