新型冠状病毒肺炎与甲型H1N1流感肺炎CT特征比较

CT Features of COVID-19 and H1N1 Influenza Pneumonia:A Comparative Study

目的分析新型冠状病毒肺炎(COVID-19)与甲型H1N1流感肺炎胸部CT表现的差异,探讨CT对两者的鉴别诊断价值。资料与方法回顾性分析87例确诊COVID-19和28例确诊甲型H1N1流感肺炎患者的胸部CT征象,比较两组CT征象的差异。结果 COVID-19组患者年龄(45±15)岁,低于甲型H1N1组的(54±17)岁(P<0.05);两组均以双肺受累多见,COVID-19组以外周(35例,40.2%)和外周+中央分布(37例,42.5%)为主;甲型H1N1组以外周+中央分布(14例,50.0%)为主。两组右肺上叶、右肺下叶、左肺上叶受累严重程度评分差异有统计学意义(P<0.05)。COVID-19组出现磨玻璃影71例(81.6%)、小叶间隔增厚67例(77.0%)及空气支气管征63例(72.4%),显著高于甲型H1N1组的15例(53.6%)、15例(53.6%)及13例(46.4%),差异有统计学意义(P均<0.05);COVID-19组出现结节影4例(4.6%)、胸腔积液1例(1.1%),明显低于甲型H1N1组的6例(21.4%)及11例(39.3%),差异有统计学意义(P均<0.05)。结论 COVID-19比甲型H1N1流感肺炎CT表现多见磨玻璃影、小叶间隔增厚、空气支气管征,少见结节影、胸腔积液,对两者的鉴别有一定的价值。

Purpose To analyze the difference of chest CT manifestations between COVID-19 and H1N1 influenza pneumonia,and to explore the value of CT in the differential diagnosis of the above diseases.Materials and Methods Chest CT features of 87 patients with confirmed COVID-19 and 28 patients with confirmed H1N1 influenza pneumonia were retrospectively analyzed,and the differences in CT features were also compared.Results Patients with COVID-19 showed a lower age compared with patients with H1N1 influenza pneumonia[(45±15)years old vs.(54±17)years old,P<0.05].Both COVID-19 and H1N1 influenza pneumonia were mostly double lung involvement.In COVID-19 group,peripheral(35 cases,40.2%)and peripheral+central distribution(37 cases,42.5%)were the main distribution;the peripheral+central distribution(14 cases,50.0%)was the main distribution in H1N1.The difference in the severity scores of the COVID-19 group and the H1N1 group in the right upper lobe,right lower lobe and left upper lobe was statistically significant(P<0.05).The proportion of ground glass changes(71 cases,81.6%),leaflet interval thickening(67 cases,77.0%)and air bronchial signs(63 cases,72.4%)in the COVID-19 group was significantly higher than that in H1N1 group(P<0.05);the proportion of nodular-like changes(4 cases,4.6%)and pleural effusion(1 case,1.1%)was significantly lower than that of the H1N1 group(6 cases,21.4%vs.11 cases,39.3%,P<0.05).Conclusion COVID-19 shows more ground glass density shadow,interlobular septal thickening,air bronchi,and less nodular changes and pleural effusion in CT images than H1N1 influenza pneumonia.CT imaging has a certain value in the identification of the two diseases.