无症状感染转确诊新型冠状病毒肺炎胸部CT分析

Analysis of COVID-19 chest CT in asymptomatic infection transferred to diagnosis patients

目的分析无症状感染转确诊新型冠状病毒肺炎(COVID-19)的临床分型及胸部CT表现,提高对无症状感染COVID-19的影像认识。方法选择内蒙古自治区17例无症状感染转确诊COVID-19患者,其中男性12例,女性5例;年龄17个月~83岁,中位年龄37岁,均为确诊患者密切接触者,行胸部CT平扫。对患者临床分型、病灶分布及累及肺叶情况、病灶形态特点及转归进行分析。结果 17例COVID-19无症状感染转确诊病例均有流行病学史,临床分型7例(7/17)为轻型,无胸部CT异常表现;10例(10/17)为普通型;无重型及危重型。普通型中2例(2/10)无胸部CT异常,8例(8/10)胸部CT可见病灶分布,左肺上叶0例,左肺下叶6(6/8)例,右肺上叶2例(2/8),右肺中叶1例(1/8),右肺下叶4例(4/8);仅左肺分布4例(4/8),仅右肺分布2例(2/8),双肺分布2例(2/8)。病灶主要表现为磨玻璃密度影及小片实变,多分布于肺外带、胸膜下;短期复查预后较好。结论无症状感染转COVID-19确诊病例临床分型以轻型及普通型为主,病变范围小,累及肺叶少,磨玻璃阴影为主,吸收较快,胸部CT在具有COVID-19流行病学史人群中排查无症状感染者具有重要价值。

Objective To analyze the clinical classification and chest CT manifestations of coronavirus disease 2019(COVID-19)in asymptomatic infection transferred to diagnosis, and improve image understanding of asymptomatic infection COVID-19.Methods A total of 17 cases of asymptomatic infection transferred to diagnosis COVID-19 were enrolled, which included 12 males and 5 females, aged 17-month-old to 83-year-old with median age of 37-year-old. All of them were close contacts with confirmed patients, and chest CT scan was performed. The clinical classification, lesion distribution and pulmonary involvement, lesion morphology and prognosis were analyzed. Results All of them had epidemiology history, 7 cases(7/17) were mild type, without abnormal chest CT findings;10 cases(10/17) were ordinary type;there were no severe or critical cases. In ordinary type, 2 cases(2/10) without chest CT abnormalities, but 8(8/10) showed visible lesions, which of 0 case at left upper lobe, 6(6/8) at left lower lobe, 2(2/8) at right upper lobe, 1(1/8) at right middle lobe, 4 at right lower lobe(4/8), 4(4/8) at left lung, 2(2/8) at right lung, and 2(2/8) at bilateral lungs. The lesions were mainly manifested as ground glass density shadows and small pieces of consolidation, which were mostly distributed peripheral lungs and subpleural;short-term reexamination showed good prognosis. Conclusion It is demonstrated that the clinical classification of asymptomatic infection transferred to diagnosis COVID-19 cases is mainly mild and ordinaring type, the range of lesions is small and less involved lung lobes with mainly ground glass shadows and absorb faster, so chest CT has important value in screening asymptomatic patients with COVID-19 epidemiological history.