普通型新型冠状病毒肺炎患者胸部高分辨率CT特点分析

Analysis of chest high-resolution CT imaging features in common-type coronavirus disease 2019 patients

目的探讨普通型新型冠状病毒肺炎患者的胸部高分辨率CT特点。方法回顾性分析2020年1月21日—2月23日于四川大学华西医院发热门诊就诊的患者35例,根据核酸检测结果分为核酸阳性组14例和核酸阴性组21例,比较两组患者的临床特点及病灶分布、形态、密度、铺路石征、空气支气管征、血管增粗征、有无胸腔积液、有无淋巴结增多增大等10项高分辨率CT影像学征象的差异。结果核酸阳性组与核酸阴性组的男女构成比例、年龄段分布、临床症状、淋巴细胞绝对值差异无统计学意义(P>0.05),流行病学史差异有统计学意义(P<0.05),核酸阴性组淋巴细胞百分率异常和白细胞计数异常的比例高于核酸阳性组(66.7%vs.28.6%,P=0.041;42.9%vs.7.1%,P=0.028)。核酸阴性组患者中出现空气支气管征的比例高于核酸阳性组(47.6%vs.7.1%,P=0.023),两组患者的其他高分辨率CT影像学表现差异无统计学意义(P>0.05)。结论普通型新型冠状病毒肺炎患者在胸部高分辨率CT上有一定的阳性表现,临床实践中可结合高分辨率CT及其他因素辅助诊断新型冠状病毒肺炎。

Objective To explore the characteristics of chest high-resolution CT in common-type coronavirus disease 2019 patients.Methods A retrospective analysis was performed on 35 patients in the Fever Clinic of West China Hospital of Sichuan University from January 21 to February 23,2020.According to the nucleic acid test results,the patients were divided into a nucleic acid positive group of 14 cases,and a nucleic acid negative group of 21 cases.The clinical characteristics and high-resolution CT results(including lesion distribution,morphology,density,paving stone sign,air bronchial sign,vascular thickening sign,pleural effusion and enlarged lymph nodes,etc.)of the patients in each group were compared.Results There was no statistically significant difference in the ratio of males to females,age distribution,clinical symptoms,or absolute lymphocyte values between the nucleic acid positive group and the nucleic acid negative group(P>0.05).The difference in epidemiological history between the two groups was statistically significant(P<0.05).The proportions of abnormal lymphocytes and white blood cell counts in the nucleic acid negative group were higher than those in the nucleic acid positive group(66.7%vs.28.6%,P=0.041;42.9%vs.7.1%,P=0.028).The proportion of air bronchial signs in the nucleic acid negative group was higher than that in the nucleic acid positive group(47.6%vs.7.1%,P=0.023).There was no significant difference in other high-resolution CT imaging findings between the two groups(P>0.05).Conclusions Common-type coronavirus disease 2019 patients have certain positive findings on chest highresolution CT imagings.In clinical practice,high-resolution CT and other factors can be combined to assist in the diagnosis of coronavirus disease 2019.