新型冠状病毒肺炎影像检查诊断与感染控制指导意见

Expert Consensus on Imaging Diagnosis and Infection Control for COVID-19

新型冠状病毒肺炎是以肺部炎症性病变为主的急性呼吸道传染病。传播途径主要是飞沫和接触传播,在相对封闭的环境中长时间暴露于高浓度气溶胶情况下存在经气溶胶传播的可能。人群普遍易感。确诊需进行病毒核酸检测、基因测序或血清新型冠状病毒特异性IgM抗体和IgG抗体检测,有临床表现而病毒核酸检测阴性或血清新型冠状病毒特异性Ig M抗体和IgG抗体检测正常者需密切观察。胸部影像学检查可以采用X线摄片和CT检查,而CT检查尤为重要,在疾病诊断、病情评估、治疗后随访中具有重要的价值。该病的影像表现具有一定特征性,可以分为早期、进展期、重症期和吸收期。典型表现为多发斑片状的胸膜下磨玻璃密度影或实变影,可见增粗的血管穿行、支气管充气征及小叶间隔增厚,胸腔积液和淋巴结肿大少见。该病需要与多种感染性疾病以及非感染性疾病相鉴别。影像科在检查诊断过程中要严格做好感染防控和辐射防护。

Coronavirus pneumonia is an acute respiratory infectious disease characterized with pulmonary inflammatory lesions.The transmission routes are mainly through droplets and contact transmission.There is a possibility of aerosol transmission in a relatively closed and high aerosols concentration environment for a long time.People at all ages are generally susceptible.Viral nucleic acid testing,gene sequencing and detection of serum new coronavirus specific IgM and IgG antibodies are needed to confirm the diagnosis.Those with clinical manifestations and negative viral nucleic acid tests or negative detection of serum new coronavirus specific IgM and IgG antibodies need further close observation.Routine digital radiography and CT can be used for chest imaging.CT is particularly important,and has a significant value in the diagnosis,evaluation,and post-treatment follow-up of the disease.The imaging manifestations of the disease demonstrate some characteristics,which can be gradually divided into early,advanced,severe,and absorption stage.The typical manifestations are multiple patchy subpleural ground glass densities or consolidation signs with enlarged vessels,air bronchi and thickened interlobular septums,as well as few pleural effusion and lymphadenopathy signs.The disease needs to be differentiated from many other infectious and noninfectious diseases.The infection prevention and control as well as radiation protection in imaging department should be strictly made.