新型冠状病毒性肺炎发病初期CT表现

CT findings at the initial stage of the onset of the novel corona virus 2019

目的探讨新型冠状病毒肺炎(COVID-19)患者早期CT表现。方法回顾分析我院确诊的24例早期患者CT影像表现。患者在发病1~3天内行HRCT检查。结果24例患者临床表现均为普通型。CT表现:病变分布及位置:15例(62.5%)累及双侧肺叶;12例(50.0%)累及右肺上叶,8例(33.3%)累及右肺中叶,19例(79.2%)累及右肺下叶,14例(58.3%)累及左肺上叶,15例(62.5%)累及左肺下叶;21例(87.5%)累及胸膜下,9例(37.5%)累及中心,6例(25.0%)同时累及胸膜下及中心;病灶大小及密度:1)单发小片状病灶6例(25.0%),其中纯磨玻璃样病灶5例,磨玻璃样密度伴实变病灶1例;2)散在多发小片状病灶16例(66.7%),其中纯磨玻璃样密度病灶12例,伴小叶间隔增厚病灶4例,伴实变病灶9例;3)大片状病灶5例(20.8%),其中纯磨玻璃样密度灶1例,伴小叶间隔增厚灶1例,伴实变病灶3例;其他表现:9例见充气支气管影;4例见穿行粗大血管。结论COVID-19患者发病初期CT以两肺多发散在小片状磨玻璃样密度病灶为主要表现,以胸膜下分布为主。

Objective To study the CT findings of early stage patients with Corona Virus Disease 2019(COVID-19).Methods Retrospective analysis of high-resolution CT(HRCT)imaging manifestations of 24 early patients confirmed at our hospital 2020.HRCT was performed within 1~3 days of onset.Results According to the NCP diagnosis and treatment protocol(5th edition),24 patients showed normal clinical manifestations.X-ray computed CT image 1)distribution and location of lesions 15 cases(62.5%)involved bilateral pulmonary lobes;12 cases(50.0%)involved the upper lobe of the right lung,8 cases(33.3%)involved the middle lobe of the right lung,19 cases(79.2%)involved the lower lobe of the right lung,14 cases(58.3%)involved the upper lobe of the left lung,and 15 cases(62.5%)involved the lower lobe of the left lung.Subpleural involvement was found in 21 cases(87.5%),9 cases(37.5%)involved the center,and 6 cases(25.0%)involved both the subpleural and the center;2)lesion size and density there were 6 cases(25.0%)of single small piece lesions,including 5 cases of pure ground glass-like lesions,1 case of ground glass-like density with consolidation lesions.There were 16 cases(66.7%)of scattered small patch lesions,of which 12 were pure ground-glass density lesions,4 were lesions with thickened lobular septum,and 9 were lesions with consolidation.There were 5 cases(20.8%)of large patchy lesions,including 1 case with pure ground glass density,1 case with septal thickening,and 3 cases with solid lesions.Other manifestations were 9 cases of inflatable bronchial shadow and 4 cases of thick blood vessels.Conclusion In the early stage of NCP patients,HRCT was mainly manifested by multiple divergence between the two lungs and small flake ground glass density lesions,which were mainly distributed under the pleura.