胸部高分辨CT在新型冠状病毒肺炎诊断中的应用价值

The Application Value of Chest High-resolution CT in the Diagnosis of COVID-19

目的:探讨胸部高分辨CT在诊断新型冠状病毒肺炎中的表现及其临床应用价值。方法:回顾性分析我院25例发热患者且肺部具有炎症的胸部高分辨CT图像,并对肺部炎症在CT图像上的位置、密度、形态、数目及分布特点进行综合分析,总结出新型冠状病毒肺炎的特征。结果:25例炎症患者中,14例新型冠状病毒肺炎确诊病例主要表现为磨玻璃影(100%),双肺多发(86%),单发(14%),病灶与胸膜平行(93%);非新型冠状病毒肺炎11例,主要表现为肺实变(91%),磨玻璃影(9%),局限在一个肺叶(82%),多叶(18%)。CT诊断灵敏度为92.86%,特异性为90.91%。CT诊断符合率为92%。CT诊断结果与病毒RNA PCR结果具有极高一致性(p=0)。结论:胸部高分辨CT扫描能及时发现新型冠状病毒肺炎患者肺部异常改变,根据肺部病变的分布、病灶形态及特点,结合临床症状及实验室检查,可以明显提高新型冠状病毒肺炎患者的诊断正确率,可以在新型冠状病毒肺炎核酸检测结果出来前就为临床提供重要的诊断依据,并能够及时进行临床干预,防止疫情的蔓延。

Objective:To investigate the manifestation and clinical value of chest high resolution CT in the diagnosis of COVID-19.Methods:the high resolution chest CT images of 25 febrile patients with pulmonary inflammation in our hospital were analyzed retrospectively,and the location,density,shape,number and distribution of pulmonary inflammation on CT images were comprehensively analyzed,and the characteristics of COVID-19 were summarized.Results:Among the 25 patients with inflammation,14 cases confirmed by COVID-19 showed ground glass shadow(100%),multiple lungs(86%),single(14%),and the focus was parallel to the pleura(93%).The main manifestations were lung consolidation(91%),ground glass shadow(9%),confined to one lung lobe(82%)and multi-lobular(18%).The sensitivity of CT diagnosis was 92.86%and the specificity was 90.91%.The consistency rate of CT diagnosis was 92%.The results of CT diagnosis were highly consistent with those of RT-PCR(p=0).Conclusion:High resolution chest CT scan can find abnormal pulmonary changes in patients with COVID-19 in time.According to the distribution,shape and characteristics of pulmonary lesions,combined with clinical symptoms and laboratory examination,it can significantly improve the diagnostic accuracy of COVID-19 patients,and can provide an important basis for clinical diagnosis before COVID-19 nucleic acid test results come out.And can carry on the clinical intervention in time to prevent the spread of the epidemic.