69例新型冠状病毒肺炎的胸部CT影像学特征分析

Chest CT features analysis of 69 patients with COVID-19

目的探讨海南地区新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)的首诊胸部CT表现和临床特点,以期提高对该病的认识。方法回顾性分析2020年1月22日—3月7日海南省人民医院收治的69例COVID-19确诊患者的临床胸部CT资料。结果 69例患者临床表现主要为发热56例,咳嗽、咳痰59例,乏力32例。临床分型,轻型3例(4.35%),普通型病例54例(78.26%),重型和危重型12例(17.39%)。69例患者中,5例(7.25%)首诊胸部CT阴性,64例(92.75%)胸部CT有异常病灶,13例(20.31%)单侧肺叶病变,51例(79.69%)为双肺受累;9例(14.06%)肺内单发病灶,55例(85.94%)肺内多发病灶。病灶的CT影像学特征为肺内磨玻璃密度影,37例(57.81%)呈胸膜下及肺外带分布为主;伴病灶中心或节段性肺实变23例(33.33%),伴支气管充气征19例(27.54%),合并病灶内血管束增粗50例(72.46%),伴小叶间隔增厚38例(55.07%),胸膜下纤维条索影9例(13.04%),2例(2.90%)伴有胸腔积液。结论海南地区COVID-19患者以输入性病例为主,部分为本地散发病例,临床以轻型和普通型病例为主。首诊胸部CT主要表现为胸膜下及肺外带分布磨玻璃密度影,伴血管束增粗及间质性改变,胸腔积液少见。

Objective To investigate clinical characteristics and CT findings of coronavirus disease 2019(COVID-19)in Hainan area, and we aim to raise awareness of the disease.MethodsThe clinical chest CT data of 69 patients withCOVID-19 diagnosed in Hainan People’s Hospital, January 22-March 7, 2020 were analyzed retrospectively.ResultsThemain clinical manifestations of 69 patients were fever(n=56), cough and expectoration(n=59), and fatigue(n=32). Among 69 patients, 3(4.35%) were mild cases, 54(78.26%) were ordinary cases, 12(17.39%) were severe and critically cases.Of the 69 patients, 5(7.25%)had negative CT findings, 64(92.75%) had abnormal findings, the lesions involved both lungs in 51 cases(79.69%), while involved single lung in 13 cases(20.31%). There were 9 cases(14.06%) with single pulmonary lesion, and 55 cases(85.94%) with multiple pulmonary lesions. The lesions were mainly distributed in the subpleural in 37 cases(57.81%),CT imaging features of the focus were ground glass density shadow in the lung, in 23 cases(33.33%) were accompanied bycentral or segmental pulmonary consolidation, air bronchus signs were observed in 19 cases(27.54%), intralesional vascularbundle thickening in 50 cases(72.46%), thickened leaflet septa were found in 38 cases(55.07%), fibrous foci were noticed in 9 cases(13.04%), and pleural effusion were seen in 2 cases(2.90%).ConclusionCOVID-19 patients in Hainan are mainlyimported cases, some of them are local sporadic, and most of them are mild and ordinary. The first chest CT findings are mainlyground glass density shadow in subpleural, accompanied by thickening of vascular bundle and thickened leaflet septa, pleuraleffusion is rare.