新型冠状病毒肺炎与非新型冠状病毒肺炎患者胸部CT影像分析

Analysis of chest CT images of patients with new coronavirus(COVID-19)and non-COVID-19 pneumonia

目的初步分析新型冠状病毒(COVID-19)肺炎与非COVID-19肺炎患者的CT影像学特征。方法回顾性分析2019年12月~2020年3月确诊的57例患者的胸部CT影像。记录并分析每位患者胸部CT图像中受累肺叶数量,病灶分布情况(胸膜下、中央区、胸膜下与中央区并存),病灶类型(纯磨玻璃结节、伴铺路石征磨玻璃结节、伴晕征实性结节、多种类型病灶共存)。对胸部CT中双肺受累情况进行半定量评分。比较两组的一般资料、影像学表现及肺叶评分的差异。结果COVID-19组33例,非COVID-19组24例;相较于非COVID-19患者,COVID-19患者发病年龄更倾向于中、老年人[平均年龄(61.73±12.95岁];影像学表现中受累肺叶以5个肺叶为主(23例,69.7%),较少出现单纯磨玻璃结节(1例,3.0%)。COVID-19组与非COVID-19组在年龄、右肺上叶评分、右肺下叶评分、左肺下叶评分、总评分中差异有统计学意义(P<0.05),其中年龄、右肺下叶评分、左肺下叶评分、总评分(AUC:0.726、0.732、0.706及0.712)都具有较好的诊断效能。结论COVID-19影像表现形式多样,较少出现单纯磨玻璃结节、多累及多个肺叶等CT征象,结合更倾向于中、老年人的流行病学特征,可以为影像诊断和临床筛查提供有利的帮助。

Objective Preliminary analysis of CT imaging characteristics of COVID-19 and non-COVID-19 patients.Methods Retrospective analysis of chest CT images of 57 patients diagnosed from December 2019 to March 2020.Record and analyze the number of affected lung lobes,the distribution of lesions(subpleural,central,coexistence of subpleural and central area),and the types of lesions(pure GGO,GGO with crazy paving sign,solid nodules with halo sign,and multiple types of lesions coexist)in each patient's chest CT image.Semi-quantitative scoring of both lungs involvement in chest CT.Differences in general information,imaging findings,and lung lobe scores were compared between the two groups.Results 33 patients in the COVID-19 group and 24 patients in the non-COVID-19 group;Compared with non-COVID-19 patients,the age of onset of COVID-19 patients is more inclined to middle-aged and elderly patients(mean age:61.73±12.95 years);More involvement of 5 lung lobes(23 cases:69.7%),fewer pure GGO(1 cases:3.0%)The COVID-19 group and the non-COVID-19 group were statistically different in age,right upper lobe score,right lower lobe score,left lower lobe score,and total score(P<0.05),in which age,right lower lobe score,left lower lobe score,and total scores(AUC:0.726,0.732,0.706,and 0.712)all have good diagnostic performance.Conclusion COVID-19 image expressions are diverse,CT signs such as the multiple lung lobe involvement,fewer pure GGO,combining epidemiological characteristics that are more inclined to middle-aged and elderly patients,which can provide beneficial help for imaging diagnosis and clinical screening.