新型冠状病毒肺炎HRCT影像学特征分析

目的探讨新型冠状病毒肺炎(COVID-19)高分辩CT(HRCT)影像学特征。方法选取2020年2月至4月确诊的COVID-19肺炎患者1252例,回顾性分析其临床资料与入院后第一次HRCT影像资朴,按照《新型冠状病毒肺炎诊疗方案》(第六版)疾病程度分为普通型652例、重型272例、危重型328例共三组,观察比较其病变范围、累及肺叶、病灶数目、边界、密度以及毗邻结构受累情况。结果磨玻璃祥病变为COVID-19肺炎典型表现;三组COVID-19患者的平均年龄比较,危重型患者高于重型患者,重型患者高于普通型患者,差异.均有统计学意义(P<0.05);COVID-19危重型、重型、普通型患者伴有基础疾病的比例分别为78.66%(258/328)、45.59%(124/272)、16.26%(106/652),组间两两比较差异有统计学意义(P<0.05);COVID-19危重型、重型、普通型悲者病变双肺累及率分别为100%、91.67%、19.05%,组间比较差异有统计学意义(P<0.05);COVID-19普通型患者跨叶段病灶、支气管兖气征、血管束增粗征、小叶间隔增厚、胸膜凹陷征发生率分别为14.29%、42.86%、38.10%、23.81%、9.52%,重型分别为63.89%、66.67%、58.33%、66.67%、33.33%,危重型分别为86.96%、100%、86.96%、100%、86.96%,组间比较差异有统计学意义(P<0.05)。结论COVID-19患者HRCT表现较有特征性,可为临床分型提供重要依据,有助于评估患者病情并指导治疗方案的制定。

Objective To investigate the imaging features of COVID-19(COVID-19)high-resolution CT(HRCT).Methods From February to April in 2020,1252 patients with COVID-19 pneumonia were selected.The clinical data and the first HRCT image data after admission were retrospectively analyzed.According to the novel coronavirus pneumonia diagnosis and treatment plan(Sixth Edition),the disease degree was divided into 652 cases of ordinary type,272 cases of severe cases and 328 cases of critical cases,then the extent of the lesion,the affected lung lobes,the number oflesions,borders,density,and the involvement of adjacent structures were observed and compared.Results Ground glass lesions Typical were manifestations of COVID-19;the average age of the three groups of COVID-19 patients was compared,critical patients were higher than severe patients,and severe patients were higher than ordinary patients,the differences were statistically significant(P<0.05);the proportion of critical,severe and ordinary patients with basic diseases were 78.66%(258/328),45.59%(124/272)and 16.26%(106/652)respectively,the difference was statistically significant among the three groups(P<0.05);the bilateral lung involvement rates of COVID-19 critical type,severe type and common patients were 100%,91.67%and 19.05%respectively,and the difference was statistically significant among the three groups(P<0.05);the incidence of translobar lesions,bronchial inflation sign,vascular bundle thickening sign,interlobular septal thickening and pleural indentation sign of the COVID-19 ordinary patients were 14.29%,42.86%,38.10%,23.81%and 9.52%,respectively,.the COVID-19 severe cases were 63.89%,66.67%,58.33%,66.67%and 33.33%,respectively,the critical cases were 86.96%,100%,86.96%,100%and 86.96%,respectively,the difference was statistically significant among the three groups(P<0.05).Conclusion HRCT diagnosis of COVID-19 pneumonia has typical characteristics,which can provide an important basis for clinical classification,evaluate the patient's condition and guide the formulation of treatment plans.