胸部薄层CT在新型冠状病毒肺炎的临床应用

Clinical Application of Chest Thin-slice CT in Novel Coronavirus Pneumonia 2019(COVID-19)

目的:分析胸部薄层CT在新型冠状病毒肺炎(COVID-19)中的临床应用价值,为临床新型冠状病毒肺炎CT检查提供参考。方法:回顾性分析2020年2月8日—3月25日本院6例经病毒核酸检测阳性确诊的COVID-19患者的胸部薄层CT动态变化图像资料,动态复查间隔时间3~5d,认真观察其肺部CT特征并进行分析。结果:6例COVID-19患者均接受胸部薄层CT检查,均有不同程度的肺部异常阴影。4例双肺见磨玻璃密度结节,其中1例为单发结节,2例见铺路石征,2例病灶呈节段性肺实变,2例病灶内见支气管充气征,1例病灶呈大面积实变影伴小叶间质增厚。1例于发病7d后由普通型转为重型,CT检查提示病灶进展,后经积极治疗,病情好转,转为轻症,CT检查提示病灶范围缩小、吸收,其余5例轻症患者病变均未见进展,CT检查提示病灶呈逐渐吸收过程。结论:胸部薄层CT能清晰显示COVID-19疾病过程中的影像学变化,提供清晰、可靠、准确的影像诊断图像,便于影像科医生做出准确判断,为临床疗效评估、预测病变发展及转归提供可靠依据。

Objective:To analyze the clinical application value of chest thin-slice CT in COVID-19 and to provide reference for clinical COVID-19 CT examination.Methods:The dynamic changes of CT images of the chest in 6 patients with viral nucleic acid positive diagnosis from February 8 th 2020 to March 25th 2020 were analyzed retrospectively.The interval of dynamic reexamination was about 3~5 days,the CT features of lung were carefully observed and analyzed.Results:All of the 6 patients underwent thin-slice CT scan of the chest,and all had abnormal lung shadow in different degree.In 4 cases,ground-glass density nodules were found in both lungs,1 case was solitary,2 cases showed paving stone sign,and 2 cases showed segmental consolidation of lung,in 2 cases,bronchus inflating sign was seen in the focus,and in 1 case,the focus showed large area consolidation with lobular interstitium thickening.1 case was changed from normal type to severe type 7 days after onset.CT examination showed the progress of the lesion.After active treatment,the disease improved and turned to mild disease.CT examination indicated that the lesion area was narrowed and absorbed,while the other 5 cases showed no progress,CT examination showed that the lesions showed a gradual absorption process.Conclusion:Thin-slice CT of chest can clearly show the imaging changes during the course of COVID-19 disease,provide clear,reliable and accurate imaging diagnosis images,facilitate imaging doctors to make accurate judgments,for clinical comprehensive treatment evaluation,to predict the development and prognosis of the disease and provide reliable evidence.