新型冠状病毒肺炎的CT表现与临床特征之间的时间顺序关系

Chronological relationship between of CT manifestations and clinical features of novel coronavirus pneumonia

目的探讨新型冠状病毒肺炎(NCP)的CT表现与临床特征之间的时间顺序关系。方法收集2020年1-2月安庆市立医院确诊为NCP的病人81例临床资料,包括病人一般情况、病人来源、发病日期及症状、全身症状缓解日期、体温异常及恢复正常日期、核酸检测日期及结果、首次CT检查日期及结果;由2名放射科主治医师评估峰值CT图像和出院前末次CT图像并评分且记录检查时间。将相关数据按照时间节点及病人数归纳出关系图,影像学评分表及潜伏期/滞后期统计表。结果81例病人中自疫源地返回的一代病人占55.6%。临床潜伏期范围在0~26 d不等。97.3%的病人影像学-临床潜伏期、77.3%的影像学-体温滞后期、78.4%的临床-影像学恢复期、84.6%的核酸转阳-影像学潜伏期和94.8%的核酸转阴-影像学滞后期均为≥0,可归纳总结为NCP病程中各节点时间顺序流程图。73.3%的峰值CT图像及88%的出院前CT图像均评分为轻度或中度。结论NCP流行性可控、大部分病人病情程度不重但病程较长,其发展趋势总体符合病程中各节点时间顺序流程图,临床医生有效利用这种时间顺序特征将对NCP病人的筛查和治疗有所裨益。

Objective To discuss the time sequence relationship between CT findings and clinical features of novel corona virus pneumonia(NCP).Methods Eighty-one patients diagnosed with NCP in Anqing Municipal Hospital from January to February 2020 were selected as the study objects,and their clinical data were retrospectively collected,including patient general condition,patient source,date of onset and symptoms,date of systemic symptom relief,abnormal body temperature and recovery date,nucleic acid detection date and results,and the date and results of the first CT examination.The two attending radiologists were asked to evaluate the peak CT images and the last CT images before hospital discharge and to score and record the examination time.The above data were summarized into a relational graph,imaging rating scale and statistical table of latency/lag period according to the time node and the number of patients.Results 55.6%of the 81 patients returned from the epidemic focus have been regarded as the first-generation patient.The clinical Latent period(CLP)ranges from 0-26 days.In 97.3%of the patients,the Radiographic Latent Period 1(RLP1),77.3%Radiographic Lag Period2(RLP2),78.4%Recovery Phase(RP),84.6%Nucleic Acid Latent Period 1(NP1)and 94.8%Nucleic Acid Latent Period2(NP2)were all≥0,which can be summarized as the time sequence flow chart of each node in the course of NCP.73.3%of the peak CT images and 88%of the pre-discharge CT images were rated mild or moderate.Conclusion The epidemic of NCP is controllable,most patients are not serious but have long course and its development trend generally conforms to the time sequence flow chart of each node in the course of disease.Effective use of this chronological feature by clinicians will benefit screening and treatment of NCP patients.