新型冠状病毒肺炎的CT表现及动态变化特点

CT features and dynamic changes of novel coronavirus pneumonia

目的正确认识新型冠状病毒肺炎(NCP)的CT表现对于明确诊断和评价疗效具有重要的临床意义。方法收集2020年1―2月阜阳市第二人民医院经安徽省或阜阳市疾病预防控制中心(CDC)核酸检测阳性确诊的NCP病人91例,分析所有病例的胸部CT表现。结果NCP早期表现主要表现为单或双肺胸膜下(包括叶间胸膜)结节状及斑片状磨玻璃影,可出现弥漫性细网格影,“充气支气管征”、“小血管增粗征”、“晕征”;进展期病灶增多伴部分实变,沿胸膜下及支气管血管束向肺门方向发展;重症期双肺可呈弥漫性实变影,少数病例出现肺门、纵膈淋巴结肿大及少量胸腔积液;消散期肺部病灶吸收仅有少许毛玻璃影及纤维索条影。结论NCP肺炎的CT表现具有一定的特征性,结合病人流行病学史、临床表现、典型影像学征象和标本核酸检测能够更准确的诊断NCP,CT是评估病灶范围、评价临床疗效的重要手段之一。

Objective To correctly understand the CT features of the novel coronavirus pneumonia(NCP)is of great clinical signifi⁃cance for the diagnosis and evaluation of curative effect.Methods A total of 91 NCP patients in The Second People's Hospital of Fuy⁃ang with positive diagnosis by CDC nucleic acid detection in Anhui province or Fuyang city were collected from January to February 2020.The chest CT manifestations of all cases were analyzed retrospectively.Results The early manifestations of NCP were mainly nodular and patchy ground glass shadow located in the subpleural area(including the interlobular pleura)of single or bilateral lung,with diffuse fine grid shadows,"air bronchogram","small vascular enlargement"and"halo sign";In the advanced stage,the lesions increased with partial consolidation,and developed along the subpleural and bronchial blood vessel bundle to the direction of the hilar lung.The diffuse consolidation shadow in bilateral lung could be seen in severe cases.In a few cases,there were lymph node enlargement in hilum and mediastinal,and a small amount of pleural effusion.There were only a few ground glass shadow and fibrous cord shadow in the absorption of lung lesions during the dissipation period.Conclusion The CT manifestations of NCP have certain charac⁃teristics,which can make a more accurate diagnosis combined with patient epidemiology history,clinical manifestations,typical imaging manifestations and sample nucleic acid detection.CT is one of the important means to evaluate the scope of lesions and clinical curative effect for NCP.