普通型新型冠状病毒肺炎的早期影像学表现(附24例分析)

Early Imaging Findings of Novel Coronavirus Pneumonia of Conventional Type:A Report of 24 Cases

目的探讨普通型新型冠状病毒肺炎(NCP)的早期影像学表现,旨在提高对该病的认识。方法回顾性分析2019年12月至2020年2月期间经病毒核酸检测证实的24例普通型NCP的临床特征及早期MSCT表现。结果24例普通型(NCP)均为在汉人员,临床表现主要有发热、咳嗽咳痰、乏力、腹泻、胸痛、浑身出汗、食欲减退、全身不适等,另有3例临床无任何不适。实验室检查表现为白细胞计数异常(13例)、嗜酸粒细胞计数下降(9例)、淋巴细胞比升高4例、C反应蛋白升高23例,血沉升高16例。24例NCP病毒7项阴性均为阴性,6例首次核酸检测阴性。24例普通型NCP早期MSCT主要表现为单发或多发毛玻璃影,6例CT初诊未见异常。其它征象包括“铺路石征”8例、小叶核心结节14例、“晕征”4例、“血管造影征”16例、“空气支气管征”11例、“反晕征”2例、局部胸膜肥厚3例,纵隔淋巴结肿大5例。结论普通型NCP的临床表现和实验室检查缺乏特异性,早期MSCT表现以单发或多发毛玻璃影为主,与常见感染性病变鉴别困难。对处于新型冠状病毒肺炎特定爆发期内的易感人群,应加强胸部MSCT检查和多次病毒核酸检测筛查,可有助于该病的早发现、早诊断、早预防和早治疗。

Objective To investigate early imaging findings of novel coronavirus pneumonia of conventional type,in order to improve the knowledge of this disease.Methods The clinical features and early MSCT findings of 24 cases about novel coronavirus pneumonia of conventional type from December 2019 to February 2020 were retrospectively analyzed,which confirmed by viral nucleic acid test.Results 24 patients with novel coronavirus pneumonia of conventional type were from Wuhan.The main clinical manifestations were fever,cough and expectoration,fatigue,diarrhea,chest pain,sweating all over,loss of appetite,general malaise,and 3 cases without any clinical discomfort.The laboratory examination showed that leukocyte count decreased(11 cases),leukocyte count increased(2 cases),eosinophil count decreased(9 cases),lymphocyte ratio increased in 4 cases,CRP increased in 23 cases,ESR increased in 16 cases.In 24 cases of novel coronavirus pneumonia,6 cases which Detection of viral nucleic acid for the first time were negative and all were negative about routine 7 items in virus detection.The early MSCT manifestations of 24 cases of common NCP were single or multiple ground glass shadows,and 6 cases had no abnormal findings on the first CT examination.Other imaging findings included 8 cases of paving stone sign,14 cases of lobular core nodule,4 cases of halo sign,16 cases of angiogram sign,11 cases of air bronchogram,2 cases of reversed halo sign,3 cases of local pleural hypertrophy and 5 cases of mediastinal lymphadenopathy.Conclusion The clinical manifestations and laboratory tests of novel coronavirus pneumonia of conventional type are lack of specificity.The main finding of MSCT is single or multiple ground glass opacity in lobe,which is difficult to distinguish from common infectious lesions.While treating Susceptible population in the specific outbreak period of novel coronavirus pneumonia,it is necessary to strengthen MSCT examination of chest and multiple detections of viral nucleic acid,which can be helpful for the early detection,diagnosis,prevention and treatment of the disease.