常态防控期间CT检查对新型冠状病毒肺炎与耶氏肺孢子菌肺炎的鉴别诊断价值

Value of CT examination in the differential diagnosis of Corona Virus Disease 2019 and pneumocystis jirovecii pneumonia during normal prevention and control period

目的对比研究新型冠状病毒肺炎(COVID-19)与耶氏肺孢子菌肺炎(PJP)的CT征象,提高鉴别诊断水平。方法收集2019年12月至2020年3月河北省保定市第一中心医院和河北省保定市传染病医院收治的32例确诊为COVID-19患者、河北省保定市第一中心医院收治的10例PJP患者的首次CT检查资料,比较其CT征象。结果COVID-19患者以双肺多发病变、胸膜下区分布为主。出现胸膜平行征、血管增粗征概率均明显高于PJP,出现肺气囊、月弓征、地图征的概率均明显低于PJP,差异均有统计学意义(P<0.05)。结论COVID-19与PJP既有共同的CT征象,又各有典型影像学特征,胸部CT检查在二者的鉴别诊断中具有重要价值。

Objective To compare the computed tomography(CT)signs of Corona Virus Disease 2019(COVID-19)and pneumocystis jirovecii pneumonia(PJP),and improve the level of differential diagnosis.Methods The first CT data of 32 COVID-19 patients admitted to Bao Ding No.1 Central Hospital and Bao Ding infectious Diseases Hospital of Hebei Province and 10 PJP patients admitted to Bao Ding No.1 Central Hospital of Hebei Province from December 2019 to March 2020 were collected,and their CT signs were compared.Results The COVID-19 patients were mainly characterized by multiple lung lesions in subpleural area,and their probability of pleural parallel sign and vascular thickening sign were significantly higher than those of the PJP patients,while the probability of pulmonary balloon sign,lunar arch sign and map sign were significantly lower than those of the PJP patients,with statistical significance(P<0.05).Conclusion COVID-19 and PJP not only share common CT features but also have typical imaging features and chest CT plays an important role in the differential diagnosis of COVID-19 and PJP.