儿童新型冠状病毒奥密克戎毒株感染的胸部CT影像特点

Chest Computed Tomography Imaging Features of NovelCoronavirus Omicron Strain Infection in Children

目的:探讨儿童新型冠状病毒奥密克戎毒株感染的胸部CT影像特点。方法:回顾性分析2022年12月10日至2022年12月31日深圳市儿童医院77例核酸检测或抗原检测确诊为COVID-19患者的胸部CT表现,男51例,女26例。其中CT表现阳性50例,年龄1月~14岁,平均5.5岁,中位年龄3.9岁,婴幼儿组(≤3岁)21例,学龄前组(3~7岁)14例,学龄组(≥7岁)15例。由两名放射科医师独立识别肺内病灶位置、肺内病灶CT表现、肺部伴随CT表现、病灶累及范围及影像分期。结果:肺部CT表现阳性50例(64.9%);病变好发于两肺下叶、胸膜下,近肺门区病变最少,病变数量单发、多发、弥漫分布均有,以弥漫分布最为多见。磨玻璃结节16例(32%),实性结节20例(40%),片状实变24例(48%),片状磨玻璃30例(60%),实变和磨玻璃20例(40%),片状磨玻璃最多见;铺路石样改变4例(8%),小叶间隔增厚12例(24%),树雾征12例(24%),血管增粗13例(26%),胸膜平行征7例(14%),反晕征6例(12%),充气支气管征17例(34%),均无空洞表现;胸腔积液5例(10%),胸膜增厚7例(14%),心包积液1例(2%),淋巴结增大7例(14%)。29例(37.7%)患者为影像分期的早期,15例(19.5%)为进展期,6例(7.8%)为重症期。结论:儿童新型冠状病毒奥密克戎毒株感染的胸部CT表现形态多样,伴随胸腔积液、胸膜增厚和心包积液提示严重预后的风险更高。儿童奥密克戎毒株感染的胸部CT检查能为诊断及判断病情提供有价值的信息。

Objective:To investigate the chest Computed Tomography(CT)imaging features of novel coronavirus omicron strain infection in children.Methods:The chest CT imaging of 77 children diagnosed with COVID-19 using nucleic acid testing or antigen testing from December 10 to 31,2022 at Shenzhen Children's Hospital were retrospectively analyzed,including 51 males and 26 females.Among them,50 cases were positive for CT presentation,and their ages ranged from 1 month to 14 years,with a mean age of 5.5 years and a median age of 3.9 years,including 21 cases in the infant and toddler group(≤3 years),14 in the preschool group(3~7 years),and 15 cases in the school-age group(≥7 years).Two radiologists independently identified the location of intrapulmonary lesions,CT manifestations of intrapulmonary lesions,concomitant CT manifestations of the lungs,extent of lesion involvement,and imaging staging.Results:50 patients(64.9%)had positive lung CT presentation,with the most lesions in the lower lobes and subpleural areas of both lungs and the least lesions in the hilus of lung,and the number of lesions were single,multiple,and diffusely distributed,with diffuse distribution being the most common.Ground-glass opacity were seen in 16 cases(32%),solid nodules in 20(40%),lamellar consolidation in 24(48%),lamellar ground glass in 30(60%),and solid and ground glass in 20(40%),with lamellar ground glass being the most common;crazy-paving pattern in 4 cases(8%),thickening of lobular septa in 12(24%),tree fog sign in 12(24%),and vascular enlargement in 13(26%).7 cases(14%)were of subpleural curvilinear line,6(12%)of reversed halo sign,and 17(34%)of air bronchogram,all without cavitation;5(10%)were of pleural effusion,7(14%)of pleural thickening,1(2%)of pericardial effusion,and 7(14%)of lymphadenopathy.29 patients(37.7%)were in the early stage of imaging,15(19.5%)were in the progressive stage,and 6(7.8%)were in the severe stage.Conclusion:The chest CT imaging of novel coronavirus omicron strain infection in children was morphologically diverse.The presence of pleural effusion,pleural thickening,and pericardial effusion suggests a higher risk of serious prognosis.Chest CT in children with omicron strain infection can provide valuable information for diagnosis and determine the extent of the disease.