^(18)F-Fluorodeoxyglucose positron emission tomography/computed tomography comparison of gastric lymphoma and gastric carcinoma

AIM To compare ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT) features in gastric lymphoma and gastric carcinoma.METHODS Patients with newly diagnosed gastric lymphoma or gastric carcinoma who underwent ^(18)F-FDG PET/CT prior to treatment were included in this study. We reviewed and analyzed the PET/CT features of gastric wall lesions,including FDG avidity,pattern(focal/diffuse),and intensity [maximal standard uptake value:(SUVmax)]. The correlation of SUVmax with gastricclinicopathological variables was investigated by χ~2 test,and receiver-operating characteristic(ROC) curve analysis was performed to determine the differential diagnostic value of SUVmax-associated parameters in gastric lymphoma and gastric carcinoma. RESULTS Fifty-two patients with gastric lymphoma and 73 with gastric carcinoma were included in this study. Abnormal gastric FDG accumulation was found in 49 patients(94.23%) with gastric lymphoma and 65 patients(89.04%) with gastric carcinoma. Gastric lymphoma patients predominantly presented with type Ⅰ and type Ⅱ lesions,whereas gastric carcinoma patients mainly had type Ⅲ lesions. The SUVmax(13.39 ± 9.24 vs 8.35 ± 5.80,P < 0.001) and SUVmax/THKmax(maximal thickness)(7.96 ± 4.02 vs 4.88 ± 3.32,P < 0.001) were both higher in patients with gastric lymphoma compared with gastric carcinoma. ROC curve analysis suggested a better performance of SUVmax/THKmax in the evaluation of gastric lesions between gastric lymphoma and gastric carcinoma in comparison with that of SUVmax alone.CONCLUSION PET/CT features differ between gastric lymphoma and carcinoma,which can improve PET/CT evaluation of gastric wall lesions and help differentiate gastric lymphoma from gastric carcinoma.

Tuberculosis versus non-Hodgkin's lymphomas involving small bowel mesentery:Evaluation with contrast-enhanced computed tomography

AIM: To evaluate the specific computed tomography (CT) imaging criteria for differentiating tuberculosis involving the small bowel mesenteric lymph nodes from lymphomas. METHODS: We retrospectively reviewed the anatomic distribution,CT enhancement patterns of lymphoma in 18 patients with mesenteric tuberculosis and 22 with untreated non-Hodgkin’s lymphomas (NHL) involving small bowel mesentery (SBM). Of the 18 patients with tuberculosis,9 had purely mesenteric tuberculous lymphadenopathy (TL),and 9 had mesenteric TL accompanied with tuberculous mesenteritis (TLM). RESULTS: CT showed that tuberculosis and NHL mainly affected lymph nodes in the body and root of SBM. Homogeneously enhanced lymph nodes in the body and root of SBM were found more often in the NHL (P < 0.05). Homogeneously mixed peripheral enhanced lymph nodes in the body of SBM were found more often in mesenteric TL and TLM (P < 0.05). Peripheral enhanced lymph nodes in the root of SBM were found more often in mesenteric TL and TLM (P < 0.01). "Sandwich sign" in the root of SBM was observed more often in NHL (P < 0.05). CONCLUSION: Anatomic lymph node distribution,sandwich sign and specific enhancement patterns of lymphadenopathy in SBM on CT images can be used in differentiating between tuberculosis and untreated NHL involving SBM.

Radiomics model for distinguishing tuberculosis and lung cancer on computed tomography scans

BACKGROUND Pulmonary tuberculosis(TB)and lung cancer(LC)are common diseases with a high incidence and similar symptoms,which may be misdiagnosed by radiologists,thus delaying the best treatment opportunity for patients.AIM To develop and validate radiomics methods for distinguishing pulmonary TB from LC based on computed tomography(CT)images.METHODS We enrolled 478 patients(January 2012 to October 2018),who underwent preoperative CT screening.Radiomics features were extracted and selected from the CT data to establish a logistic regression model.A radiomics nomogram model was constructed,with the receiver operating characteristic,decision and calibration curves plotted to evaluate the discriminative performance.RESULTS Radiomics features extracted from lesions with 4 mm radial dilation distances outside the lesion showed the best discriminative performance.The radiomics nomogram model exhibited good discrimination,with an area under the curve of 0.914(sensitivity=0.890,specificity=0.796)in the training cohort,and 0.900(sensitivity=0.788,specificity=0.907)in the validation cohort.The decision curve analysis revealed that the constructed nomogram had clinical usefulness.CONCLUSION These proposed radiomic methods can be used as a noninvasive tool for differentiation of TB and LC based on preoperative CT data.

Pulmonary lymphoma: computed tomography features with pathologic correlation

Objective: The aim of this study was to analyze the CT and pathology features of pulmonary lymphoma and to improve the understanding of this disease. Methods: The CT findings of 23 cases with pulmonary lymphoma were retrospectively analyzed and correlated with histopathology. Results: Of the 23 cases with pulmonary lymphoma, there were Hodgkin lymphoma (5 cases) and non-Hodgkin lymphoma (18 cases). Multiple lesions were assessed in 16 cases and single lesion in 7 cases. The imaging findings were classified into 3 types: lobar and segmental involvement type (9/23 cases, 39.13%), nodular or mass-like involvement type (8/23 cases, 34.78%) and mixed type (6/23 cases, 26.09%). Air bronchogram sign (14/23 cases, 60.8%), CT angiogram sign (12/23 cases, 52.17%), ground glass opacity nodules (3/23 cases, 13.04%) and lesion across pulmonary lobes (4/23,17.39%) were the characteristic features of pulmonary lymphoma. Conclusion: Relative characteristic CT features of pulmonary lymphoma could be revealed, which shows clinical significance in the diagnosis of the disease.

Prenatal Diagnosis of Proximal Femoral Focal Deficiency Combining Ultrasound and Computer Tomography

Four cases of proximal femoral focal deficiency (PFFD) in an otherwise healthy infant are described. Antenatal diagnosis was made at 27, 23, 23 and 18 weeks of gestation by routine ultrasound (US) examination. Computer Tomography (CT) was performed after 30 weeks of gestation and confirmed the images obtained by US. The diagnosis was confirmed after delivery. These cases illustrate the importance of combining US and CT to improve accuracy of prenatal diagnosis of skeletal disorders.

CT diagnosis of 52 patients with lymphoma in abdominal lymph nodes

AIM： To assess CT manifestations and its diagnostic value for lymphoma in the abdominal lymph nodes （LALN）.METHODS： CT findings in 52 cases of LALN proved by surgery or biopsy, including Hodgkin＇s disease （HD） in 16 cases and non-Hodgkin＇s lymphoma （NHL） in 36 cases, were retrospectively analyzed.RESULTS： （1） CT manifestations based on distribution of the lesions of LALN： Solitary mass type was found in 10 cases, including solitary, round, uniform-density, enlarged lymph nodes in 3 cases; and multiple, enlarged lymph nodes fusing into singular Iobular mass in 7 cases. Thirty-feur cases of multiple-nodular type showed multiple, round, enlarged lymph nodes with uniform density and clear margins. Vessels-embedded signs, including mesenteric vessels, renal vessels, abdominal aorta or inferior vena cava, were seen in 6 cases, and duodenum-embedded signs were seen in 2 cases. Eight cases of diffuse type showed characteristic ＂cobblestone signs＂. （2） CT manifestations correlated with pathological type： CT manifestations of 12 cases of HD were different from those of 40 cases of NHL in distribution, size, quantity and fused lesion of enlarged lymph nodes. （3） Twenty-eight cases of 52 patients were accompanied with extra-nodal lymphoma in the abdomen, especially gastrointestinal lymphoma, which had characteristic CT findings. （4） In follow-up examinations, CT images showed uniform, heterogeneous or rim enhancement in 15 cases, and occasional calcifications accompanied with reduction of the lesion size and quantity in 12 cases, whereas the lesions disappeared in 3 cases after treatment.CONCLUSION： CT images show many characteristic manifestations valuable for qualitative diagnosis of LALN, and it is also helpful for pathological classification of LALN and therapeutic evaluation in follow-up of patients.

Radiomic features from computed tomography to differentiate invasive pulmonary adenocarcinomas from non-invasive pulmonary adenocarcinomas appearing as part-solid groundglass nodules

Objective:We aim to investigate radiomic imaging features extracted in computed tomography(CT)images to differentiate invasive pulmonary adenocarcinomas(IPAs)from non-IPAs appearing as part-solid ground-glass nodules(GGNs),and to incorporate significant radiomic features with other clinically-assessed features to develop a diagnostic nomogram model for IPAs.Methods:This retrospective study was performed,with Institutional Review Board approval,on 88 patients with a total of 100 part-solid nodules(56 IPAs and 44 non-IPAs)that were surgically confirmed between February 2014and November 2016 in the First Affiliated Hospital of China Medical University.Quantitative radiomic features were computed automatically on 3D nodule volume segmented from arterial-phase contrast-enhanced CT images.A set of regular risk factors and visually-assessed qualitative CT imaging features were compared with the radiomic features using logistic regression analysis.Three diagnostic models,i.e.,a basis model using the clinical factors and qualitative CT features,a radiomics model using significant radiomic features,and a nomogram model combining all significant features,were built and compared in terms of receiver operating characteristic(ROC)curves.Decision curve analysis was performed for the nomogram model to explore its potential clinical benefit.Results:In addition to three visually-assessed qualitative imaging features,another three quantitative features selected from hundreds of radiomic features were found to be significantly(all P<0.05)associated with IPAs.The diagnostic nomogram model showed a significantly higher performance[area under the ROC curve(AUC)=0.903]in differentiating IPAs from non-IPAs than either the basis model(AUC=0.853,P=0.0009)or the radiomics model(AUC=0.769,P<0.0001).Decision curve analysis indicates a potential benefit of using such a nomogram model in clinical diagnosis.Conclusions:Quantitative radiomic features provide additional information over clinically-assessed qualitative features for differentiating IPAs from non-IPAs appearing as GGNs,and a diagnostic nomogram model including all these significant features may be clinically useful in preoperative strategy planning.

Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis

The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computeraided diagnosis(CAD) vs human judgment alone in characterizing solitary pulmonary nodules(SPNs) at computed tomography(CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator(BIMC) model predictions. Raters' predictions were evaluated by means of receiver operating characteristic(ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions(P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs(15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses(mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization.

Multilevel Attention Unet Segmentation Algorithmfor Lung Cancer Based on CT Images

Lung cancer is a malady of the lungs that gravely jeopardizes human health.Therefore,early detection and treatment are paramount for the preservation of human life.Lung computed tomography(CT)image sequences can explicitly delineate the pathological condition of the lungs.To meet the imperative for accurate diagnosis by physicians,expeditious segmentation of the region harboring lung cancer is of utmost significance.We utilize computer-aided methods to emulate the diagnostic process in which physicians concentrate on lung cancer in a sequential manner,erect an interpretable model,and attain segmentation of lung cancer.The specific advancements can be encapsulated as follows:1)Concentration on the lung parenchyma region:Based on 16-bit CT image capturing and the luminance characteristics of lung cancer,we proffer an intercept histogram algorithm.2)Focus on the specific locus of lung malignancy:Utilizing the spatial interrelation of lung cancer,we propose a memory-based Unet architecture and incorporate skip connections.3)Data Imbalance:In accordance with the prevalent situation of an overabundance of negative samples and a paucity of positive samples,we scrutinize the existing loss function and suggest a mixed loss function.Experimental results with pre-existing publicly available datasets and assembled datasets demonstrate that the segmentation efficacy,measured as Area Overlap Measure(AOM)is superior to 0.81,which markedly ameliorates in comparison with conventional algorithms,thereby facilitating physicians in diagnosis.

Primary lymphoma of the liver-A complex diagnosis

A 59-year-old woman presented with the clinical symptoms and radiologic investigations of a liver lesion suspect of metastasis. However, postoperative histopathology revealed a primary hepatic lymphoma (PHL). The case of a patient with a solitary PHL, which was treated by resection and subsequent chemotherapy, will be discussed with a short overview of the literature.

Evaluation of the dual vascular supply patterns in ground-glass nodules with a dynamic volume computed tomography

BACKGROUND In recent years,the detection rate of ground-glass nodules(GGNs)has been improved dramatically due to the popularization of low-dose computed tomography(CT)screening with high-resolution CT technique.This presents challenges for the characterization and management of the GGNs,which depends on a thorough investigation and sufficient diagnostic knowledge of the GGNs.In most diagnostic studies of the GGNs,morphological manifestations are used to differentiate benignancy and malignancy.In contrast,few studies are dedicated to the assessment of the hemodynamics,i.e.,perfusion parameters of the GGNs.AIM To assess the dual vascular supply patterns of GGNs on different histopathology and opacities.METHODS Forty-seven GGNs from 47 patients were prospectively included and underwent the dynamic volume CT.Histopathologic diagnoses were obtained within two weeks after the CT examination.Blood flow from the bronchial artery[bronchial flow(BF)]and pulmonary artery[pulmonary flow(PF)]as well as the perfusion index(PI)=[PF/(PF+BF)]were obtained using first-pass dual-input CT perfusion analysis and compared respectively between different histopathology and lesion types(pure or mixed GGNs)and correlated with the attenuation values of the lesions using one-way ANOVA,student’s t test and Pearson correlation analysis.RESULTS Of the 47 GGNs(mean diameter,8.17 mm;range,5.3-12.7 mm),30(64%)were carcinoma,6(13%)were atypical adenomatous hyperplasia and 11(23%)were organizing pneumonia.All perfusion parameters(BF,PF and PI)demonstrated no significant difference among the three conditions(all P>0.05).The PFs were higher than the BFs in all the three conditions(all P<0.001).Of the 30 GGN carcinomas,14 showed mixed GGNs and 16 pure GGNs with a higher PI in the latter(P<0.01).Of the 17 benign GGNs,4 showed mixed GGNs and 13 pure GGNs with no significant difference of the PI between the GGN types(P=0.21).A negative correlation(r=-0.76,P<0.001)was demonstrated between the CT attenuation values and the PIs in the 30 GGN carcinomas.CONCLUSION The GGNs are perfused dominantly by the PF regardless of its histopathology while the weight of the BF in the GGN carcinomas increases gradually during the progress of its opacification.

Values of high-resolution computed tomography and pulmonary function tests in managements of patients with chronic hepatitis C virus infection

AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.

Value of CT scan in the diagnosis of primary large bowel lymphoma

Objective: To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan. Methods: CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed. Plain CT scans were done on all patients, enhanced CT scans simultaneously with 5-10 mm section thickness, and 5-10 mm table increments in 6 cases. Results: Primary involved sites were on the cecum (n=3), the ascending colon (n=2), and the rectum (n=1). The tumor was found in multiple areas of the large bowel in 2 cases. CT appearance fell into 3 typical patterns in our study. The first was focal mass type in 2 cases, with one combined with intussusception and retroperitoneal adenopathy; the second was segmental annular involvement type in 3 cases, with one of them combined with mesenteric adenopathy; the last was diffuse involvement type in 2 cases. Multiple nodules were seen in the rectum in 1 case. Conclusion: CT was found to be accurate in detecting the primary sites and complications of lymphoma, and evaluating invasion of adjacent structures; Focal mass type, segmental annular involvement type and diffuse involvement type are the main patterns of CT features in the primary large bowel lymphoma; The features revealed by CT scan are suggestive of primary large bowel lymphoma in some cases.

Differential Diagnosis Value of lSF-FDG Imaging in Lung Histoplasmosis and Lung Cancer

In order to confirm the accuracy of ECT （emission computed tomography） scanning imaging in the diagnosis of lung histoplasmosis is higher than CT （computed tomography） scan. We retrospect a lung histoplasmosis patient, he was examined by the CT scan and ECT scanning, respectively. Results showed that lung cancer for CT diagnosis and large benign lesions for 18F-FDG （18F-fluorodeoxyglucose） ECT diagnosis. This indicated that the ECT diagnosis for benign lesions in the lung maybe have higher accuracy than CT scan.

鼻型NK/T细胞淋巴瘤与慢性鼻窦炎的鉴别诊断要点

目的对比鼻型自然杀伤细胞/T细胞淋巴瘤(natural killer/T-cell lymphoma,NKTL)及慢性鼻窦炎(CRS)的临床特点,分析鉴别诊断要点。方法收集和对比29例鼻型NKTL及54例CRS病例资料,包括病史、临床表现、影像学资料。结果NKTL组症状出现时间较短(P<0.001),更常见涕中带血症状(P=0.002),鼻甲及鼻中隔黏膜弥漫肿胀(P<0.001)和鼻腔内结构破坏体征(P=0.024),MRI更多见下鼻甲(P=0.034)、鼻中隔(P<0.001)、鼻咽部(P=0.002)及颅底(P=0.024)受累,“铸形样”改变或鼻外浸润。CRS组更多见嗅觉减退症状(P<0.001),中鼻道肿胀及鼻腔内肿物(P均<0.001),CT更常见鼻窦骨质增生(P=0.002)。结论鼻型NKTL与CRS比较,症状持续较短、常见鼻腔弥漫肿胀伴鼻腔内外结构破坏,MRI多见下鼻甲、鼻中隔、鼻咽部和颅底受累,“铸形样”改变和“跳跃式”浸润。

CT小肠造影对小肠肿瘤及肿瘤样病变的诊断与鉴别诊断的价值

目的探讨CT小肠造影(CTE)对小肠肿瘤及肿瘤样病变的诊断与鉴别诊断的价值。方法回顾性分析2015年1月—2022年12月于我院行CTE检查且手术病理检查证实为小肠肿瘤及肿瘤样病变的74例患者的影像学资料,根据病变性质分为恶性肿瘤组(54例)和非恶性肿瘤及肿瘤样病变组(20例),对两组患者的肿瘤长径、肠腔残留率及三期CT值(平扫、动脉期及静脉期)进行比较。结果恶性肿瘤组患者肿瘤长径、平扫CT值均显著高于非恶性肿瘤及肿瘤样病变组(Z=-3.512、-3.214,P<0.05),动脉期及静脉期CT值显著低于非恶性肿瘤及肿瘤样病变组(Z=-4.163、-3.475,P<0.05),肠腔残留率无显著差异(P>0.05);恶性肿瘤组中淋巴瘤患者的肿瘤长径和肠腔残留率显著高于腺癌患者(Z=-3.161、-4.853,P<0.05),动脉期及静脉期CT值显著低于腺癌患者(Z=-2.353、-2.161,P<0.05);剔除淋巴瘤患者后,两组患者的肿瘤长径、三期CT值有显著差异(Z=-3.571~-2.611,P<0.05),肠腔残留率仍无显著差异(P>0.05)。结论CTE能充分显示小肠肿瘤及肿瘤样病变的特征,可以为其诊断与鉴别诊断提供依据。

A controlled study of positron-emission-tomography and positron-emission-tomography/computed tomography in differential diagnosis of solitary pulmonary nodules—report of 60 cases

The differential diagnosis of solitary pulmonary nodules （SPNs） remains a challenge. It is acknowledged that combining positron-emission tomography （PET） and computed tomography （CT） offers the most reliable noninvasive method for the diagnosis of SPNs. Since Townsend et al1 developed integrated PET/CT in 1999, this technique has increasingly been introduced into clinical practice. To date, nuclear medicine physicians have usually undertaken PET/CT diagnosis, but the question is surfacing as how to make full use of the information of CT image to improve the accuracy of SPN diagnosis. To answer this question, we performed a retrospective study on 60 patients with SPNs.

上海市闵行区低剂量螺旋CT肺癌筛查效果评估

背景与目的低剂量螺旋计算机断层扫描(low-dose spiral computed tomography,LDCT)已被推荐应用于高危人群的肺癌筛查。我国LDCT筛查研究少,随访时间较短,且高危人群的定义不同。本研究基于上海市闵行区肺癌筛查项目,评估LDCT应用于我国人群肺癌筛查的中长期效果。方法上海市闵行区肺癌筛查项目于2013至2017年实施,共纳入26,124名40岁及以上合格参与者,并以同期闵行区全体适龄人群为对照。通过筛查登记系统及与上海市肿瘤登记和死因登记系统链接,获得所有对象至2020年12月31日的肺癌发病及全死因死亡信息。计算筛查人群相比于全人群对照的肺癌标准化发病率比(standardized incidence ratio,SIR)及95%CI,比较筛查人群与非筛查人群中肺癌病例的早期率(0-Ⅰ期)、病理类型及5年观察生存率,分析LDCT筛查与肺癌病例全死因死亡的风险比(hazard ratio,HR)及95%CI。结果筛查人群的肺癌粗发病率为373.3/10万人年(95%CI:343.1-406.1),标化发病率为70.3/10万人年,相比于总人群的SIR为1.8(95%CI:1.6-1.9),且在随访期内随时间推移而下降。筛查组病例中早期肺癌占比49.4%,显著高于同期非筛查病例中的38.4%(P<0.05);肺腺癌占比40.7%,显著高于非筛查病例中的35.9%(P<0.05);5年观察生存率为53.7%,亦显著高于非筛查病例的41.5%(P<0.05)。与同期非筛查病例相比,筛查组病例的全因死亡风险下降30%(HR=0.7,95%CI:0.6-0.8)。结论本次纳入的筛检人群肺癌发病风险较高;LDCT筛查有利于肺癌的早期检出,提高生存率,在降低人群的肺癌疾病负担方面具有一定潜力。

Differential diagnosis of coronavirus disease 2019 from community-acquired-pneumonia by computed tomography scan and follow-up

Objective Coronavirus disease 2019(COVID-19)is currently the most serious infectious disease in the world.An accurate diagnosis of this disease in the clinic is very important.This study aims to improve the differential ability of computed tomography(CT)to diagnose COVID-19 and other community-acquired pneumonias(CAPs)and evaluate the short-term prognosis of these patients.Methods The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province,China from January 21 to February 28,2020 were retrospectively analysed.The CT manifestations of the two groups were recorded and compared.A correlation analysis was used to examine the relationship between COVID-19 and age,size of lung lesions,number of involved lobes,and CT findings of patients.The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.Results The typical CT findings of COVID-19 are simple ground-glass opacities(GGO),GGO with consolidation or grid-like changes.The sensitivity and specificity of the combination of age,white blood cell count,and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%,respectively.Pulmonary consolidation,fibrous cords,and bronchial wall thickening were used as indicators to exclude COVID-19.The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%,respectively.The follow-up results showed that 67.8%(112/165)of COVID-19 patients had abnormal changes in their lung parameters,and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age.Conclusions Age,white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP.Patients aged over 60 years with COVID-19 have a poor prognosis.This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.