新型冠状病毒肺炎的早期CT表现及其临床价值

目的探讨新型冠状病毒肺炎胸部CT早期表现及其临床价值。方法收集福建省三明市11例确诊NCP患者早期胸部CT扫描图像,回顾性分析胸部CT图像,观察确诊患者胸部CT有无异常表现,并重点对异常CT图像上病灶的位置、密度、形态、数目,特别是磨玻璃样密度增高影、血管增粗、实变、支气管"充气征"、间质增厚及胸腔积液等表现进行评估。结果 11例患者胸部CT扫描,10例均有不同程度肺部异常阴影,其中1例患者首次检查未发现阳性表现,但3d后复查出现肺部阴影。11例确诊CT图像中,单发病灶1例,2个病灶1例,两肺多发9例,病灶大部分位胸膜下或肺裂旁。所有确诊患者均出现磨玻璃样改变,且磨玻璃影内均出现血管影增粗,其中5例为混杂磨玻璃影、7例病灶实变、8例出现支气管"充气征"、7例小叶间隔增厚,1例见小"空泡征",均未发现双侧胸腔积液及纵隔肺门淋巴结增大。结论胸部CT薄层扫描能早期发现新型冠状病毒患者肺部异常,在该病的早期诊断和鉴别诊断中具有重要意义,也是新型冠状病毒肺炎核酸检测前判断的重要依据。

Early CT Appearance and Clinical Value of New Coronavirus Pneumonia

Objective To explore the early CT manife stations and clinical value of new coronavirus pneumonia.Methods The early CT images of 11 patients with NCP in sanming City,Fujian province were collected.The CT images were analyzed retrospectively,The location,density,shape and number of lesions on abnormal CT images,especially ground glass density,vascular thickening,consolidation,bronchiectasis,interstitial thickening and pleural effusion were evaluated.Results In 11 patients with chest CT scan,10 patients had abnormal lung shadow in varying degrees.1 patient did not find positive expression in the first examination,but 3 days later,pulmonary shadow appeared in the reexamination.Among the 11 confirmed CT images,there were 1 single focus,1 two focus and 9 multiple lung lesions.Most of the confirmed patients had ground glass changes,and the blood vessel shadow was thickened in ground glass shadow.Among them,5 cases were mixed ground glass shadow,7 cases were focus consolidation,8 cases were bronchus inflation sign,7 cases were interlobular septal thickening,1 case was small vacuole sign,and no bilateral pleura and mediastinal hilar lymph node enlargement were found.Conclusion Thin-section CT scan of the chest can detect the lung abnormalities of the patients with new coronavirus in the early stage,which is of great significance in the early diagnosis and differential diagnosis of the disease,It is also an important basis for the detection of new coronavirus pneumonia before nucleic acid test.