蒲公英果实征: 9例新型冠状病毒肺炎的CT征象 |
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引用本文: | 傅晓彬,李杰生,黄 洲,徐志明,姚伟平,崔运能,欧阳可勋,刘怀忠.蒲公英果实征: 9例新型冠状病毒肺炎的CT征象[J].南方医科大学学报,2020,40(2):159-163. |
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作者姓名: | 傅晓彬 李杰生 黄 洲 徐志明 姚伟平 崔运能 欧阳可勋 刘怀忠 |
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摘 要: | 目的 探讨胸部CT的蒲公英果实征在新型冠状病毒肺炎(COVID-19)的诊断价值。 方法 回顾性分析佛山市三水区人民医院2020年1月24日~2月10日发热门诊和感染内科收治隔离患者行胸部HRCT检查的119例患者资料,排除胸部CT无异常
病例,获得诊断肺炎患者23例,其中COVID-19 9例、其他类型肺炎14例,并分析及对比各类型肺炎的CT征象、病灶部位及蒲公英果实征等。结果 23例肺炎中,COVID-19 9例(39.1%),临床为普通型或重症型,均有流行病学史及相应呼吸道症状;CT表现为:病灶以多发、双侧分布为主(7例),主要分布中外肺野、胸膜下区,呈斑片状、团片状、伞形磨玻璃影,常合并肺血管增粗和微血管增多、小叶间隔增厚及纤维化,内衬网格样、如小气泡样的“铺路石征”;蒲公英果实征见于9例COVID-19患者,共46个病灶(60.5%,总病灶数76个),其表现为“蒲公英果实绒团征”(9个)与“蒲公英种子征”(37个),而并未出现于14例其他类型肺炎患者中。结论 蒲公英果实征常见于COVID-19患者胸部CT,是COVID-19较特征性的影像学征象,可鉴别COVID-19与其他类型的肺炎。
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Dandelion clock-like sign on CT for diagnose of COVID-19 |
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Abstract: | Objective To explore the value of the "dandelion clock-like" sign on chest CT for diagnosis of SARS-CoV-2-associated
pneumonia. Methods This retrospective analysis was conducted based on the data of 119 cases from the Department of Fever
and the Department of Infection undergoing chest high-resolution CT examinations in Sanshui District People’s Hospital
between January, 24 and February 10, 2020. The cases with no abnormality on chest CT were excluded. Twenty-three patients
were diagnosed to have pneumonia, including 9 with SARS-CoV-2-associated pneumonia and 14 with other types of
pneumonia. We comparatively analyzed the CT signs, location of the lesions and the dandelion clock-like sign among different
types of pneumonia. Results Among the 23 patients with pneumonia, 9 (39.1% ) had common or severe SARS-CoV-2-
associated pneumonia with a positive epidemiological history and corresponding respiratory symptoms. Seven of the SARSCoV-2-associated pneumonia patients had multiple lesions in bilateral lungs, compromising mainly the lung field and the
subpleural area and showing patchy, lumpy, and umbrella-shaped ground glass opacity, often accompanied by pulmonary
vascular thickening and increased microvessels, interlobular septal thickening and fibrosis and lined with grid-like and
small-bubble-like "crazy-paving" patterns. The dandelion clock-like sign was found in all the 9 patients with SARSCoV-2-associated pneumonia, with a total of 46 lesions (60.5% , 76 total lesions); 9 of the lesions presented with a
"dandelion clek-like" sign and 37 with a "dandelion seed sign". These signs were not found in the 14 patients with other types
of pneumonia. Conclusion The dandelion clock-like sign is a common and characteristic chest CT finding in patients with
SARS-CoV-2-associated pneumonia, and can help to distinguish SARS-CoV-2-associated pneumonia from other types of
pneumonia. |
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