| 新型冠状病毒肺炎的临床与CT特征初步观察 |
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| 引用本文： | 李小虎,邱晓辉,张金平,曾小松,徐启中,黄国权,贺克武,马宜传,吴宗山,史恒峰,袁玉山,刘斌,余永强. 新型冠状病毒肺炎的临床与CT特征初步观察[J]. 首都医科大学学报, 2020, 41(2): 257-260. DOI: 10.3969/j.issn.1006-7795.2020.02.019 |
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| 作者姓名： | 李小虎 邱晓辉 张金平 曾小松 徐启中 黄国权 贺克武 马宜传 吴宗山 史恒峰 袁玉山 刘斌 余永强 |
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| 作者单位： | 安徽医科大学第一附属医院放射科 安徽省影像诊断医疗质量控制中心,合肥230022;亳州市第一人民医院放射科,安徽亳州236800;铜陵市人民医院放射科,安徽铜陵244000;安徽医科大学附属宿州医院放射科,安徽宿州234000;安徽医科大学附属巢湖医院放射科,安徽巢湖238001;芜湖市第二人民医院放射科,安徽芜湖241001;合肥市第一人民医院放射科,安徽合肥230001;蚌埠医学院第一附属医院放射科,安徽蚌埠233004;安徽医科大学附属六安医院,安徽六安237005;安徽医科大学附属安庆医院放射科,安徽安庆246003;阜阳市人民医院放射科,安徽阜阳236000 |
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| 基金项目： | 安徽省应急科研攻关项目（20200410702003），安徽省科技攻关项目（201904a07020060），安徽省高校自然科学基金重点项目（KJ2018A0197）。 |
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| 摘 要： | 目的 初步探讨新型冠状病毒肺炎（COVID-19）的临床和胸部电子计算机断层扫描（computed tomography，CT）影像学表现。方法 回顾性分析26例确诊COVID-19患者的临床和胸部CT影像学资料。结果 临床表现主要为发热26例（100%），咳嗽21例（80.8%），可伴随肌肉酸痛、胸闷、腹泻或呕吐症状。实验室检查白细胞计数正常15例（57.7%），高于正常4例（15.4%），低于正常7例（26.9%）。淋巴细胞计数减少10例（38.5%）。15例（57.7%）患者C反应蛋白升高。26例COVID-19患者CT表现均有异常，6例（23.1%）表现为单侧肺叶病变，以胸膜下分布为主；20例（76.9%）双侧肺叶受累。6例（23.1%）患者双肺所有肺叶、肺段均受累；局灶性病例中以右肺下叶受累最多见10例（38.5%）。26例COVID-19患者可见下述一种或多种征象：磨玻璃影像（ground glass opacity，GGO）16例（61.5%），以胸膜下分布为主；6例（23.1%）表现为GGO合并局灶实变影；10例（38.5%）为小斑片状边缘模糊密度增高影；7例（26.9%）为大片状实变影；8例（30.8%）可见网格状或纤维条索影；5例（19.2%）患者可见血管束增粗和血管穿行；4例（15.4%）患者可见空气支气管征象；1例（3.8%）患者可见少量胸腔积液，未见纵隔及肺门淋巴结肿大。结论 COVID-19的胸部CT表现为多部位、外周、胸膜下、下叶分布的磨玻璃影，可伴有实变，胸腔积液及肿大淋巴结少见，CT检查为该病的早期防控、早期诊断及治疗提供了重要依据。
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| 关 键 词： | 冠状病毒 新型冠状病毒肺炎 电子计算机断层扫描 |
| 收稿时间： | 2020-02-28 |
Clinical presentations and CT features of COVID-19 |
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| Li Xiaohu,Qiu Xiaohui,Zhang Jinping,Zeng Xiaosong,Xu Qizhong,Huang Guoquan,He Kewu,Ma Yichuan,Wu Zongshan,Shi Hengfeng,Yuan Yushan,Liu Bin,Yu Yongqiang. Clinical presentations and CT features of COVID-19[J]. Journal of Capital Medical University, 2020, 41(2): 257-260. DOI: 10.3969/j.issn.1006-7795.2020.02.019 |
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| Authors: | Li Xiaohu Qiu Xiaohui Zhang Jinping Zeng Xiaosong Xu Qizhong Huang Guoquan He Kewu Ma Yichuan Wu Zongshan Shi Hengfeng Yuan Yushan Liu Bin Yu Yongqiang |
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| Abstract: | Objective To investigate the thoracic computed tomography(CT) and clinical manifestations of COVID-19. Methods Chest CT and clinical data of confirmed 26 patients COVID-19 were retrospectively analyzed. Results In terms of clinical manifestations, fever and cough were main manifestations with 26 patients (100%) and 21 patients (80.8%) respectively, which could be accompanied by muscle soreness, shortness of breath, diarrhea or vomiting. Laboratory examination showed that 15 patients (57.7%) was normal in white blood cell (WBC),4 patients (15.4%) increased and 7 patients (26.9%) decreased. Lymphocytopenia occurred in 10 patients (38.5%). C-reactive protein(CRP) was elevated in 15 patients (57.7%). In terms of CT features, lesions were found in the lung high resolution computerized tomography(HRCT) of 26 all patients, with unilateral lung distribution in 6 patients (23.1%), mainly subpleural distribution;bilateral lung distribution in 20 patients (76.9%). All lobes and segments of both lungs were involved in 6 patients (23.1%). In focal cases, the involvement of the right lower lobe was the most common with 10 patients (38.5%). One or more of the following signs could be seen in 26 patients with COVID-19:ground -glass opacity(GGO) in 16 patients (61.5%), mainly subpleural distribution;GGO combined with focal consolidation in 6 patients (23.1%); small patchy blur with increased density in 10 patients (38.5%); large patchy consolidation in 7 patients (26.9%); fibrosis, grid shadow in 8 patients (30.8%); bronchovascular bundle thickening and vascular perforator sign were seen in 5 patients (19.2%); air bronchial signs were seen in 4 patients (15.4%); a small amount of pleural effusion was seen in 1 patient (3.8%). Enlargement of mediastinal and hilar lymph nodes was absent. Conclusion Chest CT of COVID-19 shows GGO distributed in multiple sites, periphery, subpleural and lower lobes, which may be accompanied by consolidation. Pleural effusion and enlarged lymph nodes are rare. Chest CT provides an important basis for early prevention and control, early diagnosis and treatment of the disease. |
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| Keywords: | coronavirus COVID-19 computed tomography (CT) |
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