新型冠状病毒肺炎的临床表现及胸部高分辨率CT影像学表现分析

目的 探讨新型冠状病毒肺炎(COVID-19)患者的胸部CT影像学表现及其与临床表现之间的关系.方法 回顾性分析17例经病毒核酸检查确诊为COVID-19患者的临床症状、实验室检查和CT影像表现及CT评分,采用Spearman秩相关分析评估CT评分与临床资料间的关系.结果 高分辨率CT(HRCT)上,12例(70.6％...     

新型冠状病毒核酸复阳患者的高分辨率CT影像分析

目的 探讨出院后新型冠状病毒核酸复阳患者的胸部高分辨率CT(HRCT)影像学表现.方法 对2020年1月21日至4月28日在岳阳市一人民医院治愈的88例新型冠状病毒肺炎(COVID-19)患者进行出院后随访,对5例新型冠状病毒核酸复阳的患者的肺部HRCT进行描述和分析.结果 在88例达到出院标准的COVID-19患者中...     

新型冠状病毒肺炎短期复查CT影像学表现及临床特征分析

目的 探讨新型冠状病毒肺炎(COVID-19)短期复查CT影像学表现及临床特征.方法 回顾性分析经病毒核酸检测证实的23例COVID-19患者初诊及短期复查的影像资料及临床特征,总结短期影像表现规律.结果 23例COVID-19患者,初诊主要临床症状为发热19例、咳嗽15例,实验室检查白细胞计数正常或降低22例,淋巴细...     

18F-FDG PET/CT在新型冠状病毒肺炎诊断中的应用

新型冠状病毒肺炎（COVID-19）被发现以来,迅速蔓延,其早期诊断有利于患者的及时救治和疾病进一步传播的有效控制。目前,诊断的依据是流行病史、临床表现、影像学特征和逆转录聚合酶链式反应（RT-PCR）检测结果,其中RT-PCR检测到新型冠状病毒核酸阳性是COVID-19确诊的主要依据,影像学特征尤其是肺部高分辨率CT表现则是诊断该病的重要临床依据。作为一种被广泛应用的影像学方法,18F-FDG PET/CT在COVID-19中的价值仍未可知。笔者分析了18F-FDG PET/CT在COVID-19中的诊断和鉴别诊断的价值,以及评估COVID-19患者纵隔淋巴结受累情况方面的潜在应用,讨论了COVID-19患者肺外器官和组织受累可能出现的18F-FDG PET/CT影像学表现。     

新型冠状病毒肺炎短期影像学随访研究

目的 探讨新型冠状病毒肺炎(COVID-19)的CT表现及短期影像学变化.方法 搜集64例COVID-19住院患者行高分辨率CT(HRCT)动态观察,所有患者均在发病5天内就诊,患者在发病时、入院后、出院前均行CT检查,每例患者最少检查3次,最多检查7次,第一次CT检查时间至最后一次检查时间间隔13 ～ 30天.结果 ...     

人工智能在新型冠状病毒肺炎早期影像诊断中的应用

目的 探讨人工智能(AI)辅助胸部CT在新型冠状病毒肺炎(COVID-19)早期定量诊断中的应用价值.方法 选取经病毒核酸检测确诊为COVID-19的患者60例,所有患者均为早期感染,在出现症状3 d内接受胸部CT平扫检查.定量分析患者胸部CT中不同密度范围内病变体积、病变平均密度、病灶/全肺体积和病灶/肺叶体积.由2...     

HRCT检查新型冠状病毒肺炎的临床应用价值

目的 探讨新型冠状病毒肺炎(COVID-19)CT表现及定量CT肺功能对COVID-19肺功能评估.方法 回顾性分析31例经病毒核酸检测确诊、且具有完整动态胸部HRCT资料的COVID-19患者,复查间隔时间48 h～14天.分析HRCT基本表现及CT-肺功能成像与临床分型的关系.结果 31例患者均于发病3天内接受HR...     

儿童新型冠状病毒肺炎（COVID-19）的临床及影像学表现

【摘要】目的：探讨儿童新型冠状病毒肺炎（COVID-19）的临床及影像学特征。方法：搜集在指定就诊医院经实验室核酸检测（RT-PCR）确诊为COVID-19的30例14岁及以下患儿的临床资料,其中男18例,女12例,年龄0～14岁,中位年龄6岁。由2名经验丰富的儿科放射诊断医师双盲阅片,分析儿童COVID-19胸部CT影像学表现。结果：入组的30例儿童COVID-19患者有12例合并其他细菌和病毒感染。临床主要症状为发热（n=25）,咳嗽（n=20）,乏力（n=2）,流涕（n=2）,腹泻（n=2）,呕吐（n=2）。胸部CT表现呈多样性：病灶多发为主,7例病灶呈弥漫性分布,23例（76.7%）累及左肺下叶。病变主要累及外周近胸膜部分,仅仅累及内带少。病变以实变及磨玻璃影为主,其中部分病例表现为支气管肺炎。所有病例均未见明显淋巴结肿大和胸腔积液。结论：儿童COVID-19患儿易合并其他病原体感染,结合流行病学史、CT影像学表现和实验室检查可协助早期治疗。     

COVID-19胸部CT结构化报告临床应用价值评价

【摘要】目的：探究新型冠状病毒肺炎（COVID-19）胸部CT结构化报告临床诊断应用价值。方法：回顾性分析310例疑似COVID-19患者胸部CT及临床资料。根据纳入标准最终共纳入253例患者,阳性组203名,阴性组50名。对胸部CT进行诊断分型,并记录CT征象。以模式1（CT诊断分型）、模式2（CT诊断分型+CT征象）、模式3（CT诊断分型+基本信息+流行病学史+临床及实验室检查）三种模式进行二元逻辑回归分析,采用ROC曲线及曲线下面积（AUC）评价三种模型诊断准确性。结果：逻辑回归分析显示三种模式诊断敏感度分别为95.6%、96.0%和95.2%,特异度分别为34.0%、48.9%和32.7%,符合率分别为83.4%、87.0%、82.2%,AUC为0.768、0.895和0.812。结论：COVID-19胸部CT结构化报告能较为准确地诊断COVID-19肺炎,敏感度较高,但缺乏特异度,结合CT征象可进一步提高诊断准确性,特别是提高诊断特异度。     

基于CT扫描的苏州地区新型冠状病毒肺炎初筛的诊断价值

目的 探讨CT在新型冠状病毒肺炎(COVID-19)初筛中的诊断价值.方法 选取180例从2020年1月13日 至2020年1月31日 在苏州大学附属传染病医院发热门诊就诊患者的胸部CT影像资料.在未知新型冠状病毒(SARS-CoV-2)核酸诊断结果的前提下,2名放射科医师根据COVID-19影像学诊断标准分别对所有胸...     

高原地区首例新型冠状病毒肺炎CT诊断分析并文献复习

目的 回顾性分析高原地区首例新型冠状病毒肺炎的CT影像特征及临床表现,以提高对该病的认识.方法 回顾性分析高原地区1例确诊新型冠状病毒患者的CT影像及临床资料并进行文献复习.结果 患者患病过程中早期、进展期及转归期的CT表现较为典型,与内地文献报道无明显差异,但诊断时应与高原性病种相互鉴别.结论 新型冠状病毒肺炎的诊断...     

CT与核酸检测对新型冠状病毒肺炎诊断及病程演变的对比分析

目的 对比评估CT与核酸检测对新型冠状病毒肺炎（COVID-19）的诊断效能和病程演变特征。 方法 回顾性分析2020年1月20日至3月5日郑州大学第一附属医院收治的164例确诊和疑似COVID-19患者的临床资料、CT和核酸检测结果,其中,确诊COVID-19患者76例[男性40例、女性36例,年龄25~83岁]、疑似COVID-19患者88例[男性47例、女性41例,年龄21~75岁]。将所有受检者按年龄分为<60岁组（122例）和≥60岁组（42例）。以咽拭子取样核酸检测结果为“金标准”,评估CT对COVID-19的诊断效能。不同年龄组间各诊断效能的比较采用独立样本卡方检验。分析确诊患者自就诊以来的多次CT图像和核酸检测结果,对比COVID-19患者病程演变过程中的临床表现、CT和核酸检测结果的转变规律。 结果 164例患者中,核酸检测最终确诊阳性76例,阳性率为46.3%;CT诊断阳性143例,阳性率为87.2%。CT诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为96.1%（73/76）、20.5%（18/88）、51.0%（73/143）、85.7%（18/21）、55.5%（91/164）。CT的各诊断效能在<60岁和≥60岁患者之间的差异均无统计学意义（χ2=0.051~0.414,均P>0.05）。88例疑似COVID-19患者中,CT诊断阳性率为79.5%（70/88）。76例确诊患者初诊时,8例（10.5%）为无症状亚临床期,7例（9.2%）CT无阳性表现,11例（14.5%）核酸检测结果为阴性[其中9例（81.8%）CT诊断有阳性表现,CT肺炎进展期核酸检测结果转为阳性]。病程演变过程中,CT能清晰显示肺炎的进展和缓解程度,4~8 d后复查,28例CT表现为缓解期的患者中有14例（50.0%）核酸检测结果转阴;9~12 d后复查,46例CT表现为缓解期的患者中有31例（67.4%）核酸检测结果转阴。 结论 CT在早期COVID-19的筛查和诊断中较核酸检测更灵敏,且能更早地评估COVID-19的病程演变,可作为COVID-19临床诊疗过程中的重要辅助手段。     

Chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19): A single-center case study in Ningbo,China

ObjectiveThe purpose of this study was to investigate the chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19) in Ningbo, China.MethodsIn this retrospective study, twenty-eight confirmed and seven highly suspected cases of COVID-19 were enrolled in Ningbo first hospital from January 26, 2020 to March 5, 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). The initial and follow-up chest CT imaging features, epidemiological history, and outcome were analyzed.ResultsThe average age of the patients was 57.3 ± 15.3 years (range: 27–96 years), including 25 females and 10 males. On CT images, 89.3% (25/28) confirmed and 100% (7/7) suspected patients had ground-glass opacities (GGOs), and GGOs with mixed consolidations were observed in 35.7% (10/28) confirmed and 42.9% (3/7) suspected cases, most of these lesions were distributed under the peripheral of both lungs. 17 confirmed and 4 suspected cases had a history of participating in Ningbo Tian-tong Temple rituals and all had GGOs in their lungs during the initial CT scan. As of March 25, 2020, the lung lesions of our cases were significantly resolved and all patients have been discharged from the hospital.ConclusionThe most common chest CT features are multiple bilateral and peripheral GGOs with mixed consolidations or not in the lungs of patients with COVID-19. Chest CT plays an important role in the diagnosis and monitoring treatment response of this disease. There was no reported death in our cases.     

新型冠状病毒肺炎患者影像学检查防控措施

目的 探讨如何确立一套防控措施,适用于新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疑似患者和确诊患者的影像学检查.方法 启动应急预案,在隔离病房放置一台移动DR摄影机,给COVID-19患者进行胸部X线摄影,来初步评估治疗效果;指定专用CT检查室,关闭通风系统,划分三区(清洁区...     

Container CT scanner: a solution for modular emergency radiology department during the COVID-19 pandemic

During the coronavirus disease 2019 (COVID-19) pandemic period, container computed tomography (CT) scanners were developed and used for the first time in China to perform CT examinations for patients with clinically mild to moderate COVID-19 who did not need to be hospitalized for comprehensive treatment, but needed to be isolated in Fangcang shelter hospitals (also known as makeshift hospitals) to receive some supportive treatment. The container CT is a multidetector CT scanner installed within a radiation-protected stand-alone container (a detachable lead shielding room) that is deployed outside the makeshift hospital buildings. The container CT approach provided various medical institutions with the solution not only for rapid CT installation and high adaptability to site environments, but also for significantly minimizing the risk of cross-infection between radiological personnel and patients during CT examination in the pandemic. In this article, we described the typical setup of a container CT and how it worked for chest CT examinations in Wuhan city, the epicenter of COVID-19 outbreak.

Fangcang shelter hospitals, also known as makeshift hospitals, were developed and used for the first time in China to tackle the coronavirus disease 2019 (COVID-19) outbreak by providing medical care and disease monitoring for patients with mild to moderate COVID-19 who were isolated from their families and communities (1). Similarly, stand-alone computed tomography (CT) scanners, known as container CTs, were developed and used for the first time in China to perform CT examinations on patients with clinically mild to moderate COVID-19 who received supportive treatment at makeshift hospitals. These container CTs were first deployed outside makeshift hospital buildings and later also at some regular hospitals as stand-alone CT scanners designated for fever patients and confirmed COVID-19 patients.Chest CT images have been widely used to help with early diagnosis, assess the degree of pulmonary infectious involvement, monitor disease progression, and evaluate treatment effects (2). These CT examinations were originally performed in regular hospital settings with normally installed CT scanners. However, at makeshift hospitals that were converted from civil building facilities such as stadiums, schools, and exhibition halls, no space was available that could meet the shielding and radiation protection standards necessary to install CT scanners. Furthermore, during that critical pandemic period, many hospitals in Wuhan urgently needed to be equipped with more CT scanners to rapidly improve the imaging examination capabilities for patients with fever, suspected patients, and patients with confirmed COVID-19. Unfortunately, these hospitals usually lack readily available sites for rapid CT installations because it normally takes at least a month to build or remodel a CT shielding room even without the complications of the complete lockdown in Wuhan city. To figure out this issue, under tremendous pressure to rapidly install new CT scanners at both regular hospitals and makeshift hospitals, Chinese medical equipment companies worked closely with frontline radiologists and technologists and developed an innovative container CT, which functions as a modular emergency radiology department. To date, more than 140 container CTs have been installed at makeshift hospitals and regular hospitals in China since the COVID-19 outbreak.In this article, we presented a typical in-depth solution for container CT deployment in Wuhan during the COVID-19 outbreak.     

COVID-19相关急性脑损伤的临床及影像学表现

目的:探讨新型冠状病毒病(COVID-19)相关急性脑损伤的临床及影像学特征.方法:回顾性分析9例COVID-19合并急性脑损伤患者的临床及影像资料,9例患者均行胸部和头颅CT检查,其中1例行MRI检查.所有患者COVID-19鼻咽拭子核酸和血清特异性抗体均为阳性.记录患者发生急性脑损伤最近时间点的超敏反应C蛋白、血沉...