21例新型冠状病毒核酸确诊病例的薄层CT周期变化

目的 回顾性分析21例治愈出院新型冠状病毒核酸确诊病例完整影像学资料，探讨新型冠状病毒肺炎HRCT短期动态影像特征。方法 按胸部CT检查时间及影像学改变过程，将病程分为早期、高峰期及转归期，并观察肺内病变在不同时期的HRCT影像学表现。结果 胸部CT有阳性改变患者16例，胸部CT始终无阳性表现患者5例。早期（1~6天，平均3天）HRCT表现为片状磨玻璃影23个，磨玻璃结节12个，实变结节伴“晕征”1个；高峰期（5~11天，平均8天）HRCT表现为单纯磨玻璃影9个，磨玻璃影伴实变影17个，磨玻璃影伴“铺路石征”6个，实变结节伴“晕征”7个，1例伴少量胸腔积液。危重型病例高峰期病变数量及累及范围高于普通型，两组差异有统计学意义。结论 HRCT检查有助于检出早期及亚临床型新型冠状病毒肺炎，患者多于患病第2周诊断为重型/危重型，HRCT复查对危重型患者具有提示意义。

Periodic changes of thin slice CT in 21 patients diagnosed with novel coronavirus infection by nucleic acid detection

Objective Retrospective analysis was carried out on the complete imaging data of 21 cured and discharged patients diagnosed with novel coronavirus infection by nucleic acid to investigate the short term changes of HRCT images of novel coronavirus pneumonia (NCP). Methods According to the time of chest CT examination and the imaging changes, the course of disease was divided into early stage, peak stage and transitional stage.And HRCT findings of lung lesions at different stages were observed. Results Totally 16 patients had positive changes in chest CT, and 5 patients had no positive findings. In the early stage (1 6 days, an average of 3 days), HRCT showed 23 ground glass opacities, 12 ground glass nodules, 1 consolidation nodule with “halo sign”; In the peak stage (5 11 days, an average of 8 days), HRCT showed 9 ground glass opacities, 17 ground glass and consolidation in combination, 6 ground glass opacities with “crazy paving sign”, 7 consolidation nodule with “halo sign”, 1 case with a small amount of pleural effusion. The number and range of lesions in peak period of critical cases were higher than that in normal cases between two groups.Conclusion HRCT examination can help detect the early and subclinical NCP.Most patients were diagnosed as severe/critical two weeks after the disease, and HRCT reexamination is suggestive for critically ill patients.