新型冠状病毒肺炎患者HRCT影像学表现及动态分析

【目的】探讨新型冠状病毒肺炎(COVID-19)的高分辨CT扫描(HRCT)表现及动态影像变化。【方法】回顾本院及周边地区经核酸检测确诊的46例COVID-19患者完整的临床及HRCT扫描资料,每例患者于首次CT检查后每隔4~5 d复查,动态观察不同时期胸部CT影像变化特点。【结果】46例患者中入院时发热38例,干咳20例,乏力20例。COVID-19患者肺内病灶形态、分布及密度随时间变化大,3例轻型患者首次CT检查阴性,第二次复查均出现异常。早期多表现为肺外周胸膜下单发或散在磨玻璃影,病灶较小,常呈烟花状、云团状;进展期肺内病灶增多、扩大,可由胸膜下亚段、段、叶(多叶)至跨叶分布,密度以磨玻璃影与实变影共存多见,形态多变不一;重症期病变分布广泛、多实变,甚至“白肺”,提示病情危重;吸收期大约在发病后2周左右,肺内病灶明显减少,密度降低,部分残留纤维条索状阴影,1例患者出现大囊腔。【结论】HRCT影像所见具有相对特征性,可较准确评估COVID-19患者肺的受累程度,对监测疾病进展与转归具有重要意义。

Imaging Manifestations and Dynamic Analysis on Chest High-resolution CT(HRCT)of COVID-19

【Objective】To investigate the imaging manifestations and dynamic analysis on HRCT of 2019 Novel Coronavirus Disease(COVID-19).【Methods】The complete clinical and HRCT data of 46 patients with COVID-19 diagnosed by nucleic acid detection in our hospital and surrounding areas were reviewed.Each patient was reexamined every 4-5 dajrs after the first CT examination,and the.dynamic changes of chest CT images in different periods were observed.【Results】Among the 46 patients,38 had fever,20 had dry cough and 20 had fatigue.The shape,distribution and density of pulmonary lesions in patients with COVID-19 changed greatly with time.The first CT examination of 3 mild patients was negative,and the second reexamination was abnormal.In the early stage,there were single or scattered ground glass shadow under the peripheral lung pleura;the lesions were small,often presented as fireworks and clouds;in the advanced stage,the lesions increased.and expanded,and distributed from subpleural subsegment,segmental,lobar(multilobed)to translobar;ground glass shadow and consolidation shadow were cotninon in density,and their shapes were variable.In the severe stage,the lesions were widely distributed,often consolidation,even"white lung",indicating that the condition was critical;in the absorption stage,about 2 weeks after the onset,the lesions in the lung were significantly reduced,the density was reduced,some residual fibrous streak shadows were found,and one patient had a large cystic cavity.【Conclusion】FIRCT images are relatively characteristic,which can accuratcly assess the degree of lung involvement, and is of great significance in monitoring ihc progress and outcome of the disease.