75例新型冠状病毒肺炎病人首诊CT表现与检验结果分析

目的探讨新型冠状病毒肺炎(COVID-19)病人首诊胸部CT特征性表现,评价CT评分与临床检验结果的相关性。方法回顾性分析75例确诊COVID-19病人首诊胸部CT、发病时间及临床检验结果。由2名高年资影像诊断医师进行阅片,CT异常表现包括单发或多发磨玻璃影(GGO)或实变影,单肺或双肺受累,分布以胸膜下为主或肺中央为主。同时对COVID-19胸部CT表现进行半定量CT评分,采用Spearman相关分析比较CT评分与发病时间、淋巴细胞计数、中性粒细胞计数及C反应蛋白(CRP)的相关性。结果75例COVID-19首诊胸部CT正常者4例(5.33%),异常者71例(94.67%)。影像表现为多发GGO(26例,36.62%)、多发实变为主伴GGO(25例,35.21%)、多发GGO为主伴部分实变(12例,16.90%)、单发或散在GGO(8例,11.27%)。多数病人双肺受累(65例,91.55%),少数为单肺受累(6例,8.45%)。病变多位于胸膜下(66例,92.96%),少数位于肺内(5例,7.04%)。首诊CT评分与发病时间(rs=0.701,P<0.05)和CRP呈正相关(rs=0.522,P<0.05),与淋巴细胞计数呈负相关(rs=-0.303,P<0.05),与中性粒细胞计数无明显相关性(P>0.05)。结论COVID-19首诊胸部CT表现具有一定特征性,且与淋巴细胞计数、CRP有一定相关性,可能对临床预后有提示作用。

Manifestations of the initial chest CT and its association with laboratory tests in 75 patients of COVID-19

Objective To investigate the initial CT features of COVID-19,and its association with laboratory tests.Methods The initial CT and clinical data of 75 cases of COVID-19 confirmed by laboratory tests,were retrospectively analyzed.The CT images were evaluated by two experienced radiologists.The CT abnormalities were categorized into single or multiple,ground glass opacity or consolidation,single lung or bilateral lungs involvement,and subpleural or intrapulmonary distribution,then the manifestations on CT(CT score)was semi-quantitatively calculated and its associations with lymphocyte count,neutrophils count and CRP were analyzed with Spearman correlation test.Results The initial CT finding of COVID-19 was normal in 4 cases(5.33%),abnormal in 71 cases(94.67%),presenting as multiple ground glass opacity(26 cases,36.62%),multiple consolidation with ground glass opacity(25 cases,35.21%),multiple ground glass opacity with partial consolidation(12 cases,16.90%),and single or scattered ground glass opacity(8 cases,11.27%).There were 65 cases(91.55%)of bilateral lungs involvement and 6 cases(8.45%)of single lung involvement.The lesions localized at subpleural zone in 66 cases(92.96%),and intrapulmonary in 5 cases(7.04%).The CT score was positively associated with the onset time and CRP(rs=0.701 and rs=0.522,respectively,P<0.05).The CT score was negatively associated with the number of lymphocytes(rs=-0.303,P<0.05).There was no significant association between the CT score and the number of neutrophils(P>0.05).Conclusion The chest CT findings of COVID-19 have some characteristic manifestations.The association between CT score and lymphocyte count and CRP might be useful for the estimation of clinical prognosis in COVID-19 patients.