蒲公英果实征： 9例新型冠状病毒肺炎的CT征象

目的 探讨胸部CT的蒲公英果实征在新型冠状病毒肺炎（COVID-19）的诊断价值。 方法 回顾性分析佛山市三水区人民医院2020年1月24日~2月10日发热门诊和感染内科收治隔离患者行胸部HRCT检查的119例患者资料，排除胸部CT无异常病例，获得诊断肺炎患者23例，其中COVID-19 9例、其他类型肺炎14例，并分析及对比各类型肺炎的CT征象、病灶部位及蒲公英果实征等。结果 23例肺炎中，COVID-19 9例（39.1%），临床为普通型或重症型，均有流行病学史及相应呼吸道症状；CT表现为：病灶以多发、双侧分布为主（7例），主要分布中外肺野、胸膜下区，呈斑片状、团片状、伞形磨玻璃影，常合并肺血管增粗和微血管增多、小叶间隔增厚及纤维化，内衬网格样、如小气泡样的“铺路石征”；蒲公英果实征见于9例COVID-19患者，共46个病灶（60.5%，总病灶数76个），其表现为“蒲公英果实绒团征”（9个）与“蒲公英种子征”（37个），而并未出现于14例其他类型肺炎患者中。结论 蒲公英果实征常见于COVID-19患者胸部CT，是COVID-19较特征性的影像学征象，可鉴别COVID-19与其他类型的肺炎。

Dandelion clock-like sign on CT for diagnose of COVID-19

Objective To explore the value of the "dandelion clock-like" sign on chest CT for diagnosis of SARS-CoV-2-associatedpneumonia. Methods This retrospective analysis was conducted based on the data of 119 cases from the Department of Feverand the Department of Infection undergoing chest high-resolution CT examinations in Sanshui District People’s Hospitalbetween January, 24 and February 10, 2020. The cases with no abnormality on chest CT were excluded. Twenty-three patientswere diagnosed to have pneumonia, including 9 with SARS-CoV-2-associated pneumonia and 14 with other types ofpneumonia. We comparatively analyzed the CT signs, location of the lesions and the dandelion clock-like sign among differenttypes of pneumonia. Results Among the 23 patients with pneumonia, 9 (39.1% ) had common or severe SARS-CoV-2-associated pneumonia with a positive epidemiological history and corresponding respiratory symptoms. Seven of the SARSCoV-2-associated pneumonia patients had multiple lesions in bilateral lungs, compromising mainly the lung field and thesubpleural area and showing patchy, lumpy, and umbrella-shaped ground glass opacity, often accompanied by pulmonaryvascular thickening and increased microvessels, interlobular septal thickening and fibrosis and lined with grid-like andsmall-bubble-like "crazy-paving" patterns. The dandelion clock-like sign was found in all the 9 patients with SARSCoV-2-associated pneumonia, with a total of 46 lesions (60.5% , 76 total lesions); 9 of the lesions presented with a"dandelion clek-like" sign and 37 with a "dandelion seed sign". These signs were not found in the 14 patients with other typesof pneumonia. Conclusion The dandelion clock-like sign is a common and characteristic chest CT finding in patients withSARS-CoV-2-associated pneumonia, and can help to distinguish SARS-CoV-2-associated pneumonia from other types ofpneumonia.