广州地区新型冠状病毒肺炎的高分辨率CT表现与临床特点

目的 初步探讨广州地区新型冠状病毒肺炎(COVID-19)的临床及首诊高分辨率CT(HRCT)影像表现特点。方法 回顾性分析2020年1月22日至30日广州市第八人民医院确诊的91例COVID-19患者,其中男39例、女52例,中位年龄50(33, 62)岁,分析91例COVID-19患者的临床及HRCT特点。结果 临床表现主要为发热70例,咳嗽57例,以干咳为主(39例)。首次HRCT有24例COVID-19患者呈阴性表现,67例HRCT有异常病灶,主要表现为肺内磨玻璃影65例、病灶内合并血管束增粗64例、病灶邻近胸膜增厚50例、间质间隔增厚47例、斑片影42例。所有患者均未见肿大淋巴结。病灶分布:双肺弥漫分布的2例,多发57例,单肺叶出现8例;病灶主要分布于胸膜下46例,肺下叶分布为著39例,上叶为著7例,在肺内无明显分布特征的有13例。结论 广州地区COVID-19早期影像主要表现为多发磨玻璃影,以胸膜下及下肺野多见,多有肺间质间隔的增厚,广州地区COVID- 19轻型及普通型患者比例较高,部分确诊患者首次HRCT呈阴性表现,对于HRCT呈阴性的患者,应及时复查。

High resolution CT findings and clinical features of COVID-19 in Guangzhou

Objective To investigate the initial high resolution CT(HRCT)manifestations and clinical features of imported COVID-19 in Guangzhou.Methods A retrospective analysis of 91 COVID-19 patients admitted to the Guangzhou Eighth People's Hospital from January 22 to 30,2020 was performed including 39 males and 52 females,with a median age of 50(33-62)years,then their clinical features and HRCT characteristics were analyzed.Results The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry cough in 39 cases).The first time HRCT showed that 24 cases with COVID-19 were normal,however other 67 cases were abnormal.The ground glass opacity in the lung on HRCT was found in 65 cases,including 64 cases with dilated blood vessel crossing the lesion,50 cases with thickened adjacent pleura,and 47 cases with thickening of interstitial septum.The patchy opacity was seen in 42 cases,and no enlarged lymph nodes were observed in all patients.As for the lesion distribution,there were two cases with bilateral diffuse changes,57 cases with multiple lesions,8 cases with the lesion in only one lobe.The lesions were mainly located under the pleura area in 46 cases,including 39 cases in the lower lobe and other 7 cases in the upper lobe.And there were 13 cases without characteristic distribution in the lung.Conclusion The initial images of COVID-19 in Guangzhou mainly showed multiple ground glass opacity,which were mostly seen in the subpleural and lower lung fields,most of them with thickened pulmonary interstitium.Guangzhou has a higher proportion of COVID-19 patients with mild and general patients,and some confirmed patients show negative HRCT for the first time.Patients without HRCT changes should be reviewed in a timely manner.