新型冠状病毒肺炎130例CT分布特点及征象研究

目的探讨2019新型冠状病毒肺炎(COVID-19)影像学表现。方法根据纳入标准和排除标准收集2020年1月20日至2月5日来自全国多家医院确诊COVID-19病例130例,按分布特点进行分型,分析其影像学特征。结果(1)分布:单侧14例(10.7%),双侧116例(89.3%);胸膜下型(102例78.4%),小叶核心型99例(76.1%),弥漫型8例(6.1%);(2)数目:单发病灶9例(6.9%),多发病灶113例(86.9%),弥漫8例(6.1%);(3)密度:仅为磨玻璃影(GGO)70例(53.8%),GGO与实变影兼有60例(46.2%);(3)伴随征象:血管增粗100例(76.9%),胸膜平行征98例(75.3%),"细网格征"100例(76.9%),"晕征"13例(10%),"反晕征"6例(4.6%),3例胸腔积液(2.3%),2例肺气囊(1.5%)。未见空洞。35患者行CT复查,21例(60%)好转,14例(40%)加重。结论COVID-19影像学特点主要以胸膜下及小叶核心分布为主,两者均可融合成片,重症者发展为双肺弥漫;最有价值的特征是"胸膜平行征";恢复期表现为边缘收缩的实变影,支气管扩张,胸膜下线或纤维条索影。

Novel coronavirus pneumonia(COVID-19)CT distribution and sign features

Objective To investigate the imaging findings of 2019 novel coronavirus pneumonia(COVID-19).Methods From January 20 to February 5,2020,a total of 130 patients diagnosed with COVID-19 from seven hospitals in China were collected.The imaging data were reviewed and analyzed in detail.Results(1)Distribution:the lesion detected in the lung unilaterally in 14 cases(10.7%)and bilaterally in 116 cases(89.3%).According to the distribution in the lobes of the lung,all cases could be classified into subpleural distribution(102 cases,78.4%),centrilobular distribution(99 cases,76.1%)and diffused distribution(8 cases,6.1%).(2)Number of lesions:single lesion 9 cases(6.9%);multiple lesions 113 cases(86.9%),diffuse lesions 8 cases(6.1%).(3)Imaging density:70 cases(53.8%)of ground-glass opacity(GGO),60 cases(46.2%)of GGO+consolidation.(4)Accompanying signs:100 cases(76.9%)with vascular thickening,98 cases(75.3%)with"pleural parallel sign";"intralobular septal thickening"in 100 cases(76.9%);"halo sign"in 13 cases(10%);"reversed-halo sign"in 6 cases(4.6%);pleural effusion in 3 cases(2.3%),and pneumatocele in 2 cases(1.5%);no case with pulmonary cavity.Among 35 patients that underwent follow-up CT,21 patients(60%)improved while 14(40%)exacerbated.Conclusions COVID-19 imaging characteristic mainly has subpleural,centrilobular and diffused distribution.The first two distributions can overlap or progress to diffused distribution.In the later period,it was mainly manifested as organizing pneumonia and fibrosis.The most valuable characteristic is the pleural parallel sign.