150例新型冠状病毒肺炎CT影像表现分析

目的:分析新型冠状病毒肺炎(以下简称“新冠肺炎”)的CT表现,提高CT诊断准确率。方法:回顾性分析150例经核酸检测证实的新冠肺炎患者的临床及CT影像资料,分析其肺部病灶部位、形态和主要CT征象(如磨玻璃密度影、实变影和间质性改变等),总结CT对新冠肺炎的诊断价值。结果:(1)病变部位:累及单侧肺15例(10%),累及双侧肺135例(90%);累及右肺79例(52.7%),累及左肺71例(47.3%);病变局限于1个肺叶14例(9.3%),病变累及2个肺叶54例(36.0%),病变累及多个肺叶82例(54.7%)。(2)病灶类型:单形态表现24例(16%);孤立性类圆形表现18例(12%);多形态表现(至少3种以上CT表现)108例(72%)。(3)CT表现:早期呈多发小斑片影及间质样改变,以肺野外带为著,进而发展为双肺多发或弥漫磨玻璃密度影、渗出及实变影,严重者可出现肺间质纤维化。结论:CT诊断是新冠肺炎的重要诊断方法之一,尤其对核酸检测假阴性患者更是重要的诊断依据。

Analysis of CT imaging features of 150 cases of COVID-19

Objective To investigate the CT manifestations of COVID-19 and improve the accuracy of CT diagnosis.Methods Totally 150 COVID-19 cases confirmed with nucleic acid test had their clinical and CT data analyzed retrospectively,and the diagnosis values of CT for COVID-19 were summarized by exploring the site,morphology and main signs(such as ground glass opacity,consolidation,interstitial changes and etc)of the lung lesion.Results Lesion site:there were 15 cases(10%)with unilateral lung involved and 135 ones(90%)with bilateral lung involved;79 ones(52.7%)had their right lungs involved and 71 ones(47.3%)had their left lungs involved;14 ones(9.3%)had the lesions restrained in one lobe,54 ones(36.0%)had the lesions involving in two lobes and 82 ones(54.7%)had the lesions involving in multi lobes.Lesion type:24 cases(16%)showed monomorphic manifestations,18 ones(12%)had solitary circular shapes,and 108 ones(72%)had polymorphous manifestations involving in at least three kinds of CT features.CT manifestations:in the early stage,multiple small patchy shadows and interstitial-like changes emerged mainly at lateral field of the lung,and then developed into multiple or diffuse ground glass shadows,exudation and consolidation shadows in both lungs.In severe cases,pulmonary interstitial fibrosis might occur.Conclusion CT is of great significance for the diagnosis of COVID-19 patients,especially those with false positive results.