摘要
目的初步探讨输入性新型冠状病毒肺炎(COVID-19)患者达到出院标准时肺内病变的影像学变化。方法回顾性收集2020年1至2月安徽省治愈出院的60例输入性COVID-19患者的临床及CT影像学资料,初诊时临床轻型5例、普通型53例、重型2例,分析患者的临床特点、达到出院标准时胸部CT影像变化特点。结果60例患者中发热(57例)、咳嗽(55例)为主要症状。5例轻型患者3例全程CT检查为阴性,2例首次CT阴性表现,第2次胸部CT发现异常。55例(53例普通型和2例重型)首次CT异常患者影像学特点为病变双肺受累为主(51例),病灶多发(33例),胸膜下多见(40例),磨玻璃影像最为常见(55例)。转归中胸部CT特征主要表现为肺内磨玻璃影逐渐变淡,完全吸收(19例);肺内磨玻璃影范围扩大,进展为铺路石征、实变影,病灶再逐渐吸收后可见纤维条索影(27例);肺内磨玻璃影快速进展为实变影像,病灶吸收较慢,病灶大部分吸收后伴有较多纤维条索影残留(4例),2例重型患者肺内病灶广泛磨玻璃影、实变影缓慢吸收后可见较多纤维灶残留。结论胸部CT在输入性COVID-19诊疗过程中发挥重要作用,CT影像所见肺的受累程度与临床转归有较好的一致性。
Objective To explore the imaging changes of lung lesions in patients with imported COVID-19 when reaching the discharge standard.Methods The clinical and CT imaging data of 60 cured patients with imported COVID-19 and discharged from January to February 2020 in Anhui Province were retrospectively collected.At the initial diagnosis,5 cases were mild,53 were ordinary,and 2 were severe.The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.Results Fever(57 cases)and cough(55 cases)were the main symptoms in 60 patients.In 5 mild patients,3 cases were negative in the whole course of CT examination,2 cases were negative in the first time and abnormal in the second time.The first CT imaging features of 55 patients(53 common type and 2 severe type)were mainly bilateral lung involvement(51 cases),multiple lesions(33 cases),more common under the pleura(40 cases),and ground glass opacities were the most common(55 cases).The features of chest CT in clinical outcomes were that the ground glass shadow in the lung gradually faded and was completely absorbed(19 cases);the scope of ground glass shadow in the lung expanded and progressed to crazy-paving,consolidation shadow,and the lesion gradually absorbed again followed by fibrous cord shadows(27 cases);ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed.Most of the lesions were accompanied by more residual fibrous cord shadows(4 cases).In 2 severe patients,the lesions in the lungs were larger ground glass,and a large amount of fibrous foci remained after slow absorption.Conclusions Chest CT plays an important role in the diagnosis and treatment of imported COVID-19,and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.
作者
李小虎
王海涛
朱娟
邱晓辉
张金平
黄国权
曾小松
贺克武
谢宗玉
徐启中
刘斌
余永强
Li Xiaohu;Wang Haitao;Zhu Juan;Qiu Xiaohui;Zhang Jinping;Huang Guoquan;Zeng Xiaosong;He Kewu;Xie Zongyu;Xu Qizhong;Liu Bin;Yu Yongqiang(Department of Radiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Radiology,No.2 People's Hospital of Fuyang City,Fuyang 236015,China;Department of Radiology,Anqing Municipal Hospital,Anqing 246003,China;Department of Radiology,the People's Hospital of Bozhou,Bozhou 236800,China;Department of Radiology,Tongling People's Hospital,Tongling 244000,China;Department of Radiology,the Second People's Hospital of Wuhu,Wuhu 241001,China;Department of Radiology,Suzhou Hospital Affiliated to Anhui Medical University,Suzhou 234000,China;Department of Radiology,the First People's Hospital of Hefei,Hefei 230001,China;Department of Radiology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China;Department of Radiology,Chaohu Hospital of Anhui Medical University,Chaohu 238001,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2020年第5期435-439,共5页
Chinese Journal of Radiology
基金
安徽省新型冠状病毒感染的肺炎疫情应急科研攻关项目(202004a0702003)。
