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韩国 9 例新型冠状病毒病(COVID-19)患者的胸部 X 线和 CT 表现分析

Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea.

机构信息

Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Korean J Radiol. 2020 Apr;21(4):494-500. doi: 10.3348/kjr.2020.0132. Epub 2019 Feb 26.

Abstract

OBJECTIVE

This study presents a preliminary report on the chest radiographic and computed tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) pneumonia in Korea.

MATERIALS AND METHODS

As part of a multi-institutional collaboration coordinated by the Korean Society of Thoracic Radiology, we collected nine patients with COVID-19 infections who had undergone chest radiography and CT scans. We analyzed the radiographic and CT findings of COVID-19 pneumonia at baseline. Fisher's exact test was used to compare CT findings depending on the shape of pulmonary lesions.

RESULTS

Three of the nine patients (33.3%) had parenchymal abnormalities detected by chest radiography, and most of the abnormalities were peripheral consolidations. Chest CT images showed bilateral involvement in eight of the nine patients, and a unilobar reversed halo sign in the other patient. In total, 77 pulmonary lesions were found, including patchy lesions (39%), large confluent lesions (13%), and small nodular lesions (48%). The peripheral and posterior lung fields were involved in 78% and 67% of the lesions, respectively. The lesions were typically ill-defined and were composed of mixed ground-glass opacities and consolidation or pure ground-glass opacities. Patchy to confluent lesions were primarily distributed in the lower lobes ( = 0.040) and along the pleura ( < 0.001), whereas nodular lesions were primarily distributed along the bronchovascular bundles ( = 0.006).

CONCLUSION

COVID-19 pneumonia in Korea primarily manifested as pure to mixed ground-glass opacities with a patchy to confluent or nodular shape in the bilateral peripheral posterior lungs. A considerable proportion of patients with COVID-19 pneumonia had normal chest radiographs.

摘要

目的

本研究报告了韩国 2019 年新型冠状病毒病(COVID-19)肺炎的胸部 X 线和计算机断层扫描(CT)表现。

材料与方法

作为韩国胸放射学会多机构合作的一部分,我们收集了 9 例经胸部 X 线和 CT 扫描确诊的 COVID-19 感染患者。我们分析了 COVID-19 肺炎的基线期影像学表现。采用 Fisher 确切概率法比较了不同肺内病变形态的 CT 表现。

结果

9 例患者中有 3 例(33.3%)经胸部 X 线检查发现实质异常,且大部分异常表现为外周实变。9 例患者中有 8 例 CT 表现为双侧受累,另 1 例为单侧反晕征。共发现 77 个肺部病变,包括斑片状病变(39%)、大片融合性病变(13%)和小结节状病变(48%)。病变累及外周和后肺野分别占 78%和 67%。病变边界不清,由混合磨玻璃密度影和实变或单纯磨玻璃密度影组成。斑片状至融合性病变主要分布于下叶(=0.040)和胸膜下(<0.001),而结节状病变主要沿支气管血管束分布(=0.006)。

结论

韩国的 COVID-19 肺炎主要表现为双侧外周后肺的纯磨玻璃影至混合磨玻璃影,呈斑片状至融合性或结节状。相当一部分 COVID-19 肺炎患者的胸部 X 线检查结果正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d596/7082662/8af37a75138a/kjr-21-494-g001.jpg

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