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SARS-CoV-2 引起的新型冠状病毒肺炎的临床和计算机断层扫描影像学特征。

Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARS-CoV-2.

机构信息

Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, 100 West Fourth Ring Road, Fengtai District, Beijing 100039, China.

Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, 100 West Fourth Ring Road, Fengtai District, Beijing 100039, China.

出版信息

J Infect. 2020 Apr;80(4):394-400. doi: 10.1016/j.jinf.2020.02.017. Epub 2020 Feb 25.

Abstract

PURPOSE

To investigate the clinical and imaging characteristics of computed tomography (CT) in novel coronavirus pneumonia (NCP) caused by SARS-CoV-2.

MATERIALS AND METHODS

A retrospective analysis was performed on the imaging findings of patients confirmed with COVID-19 pneumonia who had chest CT scanning and treatment after disease onset. The clinical and imaging data were analyzed.

RESULTS

Fifty patients were enrolled, including mild type in nine, common in 28, severe in 10 and critically severe in the rest three. Mild patients (29 years) were significantly (P<0.03) younger than either common (44.5 years) or severe (54.7) and critically severe (65.7 years) patients, and common patients were also significantly (P<0.03) younger than severe and critically severe patients. Mild patients had low to moderate fever (<39.1 °C), 49 (98%) patients had normal or slightly reduced leukocyte count, 14 (28%) had decreased counts of lymphocytes, and 26 (52%) patients had increased C-reactive protein. Nine mild patients were negative in CT imaging. For all the other types of NCP, the lesion was in the right upper lobe in 30 cases, right middle lobe in 22, right lower lobe in 39, left upper lobe in 33 and left lower lobe in 36. The lesion was primarily located in the peripheral area under the pleura with possible extension towards the pulmonary hilum. Symmetrical lesions were seen in 26 cases and asymmetrical in 15. The density of lesion was mostly uneven with ground glass opacity as the primary presentation accompanied by partial consolidation and fibrosis.

CONCLUSION

CT imaging presentations of NCP are mostly patchy ground glass opacities in the peripheral areas under the pleura with partial consolidation which will be absorbed with formation of fibrotic stripes if improved. CT scanning provides important bases for early diagnosis and treatment of NCP.

摘要

目的

研究由 SARS-CoV-2 引起的新型冠状病毒肺炎(NCP)的计算机断层扫描(CT)的临床和影像学特征。

材料与方法

回顾性分析了经胸部 CT 扫描及发病后治疗确诊为 COVID-19 肺炎的患者的影像学表现。分析了临床和影像学资料。

结果

共纳入 50 例患者,其中轻症 9 例,普通型 28 例,重型 10 例,危重型 3 例。轻症患者(29 岁)明显(P<0.03)比普通型(44.5 岁)和重型(54.7 岁)及危重型(65.7 岁)患者年轻,普通型患者也明显(P<0.03)比重型和危重型患者年轻。轻症患者有中低度发热(<39.1°C),49 例(98%)患者白细胞计数正常或略低,14 例(28%)淋巴细胞计数减少,26 例(52%)C 反应蛋白升高。9 例轻症患者 CT 影像呈阴性。对于其他类型的 NCP,病变位于右肺上叶 30 例,右中叶 22 例,右肺下叶 39 例,左肺上叶 33 例,左肺下叶 36 例。病变主要位于胸膜下外周区,可能向肺门延伸。26 例病变呈对称分布,15 例病变呈不对称分布。病变密度多不均匀,以磨玻璃影为主要表现,伴有部分实变和纤维化。

结论

NCP 的 CT 影像学表现多为胸膜下外周区斑片状磨玻璃影,部分实变,吸收后形成纤维性条纹。CT 扫描为 NCP 的早期诊断和治疗提供了重要依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07a7/7102535/253cbeb32d8f/gr1_lrg.jpg

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