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新型冠状病毒肺炎(COVID-19)感染患者的临床和计算机断层扫描(CT)图像特征:放射科医生需要了解什么?

Clinical and computed tomographic (CT) images characteristics in the patients with COVID-19 infection: What should radiologists need to know?

机构信息

Department of Radiology, the Affiliated Hospital of Guizhou Medical University. Guiyang, China.

Department of Medical Insurance, the Affiliated Hospital of Guizhou Medical University, Guiyang, China.

出版信息

J Xray Sci Technol. 2020;28(3):369-381. doi: 10.3233/XST-200670.

Abstract

OBJECTIVE

To evaluate the clinical and computed tomographic (CT) features in the patients with COVID-19 pneumonia confirmed by the real-time reverse transcriptase polymerase chain reaction (rRT-PCR) amplification of the viral DNA from a sputum sample.

MATERIAL AND METHODS

Clinical information and CT findings of a total of 14 patients with COVID-19 infection (age range, 12-83 years; females 6) were analyzed retrospectively. The clinical information includes the history of exposure, laboratory results, and the symptoms (such as fever, cough, headache, etc.); CT findings of chest include the extension and distribution of lesion, the ground-glass opacity (GGO), consolidation, bronchovascular enlarged, irregular linear appearances, pleural effusion, and lymphadenopathy.

RESULTS

Eight patients had the exposure history for recent travel to Wuhan of Hubei province (8/14, 57%), 6 had the exposure to patients with COVID-19 infection. Significant statistical differences were observed in lymphocyte percentage decreased and C-reactive protein elevated (p = 0.015). Seven patients had fever, 7 had cough, 2 had headache, 3 had fatigue, 1 had body soreness, 3 had diarrhea, and 2 had no obvious symptoms. In chest CT examination, 10 patients were positive (10/14, 71.43%). Among these patients, 9 had lesions involving both lungs (9/10, 90%), 8 had lesions involving 4 to 5 lobes (8/10, 80%). Most of lesions were distributed peripherally and the most significant lesions were observed in the right lower lobe in 9 patients (9/10, 90%). Nodules were observed in 5 patients (5/10, 50%); GGO, consolidation, and bronchovascular enlarged were shown in 9 patients (9/10, 90%); irregular linear appearances were revealed in 7 patients (7/10, 70%); and pleural effusions were exhibited in 2 patients (2/10, 20%). Last, no patients showed lymphadenopathy.

CONCLUSION

There were some typical CT features for diagnosis of COVID-19 pneumonia. The radiologists should know these CT findings and clinical information, which could help for accurate analysis in the patients with 2019 novel coronavirus infection.

摘要

目的

评估通过实时逆转录聚合酶链反应(rRT-PCR)扩增病毒 DNA 从痰样本中检测到的新型冠状病毒肺炎(COVID-19)患者的临床和计算机断层扫描(CT)特征。

材料与方法

回顾性分析了 14 例经病毒 DNA 实时 rRT-PCR 扩增确诊的 COVID-19 感染患者的临床资料和 CT 表现(年龄 12-83 岁,女性 6 例)。临床资料包括接触史、实验室结果和症状(如发热、咳嗽、头痛等);胸部 CT 表现包括病变的范围和分布、磨玻璃密度影(GGO)、实变、支气管血管增粗、不规则线状影、胸腔积液和淋巴结肿大。

结果

8 例(8/14,57%)有近期前往湖北省武汉市的旅行史,6 例有 COVID-19 感染患者的接触史。淋巴细胞百分比下降和 C 反应蛋白升高有显著统计学差异(p=0.015)。7 例发热,7 例咳嗽,2 例头痛,3 例乏力,1 例全身酸痛,3 例腹泻,2 例无明显症状。胸部 CT 检查 10 例阳性(10/14,71.43%)。其中 9 例病变累及双肺(9/10,90%),8 例病变累及 4-5 个肺叶(8/10,80%)。病变多位于外周,9 例(9/10,90%)右肺下叶病变最明显。5 例(5/10,50%)可见结节,9 例(9/10,90%)可见磨玻璃影、实变和支气管血管增粗,7 例(7/10,70%)可见不规则线状影,2 例(2/10,20%)可见胸腔积液。最后,无患者出现淋巴结肿大。

结论

COVID-19 肺炎有一些典型的 CT 特征。放射科医生应了解这些 CT 表现和临床信息,这有助于对 2019 年新型冠状病毒感染患者进行准确分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e01/7369068/b631ea87a707/xst-28-xst200670-g001.jpg

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