Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071, PR China.
Eur J Radiol. 2020 Jun;127:109009. doi: 10.1016/j.ejrad.2020.109009. Epub 2020 Apr 18.
To evaluate lung abnormalities on thin-section computed tomographic (CT) scans in patients with COVID-19 and correlate findings to duration of symptoms.
In total, 348 CT scans in 112 patients were classified according to the time after the onset of the initial symptoms, namely stage-1 (0-4 days); stage-2 (5-9 days); stage-3 (10-14 days); stage-4 (15-21 days); stage-5 (22-28 days); and stage-6 (＞28 days). Each lung lobe was evaluated for extent affected by ground-glass opacities (GGO), crazy-paving pattern and consolidation, in five categories of percentual severity. Summation of scores from all five lung lobes provided the total CT score (maximal CT score, 25).
The predominant patterns of lung abnormalities were GGOs, crazy-paving pattern, consolidation and linear opacities. The frequency of crazy-paving pattern, consolidation and linear opacities peaked at stage-3 (62.7 %), stage-4 (75.0 %) and stage-5 (83.1 %), respectively, and decreased thereafter. Total CT scores increased from stage-1 to stage-2 (2.8 ± 3.1, vs. 6.5 ± 4.6, respectively, P < 0.01), and thereafter remained high. The lower lobes were more inclined to be involved with higher CT scores except for stage-1. At stage-6 98.1 % of CT scans still showed abnormalities (CT score 7.5 ± 4.1).
Thin-section CT could provide semi-quantitative analysis of pulmonary damage severity. This disease changed rapidly at the early stage, then tended to be stable and lasted for a long time.
评估 COVID-19 患者的肺部 CT 扫描的异常情况，并将其与症状持续时间相关联。
总共对 112 名患者的 348 个 CT 扫描进行分类，根据初始症状发作后的时间，即第 1 期（0-4 天）；第 2 期（5-9 天）；第 3 期（10-14 天）；第 4 期（15-21 天）；第 5 期（22-28 天）；第 6 期（＞28 天）。每个肺叶均按磨玻璃影（GGO）、铺路石征和实变的程度分为五个等级进行评估。五个肺叶评分总和即为总 CT 评分（最大 CT 评分，25 分）。
肺部异常的主要表现为 GGO、铺路石征、实变和线性混浊。铺路石征、实变和线性混浊的频率在第 3 期（62.7%）、第 4 期（75.0%）和第 5 期（83.1%）达到峰值，此后逐渐下降。总 CT 评分从第 1 期到第 2 期（分别为 2.8±3.1 分和 6.5±4.6 分，P<0.01）升高，此后保持较高水平。除第 1 期外，下叶更容易出现较高的 CT 评分。在第 6 期，98.1%的 CT 扫描仍显示异常（CT 评分 7.5±4.1）。
薄层 CT 可对肺部损伤严重程度进行半定量分析。这种疾病在早期变化迅速，随后趋于稳定并持续很长时间。
