Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China.
Department of Radiology, Huadu District People's Hospital of Guangzhou, Guangzhou, China.
AJR Am J Roentgenol. 2021 Jan;216(1):66-70. doi: 10.2214/AJR.20.23012. Epub 2020 May 5.
The purpose of this study was to explore the value of CT in the diagnosis of coronavirus disease (COVID-19) pneumonia, especially for patients who have negative initial results of reverse transcription-polymerase chain reaction (RT-PCR) testing. Patients with COVID-19 pneumonia from January 19, 2020, to February 20, 2020, were included. All patients underwent chest CT and swab RT-PCR tests within 3 days. Patients were divided into groups with negative (seven patients) and positive (14 patients) initial RT-PCR results. The imaging findings in both groups were recorded and compared. Twenty-one patients with symptoms (nine men, 12 women; age range, 26-90 years) were evaluated. Most of the COVID-19 lesions were located in multiple lobes (67%) in both lungs (72%) in our study. The main CT features were ground-glass opacity (95%) and consolidation (72%) with a subpleural distribution (100%). Otherwise, 33% of patients had other lesions around the bronchovascular bundle. The other CT features included air bronchogram (57%), vascular enlargement (67%), interlobular septal thickening (62%), and pleural effusions (19%). Compared with that in the group with positive initial RT-PCR results, CT of the group with negative initial RT-PCR results was less likely to show pulmonary consolidation ( < 0.05). The less pulmonary consolidation found at CT, the greater is the possibility of negative initial RT-PCR results. Chest CT is important in the screening of patients in whom disease is clinically suspected, especially those who have negative initial RT-PCR results.
本研究旨在探讨 CT 在冠状病毒病（COVID-19）肺炎诊断中的价值，尤其是对初始反转录-聚合酶链反应（RT-PCR）检测结果为阴性的患者。纳入 2020 年 1 月 19 日至 2 月 20 日期间的 COVID-19 肺炎患者。所有患者均在 3 天内接受胸部 CT 和咽拭子 RT-PCR 检测。将患者分为初始 RT-PCR 结果阴性（7 例）和阳性（14 例）两组。记录并比较两组患者的影像学表现。评估了 21 例有症状患者（9 例男性，12 例女性；年龄 26-90 岁）。在本研究中，大多数 COVID-19 病变位于双肺多个肺叶（67%）（72%）。主要 CT 特征为磨玻璃密度影（95%）和实变（72%），呈胸膜下分布（100%）。此外，33%的患者在支气管血管束周围有其他病变。其他 CT 特征包括空气支气管征（57%）、血管扩张（67%）、小叶间隔增厚（62%）和胸腔积液（19%）。与初始 RT-PCR 结果阳性组相比，初始 RT-PCR 结果阴性组 CT 显示肺实变的可能性较小（<0.05）。CT 显示的肺实变越少，初始 RT-PCR 结果为阴性的可能性越大。胸部 CT 对临床上怀疑患有该病的患者，尤其是初始 RT-PCR 结果为阴性的患者的筛查非常重要。
