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[CT上的蒲公英时钟样征象用于诊断新型冠状病毒肺炎]

[Dandelion clock-like sign on CT for diagnose of COVID-19].

作者信息

Fu Xiaobin, Li Jiesheng, Huang Zhou, Xu Zhiming, Yao Weiping, Cui Yunneng, Ouyang Kexun, Liu Huaizhong

机构信息

Department of Medical Imaging, Foshan Sanshui District People's Hospital, Guangdong Province, Foshan Sanshui 528100, China.

Department of Respiratory Medicine, Foshan Sanshui District People's Hospital, Guangdong Province, Foshan Sanshui 528100, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2020 Feb 29;40(2):159-163. doi: 10.12122/j.issn.1673-4254.2020.02.03.

Abstract

OBJECTIVE

To explore the value of the "dandelion clock-like" sign on chest CT for diagnosis of SARS-CoV-2-associated pneumonia.

METHODS

This retrospective analysis was conducted based on the data of 119 cases from the Department of Fever and the Department of Infection undergoing chest high-resolution CT examinations in Sanshui District People's Hospital between January, 24 and February 10, 2020. The cases with no abnormality on chest CT were excluded. Twenty-three patients were diagnosed to have pneumonia, including 9 with SARS-CoV-2-associated pneumonia and 14 with other types of pneumonia. We comparatively analyzed the CT signs, location of the lesions and the dandelion clock-like sign among different types of pneumonia.

RESULTS

Among the 23 patients with pneumonia, 9 (39.1%) had common or severe SARS-CoV-2- associated pneumonia with a positive epidemiological history and corresponding respiratory symptoms. Seven of the SARSCoV-2-associated pneumonia patients had multiple lesions in bilateral lungs, compromising mainly the lung field and the subpleural area and showing patchy, lumpy, and umbrella-shaped ground glass opacity, often accompanied by pulmonary vascular thickening and increased microvessels, interlobular septal thickening and fibrosis and lined with grid-like and small-bubble-like "crazy-paving" patterns. The dandelion clock-like sign was found in all the 9 patients with SARSCoV-2-associated pneumonia, with a total of 46 lesions (60.5%, 76 total lesions); 9 of the lesions presented with a "dandelion clek-like" sign and 37 with a "dandelion seed sign". These signs were not found in the 14 patients with other types of pneumonia.

CONCLUSIONS

The dandelion clock-like sign is a common and characteristic chest CT finding in patients with SARS-CoV-2-associated pneumonia, and can help to distinguish SARS-CoV-2-associated pneumonia from other types of pneumonia.

摘要

目的

探讨胸部CT上“蒲公英时钟样”征象对新型冠状病毒肺炎的诊断价值。

方法

回顾性分析2020年1月24日至2月10日在佛山市三水区人民医院发热门诊及感染科行胸部高分辨率CT检查的119例患者资料,排除胸部CT无异常者。23例患者诊断为肺炎,其中新型冠状病毒肺炎9例,其他类型肺炎14例。比较分析不同类型肺炎的CT征象、病变部位及“蒲公英时钟样”征象。

结果

23例肺炎患者中,9例(39.1%)为普通型或重型新型冠状病毒肺炎,有阳性流行病学史及相应呼吸道症状。新型冠状病毒肺炎患者中7例双肺多发病变,主要累及肺野及胸膜下区,表现为斑片状、结节状及伞状磨玻璃影,常伴有肺血管增粗、微血管增多、小叶间隔增厚及纤维化,呈网格状及小泡状“铺路石”样改变。9例新型冠状病毒肺炎患者均出现“蒲公英时钟样”征象,共46个病灶(占全部76个病灶的60.5%);其中9个病灶表现为“蒲公英钟样”征象,37个病灶表现为“蒲公英籽样”征象。14例其他类型肺炎患者未出现上述征象。

结论

“蒲公英时钟样”征象是新型冠状病毒肺炎患者胸部CT常见的特征性表现,有助于新型冠状病毒肺炎与其他类型肺炎的鉴别诊断。

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