Xiang Ying, Yang Quanxin, Sun Honghong, Qin Xingru, Li Xiaohui, Zhang Qiujuan
Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Mar 30;40(3):327-332. doi: 10.12122/j.issn.1673-4254.2020.03.05.
To define chest CT findings and their dynamic changes in patients with coronavirus disease 2019 (COVID-19) from disease onset to the cure.We analyzed the clinical and chest CT data of 6 patients with RT-PCR-confirmed COVID-19. According to the time from the disease onset to the cure or from the onset to each CT scan, the total of 30 chest CT scans were divided into 4 stages, namely stage 1 (0-4 days), stage 2 (5-9 days), stage 3 (10-14 days), and stage 4 (over 14 days). A semi-quantitative scoring system was used to quantitatively assess the pulmonary involvement on the basis of the involved area. The differences in chest CT signs and the lung injury scores based on CT findings were compared among the 4 stages.In stage 1, ground-glass opacities (GGO) was found frequently in the subpleura, and the CT score was the lowest at 4.00±0.40. Stage 2 was characterized by an increased and mixed density (crazy-paving pattern) with mild consolidation of the lungs, and the CT score reached its peak level of 7.38±3.34 ( < 0.05). In stage 3, an expanded range of consolidation and linear lesions were found in the lungs, and the total CT score averaged 6.86±2.91. In stage 4, a gradual resolution of the consolidation occurred with more linear lesions in the lungs, and the total CT score was 6.21±1.56. The CT scores of the lower lobes were significantly higher compared with those of the middle/upper lobes ( < 0.05) in stage 3 and stage 4.Chest CT scans allows dynamic monitoring of the changes in the distribution, density and extent of the pulmonary lesions in the 4 stages, which are closely correlated with the evolution of the disease course of COVID-19.
明确新型冠状病毒肺炎（COVID-19）患者从发病到治愈期间胸部CT表现及其动态变化。我们分析了6例经逆转录聚合酶链反应（RT-PCR）确诊的COVID-19患者的临床和胸部CT数据。根据从发病到治愈或从发病到每次CT扫描的时间，将总共30次胸部CT扫描分为4个阶段，即第1阶段（0 - 4天）、第2阶段（5 - 9天）、第3阶段（10 - 14天）和第4阶段（超过14天）。采用半定量评分系统，根据受累面积对肺部受累情况进行定量评估。比较4个阶段胸部CT征象及基于CT表现的肺损伤评分差异。在第1阶段，胸膜下常见磨玻璃影（GGO），CT评分为4.00±0.40，为最低。第2阶段的特征是密度增加且混合（铺路石样），伴有轻度肺实变，CT评分达到峰值7.38±3.34（<0.05）。在第3阶段，肺部实变范围扩大并出现线状病变，总CT评分为6.86±2.91。在第4阶段，实变逐渐消退，肺部线状病变增多，总CT评分为6.21±1.56。在第3阶段和第4阶段，下叶CT评分显著高于中/上叶（<0.05）。胸部CT扫描能够动态监测4个阶段肺部病变分布、密度及范围的变化情况，这些变化与COVID-19病程演变密切相关。
