Li Ming, Peng Wanxiang, Chen Miaomiao, Zhu Qichao, Zou Xia, Long Xiaoli
Department of Radiology, Zhuzhou Central Hospital, Zhuzhou Hunan 412007
Department of Radiology, Zhuzhou Central Hospital, Zhuzhou Hunan 412007.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Mar 28;45(3):243-249. doi: 10.11817/j.issn.1672-7347.2020.200168.
To analyze the imaging features of coronavirus disease 2019 (COVID-19) in different periods, and summarize the characteristics with itsdevelopment.
We retrospectively analyzed the CT image data of COVID-19 patients diagnosed by nucleic acid test and CT examination in 57 patients in Zhuzhou Central Hospital and Zhuzhou First People's Hospital, and summarized the characteristics of CT imaging and the development of lesions.
Most of the cases were characterized by peripheral distribution of lesions. A total of 37 cases (64.91%) were purely peripherally distributed, 16 cases (28.07%) coexisted with peripheral and mid-internal distribution, and 4 cases (7.02%) had simple mid-inner band distribution. In peripherally distributed cases, the long axis of the lesion was mostly parallel to the pleura in 36 cases (63.16%). In the case of inner-middle zone distribution, the long axis of the lesion was mostly parallel and surrounded the bronchial vascular bundle, or distributed along the lung lobules (31.58%). All cases had ground-glass-density foci, 31 cases (54.38%) had fine grid shadows in the lesions, 46 cases (80.70%) had thick vascular shadows in the lesions, and 23 cases (40.35%) showed signs of bronchial inflation. Among the 10 cases of "wrinkling shape" lesions in the first CT examination, except for 1 case without reexamination, the remaining 9 cases had different degrees of absorption in the second CT examination. Among the 26 cases of "wrinkling shape" lesions in the second CT examination, except for 11 cases without reexamination, the other 15 patients had different degrees of absorption in the third CT examination.
The early CT manifestations of COVID-19 are mostly ground-glass-density foci distributed in the subpleural region, some of which are distributed near the bronchial blood vessel bundle and in the central area of the lobule. As the course of the disease progresses, there may be varying degrees of solid components in the lesion. When the lesions show a "wrinkling shape", it is often suggested that the lesions will evolve towards the direction of absorption. These characteristics are of great value in assisting clinical diagnosis and dynamically observing changes undersuch condition.
分析新型冠状病毒肺炎（COVID-19）不同时期的影像学特征，并总结其发展特点。
回顾性分析株洲市中心医院和株洲市一医院57例经核酸检测及CT检查确诊的COVID-19患者的CT图像资料，总结CT影像学特征及病变发展情况。
多数病例表现为病变周边分布。单纯周边分布37例（64.91%），周边与中内带分布共存16例（28.07%），单纯中内带分布4例（7.02%）。周边分布病例中，36例（63.16%）病变长轴多与胸膜平行。中内带分布病例中，病变长轴多平行并包绕支气管血管束，或沿肺小叶分布（31.58%）。所有病例均有磨玻璃密度灶，31例（54.38%）病变内有细网格影，46例（80.70%）病变内有增粗血管影，23例（40.35%）表现为支气管充气征。首次CT检查呈“皱缩状”病变的10例中，除1例未复查外，其余9例在第二次CT检查时有不同程度吸收。第二次CT检查呈“皱缩状”病变的26例中，除11例未复查外，其余15例在第三次CT检查时有不同程度吸收。
COVID-19的早期CT表现多为分布于胸膜下区域的磨玻璃密度灶，部分分布于支气管血管束附近及小叶中心区。随着病程进展，病变内可能出现不同程度的实性成分。当病变呈“皱缩状”时，常提示病变将向吸收方向演变。这些特征对辅助临床诊断及动态观察病情变化具有重要价值。
