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新型冠状病毒肺炎患者胸部CT影像学的动态变化

[Dynamic changes of chest CT imaging in patients with COVID-19].

作者信息

Wang Jincheng, Liu Jinpeng, Wang Yuanyuan, Liu Wei, Chen Xiaoqun, Sun Chao, Shen Xiaoyong, Wang Qidong, Wu Yaping, Liang Wenjie, Ruan Lingxiang

机构信息

Radiology Department, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 Feb 24;49(2):191-197. doi: 10.3785/j.issn.1008-9292.2020.02.03.

Abstract

OBJECTIVE

To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019 (COVID-19).

METHODS

Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed.

RESULTS

The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%).

CONCLUSIONS

The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.

摘要

目的

分析2019冠状病毒病(COVID-19)患者胸部CT图像的动态变化。

方法

浙江大学医学院附属第一医院收治了52例COVID-19患者。对所有患者进行连续胸部CT扫描随访,住院期间平均每位患者进行4次扫描。每次扫描的最短间隔为2天,最长为7天。回顾了肺阴影的形态、数量和分布以及CT图像上的病变特征。

结果

50例患者的CT图像显示肺部有明显的浸润阴影,另外2例患者首次CT检查时肺部无异常变化。48例(92.3%)发现磨玻璃影(GGO),19例(36.5%)有斑片状实变和亚实变,其中17例(32.7%)伴有空气支气管征。41例(78.8%)小叶间隔增厚,4例(7.6%)有少量纤维条索。住院期间,COVID-19患者的GGO病变逐渐减少,纤维条索影增多并成为最常见的影像学表现。39例(75.0%)患者入院后6-9天内病变迅速进展。入院第10-14天,40例(76.9%)患者病变明显吸收。

结论

COVID-19患者的胸部CT图像具有一定特征且有动态变化,对监测病情进展及临床治疗具有重要价值。

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