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胸部 CT 在 COVID-19 肺炎诊断中的应用。

Utility of chest CT in diagnosis of COVID-19 pneumonia.

机构信息

Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian City, China.

Department of Radiology, Suizhou Hospital, Hubei University of Medicine, Suizhou Central Hospital, Hubei, China.

出版信息

Diagn Interv Radiol. 2020 Sep;26(5):437-442. doi: 10.5152/dir.2020.20144.

Abstract

PURPOSE

We aimed to explore the imaging findings of computed tomography (CT) in diagnosing coronavirus disease 2019 (COVID-19) and its clinical value for further evaluation of suspected cases.

METHODS

Files of 155 patients visiting the fever clinics at our hospital and affiliated hospitals from January 20th to February 9th, 2020 were searched. Among them, 140 cases (including 82 males and 58 females) were included as suspected COVID-19 cases based on clinical and epidemiological history; the CT image features of 70 cases with suggestive findings on CT, confirmed by positive nucleic acid test were analyzed and evaluated. The sensitivity and specificity of CT in diagnosing COVID-19 were evaluated in patients with epidemiological history.

RESULTS

Of the 70 patients, 84.3% showed bilateral lung involvement on CT; 27 cases (38.6%) showed ground-glass opacity (GGO), which was mostly distributed in the subpleural area (55.7%), and this sign was mainly observed in early COVID-19 patients. In addition, 41 cases (58.6%) manifested GGO combined with focal consolidation opacity, 2 (2.8%) had flake-like consolidation opacity, with involvements of the periphery of lung field and the central zone (44.3%), and this sign was mostly observed in severe or critical patients. Concomitant signs such as pleural effusion and mediastinal lymph node enlargement were rare. Among patients with epidemiological history, the sensitivity of CT in diagnosing COVID-19 was 89.7% (70/78), and the specificity was 88.7% (55/62).

CONCLUSION

CT shows high sensitivity and specificity in diagnosing COVID-19. CT is an important examination method in evaluation of suspected cases and assessment of disease severity.

摘要

目的

探讨计算机断层扫描(CT)在诊断 2019 年冠状病毒病(COVID-19)中的影像学表现及其对疑似病例进一步评估的临床价值。

方法

检索 2020 年 1 月 20 日至 2 月 9 日我院及附属医院发热门诊就诊患者的病历资料,共 155 例,其中根据临床和流行病学史,将 140 例(男 82 例,女 58 例)患者作为 COVID-19 疑似病例,对 70 例有 CT 提示性表现且核酸检测阳性的患者的 CT 图像特征进行分析和评价。评估 CT 对有流行病学史患者 COVID-19 的诊断灵敏度和特异度。

结果

70 例患者中,CT 示双肺受累 84.3%;磨玻璃密度影(GGO)27 例(38.6%),多分布于胸膜下区(55.7%),此征象多见于早期 COVID-19 患者;GGO 合并局灶实变影 41 例(58.6%),斑片状实变影 2 例(2.8%),病变累及肺野外带和肺内中带(44.3%),此征象多见于重症或危重症患者;合并胸腔积液和纵隔淋巴结肿大少见。有流行病学史的患者中,CT 诊断 COVID-19 的灵敏度为 89.7%(70/78),特异度为 88.7%(55/62)。

结论

CT 对 COVID-19 具有较高的灵敏度和特异度,是疑似病例评估和疾病严重程度评估的重要检查方法。

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