Li S K, Ng F H, Ma K F, Luk W H, Lee Y C, Yung K S
Department of Radiology, Princess Margaret Hospital, Hong Kong.
Hong Kong Med J. 2020 Aug;26(4):289-293. doi: 10.12809/hkmj208521. Epub 2020 Jul 30.
As the designated tertiary referral centre for infectious diseases in Hong Kong, our hospital received the city's first group of patients diagnosed with coronavirus disease 2019 (COVID-19). Herein, we studied the earliest patients admitted to our centre in order to clarify the typical radiological findings, particularly computed tomography (CT) findings, associated with COVID-19.
From 22 January 2020 to 29 February 2020, 19 patients with confirmed COVID-19 underwent high-resolution or conventional CT scans of the thorax in our centre. The CT imaging findings of these patients with confirmed COVID-19 in Hong Kong were reviewed in this study.
Ground-glass opacities (GGO) with peripheral subpleural distribution were found in all patients (100%). No specific zonal predominance was observed. All lobes were involved in 16 (84.2%) patients, focal subsegmental consolidations were observed in 14 (73.7%) patients, and interlobular septal thickening was present in 12 (63.2%) patients. No mediastinal lymph node enlargement, centrilobular nodule, or pleural effusion was detected in any of the patients. Other imaging features present in several patients include bronchial dilatation, bronchial wall thickening, and crazy-paving patterns.
Peripheral subpleural GGO without zonal predominance in the absence of centrilobular nodule, pleural effusion, and lymph node enlargement were consistent findings in patients with confirmed COVID-19. The observed radiological patterns on CT scans can help identify COVID-19 and assess affected patients in the context of the ongoing outbreak.
作为香港指定的传染病三级转诊中心,我院接收了本市首批被诊断为2019冠状病毒病(COVID-19)的患者。在此,我们对最早入住我院中心的患者进行了研究,以明确与COVID-19相关的典型影像学表现,尤其是计算机断层扫描(CT)表现。
2020年1月22日至2020年2月29日,19例确诊为COVID-19的患者在我院中心接受了胸部高分辨率或常规CT扫描。本研究回顾了这些香港确诊COVID-19患者的CT影像表现。
所有患者(100%)均发现有外周胸膜下分布的磨玻璃影(GGO)。未观察到特定的区域优势。16例(84.2%)患者所有肺叶均受累,14例(73.7%)患者观察到局灶性亚段实变,12例(63.2%)患者存在小叶间隔增厚。所有患者均未检测到纵隔淋巴结肿大、小叶中心结节或胸腔积液。部分患者还存在其他影像特征,包括支气管扩张、支气管壁增厚和铺路石样表现。
确诊COVID-19的患者中,外周胸膜下GGO无区域优势,且无小叶中心结节、胸腔积液和淋巴结肿大是一致的表现。CT扫描观察到的影像学模式有助于在当前疫情爆发背景下识别COVID-19并评估受影响患者。