Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Curr Med Res Opin. 2021 Feb;37(2):219-224. doi: 10.1080/03007995.2020.1846173. Epub 2020 Nov 26.
To describe the radiological features of coronavirus disease 19 (COVID-19) and to explore the significant signs that indicate severity of disease.
We collected data retrospectively of 180 cases of COVID-19, from 15 January 2020 to 31 March 2020, from both the Wuhan Zhongnan and Beijing Ditan Hospitals, including 103 cases of mild and 77 cases of severe pneumonia. All patients had their first chest computed tomography scan within five days of symptom onset. The dandelion sign was defined by a focal ground glass opacity (GGO) with a central thickening of the airway wall, and the focal crazy paving sign was defined by a focal GGO with thickening of the interlobular septa.
Consolidation presented in only 4.9% (5/103) of the mild pneumonia cases, which was significantly lower than that in severe pneumonia cases (70.1% 54/77), < .001). Multifocal distribution and pure GGOs were observed more frequently in severe cases of pneumonia ( < .05). The dandelion sign was present in 86.4% (89/103) of the mild pneumonia cases, significantly more frequent than those with severe pneumonia (13.0% [10/77], < .001). The focal crazy paving sign presented in 65.0% (67/103) of the mild pneumonia cases and was significantly more frequent than in severe cases (23.4% [18/77], < .001). The hospital stay duration of the mild pneumonia group (13.6 ± 7.2 days) was significantly shorter than the severe pneumonia group (26.6 ± 11.7 days, < .001).
Consolidation, pure GGO and multifocal distribution on a CT scan were associated with severe COVID-19. The dandelion and focal crazy paving signs indicate mild COVID-19.
描述 2019 年冠状病毒病（COVID-19）的放射学特征，并探讨提示疾病严重程度的显著征象。
我们回顾性收集了 2020 年 1 月 15 日至 3 月 31 日期间来自武汉中南医院和北京地坛医院的 180 例 COVID-19 患者的数据，包括 103 例轻症和 77 例重症肺炎患者。所有患者均在症状出现后 5 天内进行了首次胸部计算机断层扫描（CT）检查。蒲公英征定义为局灶性磨玻璃影（GGO）伴气道壁中央增厚，局灶性杂乱铺路征定义为局灶性 GGO 伴小叶间隔增厚。
在轻症肺炎病例中，仅 4.9%（5/103）出现实变，明显低于重症肺炎病例（70.1%，54/77）， < 0.001）。多发病灶分布和单纯 GGO 在重症肺炎病例中更为常见（ < 0.05）。蒲公英征在轻症肺炎病例中占 86.4%（89/103），明显高于重症肺炎病例（13.0%，10/77）， < 0.001）。局灶性杂乱铺路征在轻症肺炎病例中占 65.0%（67/103），明显高于重症肺炎病例（23.4%，18/77）， < 0.001）。轻症肺炎组的住院时间（13.6±7.2 天）明显短于重症肺炎组（26.6±11.7 天）， < 0.001）。
CT 扫描上的实变、单纯 GGO 和多发病灶分布与严重 COVID-19 相关。蒲公英征和局灶性杂乱铺路征提示为轻症 COVID-19。
