Kong Min, Yang Hai, Li Xiaodong, Shen Jianfei, Xu Xinjian, Lv Dongqing
Department of Thoracic Surgery, Taizhou Enze Medical center (Group) Enze Hospital, Taizhou, Zhejiang Province, China.
Department of Radiology, Taizhou Enze Medical Center (Group) Enze Hospital, Taizhou, China.
J Thorac Dis. 2020 Sep;12(9):4892-4907. doi: 10.21037/jtd-20-1363.
The aim of this study was to investigate the chest CT manifestations of COVID-19 and its CT evolving process to explore its inherent outcomes.
Inpatients diagnosed with COVID-19 at the Enze Hospital from January 17, 2020 to February 15, 2020 were included. The evolving characteristics of CT manifestations and treatment outcomes were analyzed.
Twenty-two patients with COVID-19 were included in the study. Clinical symptoms at the time of onset included fever (n=19) and cough (n=8). The first CT findings mainly included ground-glass opacities (GGOs) (n=18), lung consolidation (n=7), interlobular septal thickening (n=5), and fibrosis-like stripes (n=4). Dynamic CT showed GGOs, lung consolidation, and fibrosis-like stripes, all of which demonstrated a trend that initially increased in number, and then gradually decreased in number or disappeared. According to the characteristics of CT evolution. COVID-19 could be divided into early stage, progressing stage, recovery stage, and dissipation stage. The median times of the respective stages were: early stage-3 days (1-8 days) after disease onset, progressing stage-7 days (4-17 days) after onset, recovery stage-10 days (8-14 days) after onset, and dissipation stage-19.5 days (11-25 days) after onset.
COVID-19 has an acute onset, with main imaging manifestations of different types of GGO with or without lung consolidation in the subpleural regions of the bilateral lungs. The CT manifestations of lung lesions change rapidly. The lung lesions of mild and ordinary types of COVID-19 may improve significantly or disappear in a short period after active treatment, with good prognosis. Moreover, fibrosis-like stripes may be a sign of atelectasis of sub-segment lung tissue of COVID-19 and may be a specific sign for the diagnosis of COVID-19.
本研究旨在探讨新型冠状病毒肺炎（COVID-19）的胸部CT表现及其CT演变过程，以探索其内在转归。
纳入2020年1月17日至2020年2月15日在恩泽医院确诊为COVID-19的住院患者。分析CT表现的演变特征及治疗转归。
本研究共纳入22例COVID-19患者。发病时的临床症状包括发热（n=19）和咳嗽（n=8）。首次CT表现主要包括磨玻璃影（GGOs）（n=18）、肺实变（n=7）、小叶间隔增厚（n=5）和纤维条索影（n=4）。动态CT显示GGOs、肺实变和纤维条索影，三者均呈现出数量先增多，随后逐渐减少或消失的趋势。根据CT演变特征，COVID-19可分为早期、进展期、恢复期和消散期。各期的中位时间分别为：早期-发病后3天（1-8天），进展期-发病后7天（4-17天），恢复期-发病后10天（8-14天），消散期-发病后19.5天（11-25天）。
COVID-19起病急，主要影像学表现为双肺胸膜下区域不同类型的GGO，可伴有或不伴有肺实变。肺部病变的CT表现变化迅速。轻型和普通型COVID-19患者经积极治疗后肺部病变可在短期内明显改善或消失，预后良好。此外，纤维条索影可能是COVID-19亚段肺组织肺不张的征象，可能是诊断COVID-19的特异性征象。
