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高分辨率计算机断层扫描在2019新型冠状病毒(2019-nCoV)肺炎诊断中的应用:来自中国西部多个医学中心的研究

High resolution computed tomography for the diagnosis of 2019 novel coronavirus (2019-nCoV) pneumonia: a study from multiple medical centers in western China.

作者信息

Li Hong-Wei, Zhuo Li-Hua, Yan Gao-Wu, Wang Ji-Sheng, Huang Guo-Ping, Li Jia-Bing, Long Yong-Jun, Zhang Fang, Jiang Yi-Shan, Deng Li-Hua, Su Li-Ping, Yao Hong-Chao, Wu Jun-Lin, Das Sushant-Kumar, Yang Guo-Qing, Li Yong, Yang Han-Feng, Du Yong

机构信息

Department of Radiology, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.

Department of Radiology, Suining Central Hospital, Suining, China.

出版信息

Ann Transl Med. 2020 Sep;8(18):1158. doi: 10.21037/atm-20-5731.

DOI:10.21037/atm-20-5731
PMID:33241007
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7576043/
Abstract

BACKGROUND

To evaluate the role of high-resolution computed tomography (HRCT) in the diagnosis of 2019 novel coronavirus (2019-nCoV) pneumonia and to provide experience in the early detection and diagnosis of 2019-nCoV pneumonia.

METHODS

Seventy-two patients confirmed to be infected with 2019-nCoV from multiple medical centers in western China were retrospectively analyzed, including epidemiologic characteristics, clinical manifestations, laboratory findings and HRCT chest features.

RESULTS

All patients had lung parenchymal abnormalities on HRCT scans, which were mostly multifocal in both lungs and asymmetric in all patients, and were mostly in the peripheral or subpleural lung regions in 52 patients (72.22%), in the central lung regions in 16 patients (22.22%), and in both lungs with "white lung" manifestations in 4 patients (5.56%). Subpleural multifocal consolidation was a predominant abnormality in 38 patients (52.78%). Ground-glass opacity was seen in 34 patients (47.22%). Interlobular septal thickening was found in 18 patients, 8 of whom had only generally mild thickening with no zonal predominance. Reticulation was seen in 8 patients (11.11%), and was mild and randomly distributed. In addition, both lungs of 28 patients had 2 or 3 CT imaging features. Out of these 72 patients, 36 were diagnosed as early stage, 32 patients as progressive stage, and 4 patient as severe stage pneumonia. Moreover, the diagnostic accuracy of HRCT features combined with epidemiological history was not significantly different from the detection of viral nucleic acid (all P >0.05).

CONCLUSIONS

The HRCT features of 2019-nCoV pneumonia are characteristic to a certain degree, which when combined with epidemiological history yield high clinical value in the early detection and diagnosis of 2019-nCoV pneumonia.

摘要

背景

评估高分辨率计算机断层扫描(HRCT)在2019新型冠状病毒(2019-nCoV)肺炎诊断中的作用,并为2019-nCoV肺炎的早期检测和诊断提供经验。

方法

回顾性分析来自中国西部多个医疗中心的72例确诊感染2019-nCoV的患者,包括流行病学特征、临床表现、实验室检查结果和胸部HRCT特征。

结果

所有患者的HRCT扫描均显示肺实质异常,大多为双肺多发且不对称,52例患者(72.22%)主要位于肺外周或胸膜下区域,16例患者(22.22%)位于肺中央区域,4例患者(5.56%)双肺表现为“白肺”。38例患者(52.78%)以胸膜下多发实变为主。34例患者(47.22%)可见磨玻璃影。18例患者发现小叶间隔增厚,其中8例仅为一般轻度增厚,无区域优势。8例患者(11.11%)可见网状影,呈轻度且随机分布。此外,28例患者双肺具有2种或3种CT影像特征。在这72例患者中,36例被诊断为早期,32例为进展期,4例为重症肺炎。而且,HRCT特征结合流行病学史的诊断准确性与病毒核酸检测无显著差异(所有P>0.05)。

结论

2019-nCoV肺炎的HRCT特征在一定程度上具有特征性,结合流行病学史在2019-nCoV肺炎的早期检测和诊断中具有较高的临床价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/4809bc96b86d/atm-08-18-1158-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/7a77a955c746/atm-08-18-1158-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/3c2dc7270716/atm-08-18-1158-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/15354994ffc9/atm-08-18-1158-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/87f4a61ee24e/atm-08-18-1158-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/6695b300d96d/atm-08-18-1158-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/4809bc96b86d/atm-08-18-1158-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/7a77a955c746/atm-08-18-1158-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/3c2dc7270716/atm-08-18-1158-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/15354994ffc9/atm-08-18-1158-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/87f4a61ee24e/atm-08-18-1158-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/6695b300d96d/atm-08-18-1158-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0408/7576043/4809bc96b86d/atm-08-18-1158-f6.jpg

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