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2019年冠状病毒病(COVID-19)患者的胸部计算机断层扫描结果:西非加纳三个中心的初步经验。

Chest Computed Tomography findings in patients with corona virus disease 2019 (COVID-19): An initial experience in three centres in Ghana, West Africa.

作者信息

Sarkodie Benjamin Dabo, Mensah Yaw Boateng, Ayetey Harold, Dzefi-Tettey Klenam, Brakohiapa Edmund, Kaminta Andrew, Idun Ewurama

机构信息

Department of Radiology, University of Ghana Medical School, Accra, Ghana.

Department of Radiology, University of Ghana Medical School, Accra, Ghana.

出版信息

J Med Imaging Radiat Sci. 2020 Dec;51(4):604-609. doi: 10.1016/j.jmir.2020.09.005. Epub 2020 Sep 19.

Abstract

BACKGROUND

Radiological examinations have a significant role in the diagnosis and management of Coronavirus disease 2019 (COVID-19), the disease caused by the novel coronavirus SARS-CoV-2. Many COVID-19 patients show typical Chest Computed Tomography (CT Scan) features which can aid in the diagnoses and triaging of such patients. This is especially so in resource-limited settings where access to molecular diagnostic techniques such as Reverse Transcription Polymerase Chain Reaction (RT-PCR) is not optimal. We report chest CT findings in 28 patients diagnosed with COVID-19 in Ghana.

OBJECTIVE

To document common chest CT scan findings amongst patients with COVID-19 infection in Ghana.

METHOD

Chest CT scans of twenty-eight COVID-19 patients (n = 28) were retrieved and reviewed independently by two experienced radiologists and their findings documented. Two 64 and one 32 slice spiral CT scanners were used at three centres.

RESULTS

Chest CT Images from 16 males (57.1.7%) and 12 females (42.9%) patients aged between 36 and 65 years with mean age of 55.9 years (SD-8.4years) were evaluated. Of these, 21 (75.0%) of them were COVID-19 patients who were undiagnosed at the time of imaging while 7 (25.0%) were known confirmed COVID-19 patients. On the chest CT scans (n = 28), 17 (66.7%) patients showed predominantly ground glass opacities while 12 (42.9%) had evidence of consolidation predominantly. In 26 (92.9%) of the patients, the opacities were bilateral and peripheral in distribution. None of these patients had pleural effusion.

CONCLUSION

COVID-19 patients tend to manifest typical imaging features on chest CT scan. The most common chest imaging finding was bilateral, peripheral and predominantly basal ground glass opacities. Importantly, these findings were frequently obtained before PCR diagnosis. Chest CT scan can help in the diagnosis and triaging of suspected or confirmed COVID-19 patients in jurisdictions with limited PCR diagnostic capacity and can improve early isolation, contact tracing and treatment thus helping to reduce community spread, morbidity and mortality.

摘要

背景

放射学检查在2019冠状病毒病(COVID-19,由新型冠状病毒SARS-CoV-2引起的疾病)的诊断和管理中发挥着重要作用。许多COVID-19患者表现出典型的胸部计算机断层扫描(CT扫描)特征,这有助于对此类患者进行诊断和分诊。在资源有限的环境中尤其如此,在这些环境中,获得诸如逆转录聚合酶链反应(RT-PCR)等分子诊断技术的机会并不理想。我们报告了在加纳被诊断为COVID-19的28例患者的胸部CT检查结果。

目的

记录加纳COVID-19感染患者常见的胸部CT扫描结果。

方法

检索28例COVID-19患者的胸部CT扫描图像(n = 28),由两名经验丰富的放射科医生独立进行评估,并记录他们的发现。在三个中心使用了两台64层和一台32层螺旋CT扫描仪。

结果

评估了年龄在36至65岁之间、平均年龄为55.9岁(标准差8.4岁)的16名男性(57.1%)和12名女性(42.9%)患者的胸部CT图像。其中,21例(75.0%)是在成像时未被诊断出的COVID-19患者,7例(25.0%)是已知确诊的COVID-19患者。在胸部CT扫描(n = 28)中,17例(66.7%)患者主要表现为磨玻璃影,12例(42.9%)主要有实变证据。26例(92.9%)患者的病变呈双侧性且分布于外周。这些患者均无胸腔积液。

结论

COVID-19患者在胸部CT扫描上往往表现出典型的影像学特征。最常见的胸部影像学表现是双侧、外周且主要位于基底的磨玻璃影。重要的是,这些发现经常在PCR诊断之前获得。胸部CT扫描有助于在PCR诊断能力有限的地区对疑似或确诊的COVID-19患者进行诊断和分诊,并可改善早期隔离、接触者追踪和治疗,从而有助于减少社区传播、发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c0b/7501844/303f428fdd75/gr1_lrg.jpg

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