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COVID-19 患者胸部 CT 中纵隔胸膜下肺实质的受累:病例系列研究。

Involvement of the Mediastinal Subpleural Pulmonary Parenchyma on Chest CT in COVID-19 patients: A Case Series.

机构信息

Department of Radiology, G. Criscuoli Hospital, Sant'Angelo dei Lombardi, ASL Avellino, Avellino, Italy.

Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.

出版信息

J Radiol Case Rep. 2020 Nov 30;14(11):1-15. doi: 10.3941/jrcr.v14i11.3974. eCollection 2020 Nov.

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First identified in December 2019 in Wuhan, China, it has since become a global pandemic. Although the reference standard for SARS-CoV-2 diagnosis is real-time reverse transcription polymerase chain reaction (RT-PCR), computed tomography (CT) is recommended for both initial evaluation and follow-up. The CT findings in COVID-19 are varied, but typical ground-glass opacities are usually reported to occupy a peripheral costal subpleural distribution. Here we report eight confirmed COVID-19 cases who underwent clinical evaluation, laboratory testing, and unenhanced chest CT. In all patients, chest CT showed the presence of ground-glass opacities in the mediastinal subpleural parenchyma. While these cases also showed the typical CT features of COVID-19, involvement of the mediastinal subpleural parenchyma should not lower the index of suspicion for COVID-19.

摘要

新型冠状病毒病(COVID-19)是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的传染病。该病毒于 2019 年 12 月在中国武汉首次被发现,此后已成为全球大流行。尽管实时逆转录聚合酶链反应(RT-PCR)是 SARS-CoV-2 诊断的参考标准,但 CT 检查仍被推荐用于初始评估和随访。COVID-19 的 CT 表现多种多样,但通常报告有典型的磨玻璃样混浊,呈外周肋胸膜下分布。在此,我们报告了 8 例经临床评估、实验室检测和未增强胸部 CT 检查确诊的 COVID-19 病例。在所有患者中,胸部 CT 均显示在纵隔肋胸膜下实质中存在磨玻璃样混浊。虽然这些病例也显示了 COVID-19 的典型 CT 特征,但纵隔肋胸膜下实质受累不应降低对 COVID-19 的怀疑指数。

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本文引用的文献

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The Many Faces of COVID-19: Spectrum of Imaging Manifestations.新冠病毒肺炎的多样面貌:影像表现谱
Radiol Cardiothorac Imaging. 2020 Feb 14;2(1):e200037. doi: 10.1148/ryct.2020200037. eCollection 2020 Feb.
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Chest CT Features of COVID-19 in Rome, Italy.意大利罗马地区 COVID-19 的胸部 CT 特征。
Radiology. 2020 Aug;296(2):E79-E85. doi: 10.1148/radiol.2020201237. Epub 2020 Apr 3.

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