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新型冠状病毒肺炎的CT特征及短期预后:来自伊朗卡尚的一项单中心研究

CT Features and Short-term Prognosis of COVID-19 Pneumonia: A Single-Center Study from Kashan, Iran.

作者信息

Tabatabaei Seyed Mohammad Hossein, Talari Hamidreza, Moghaddas Fahimeh, Rajebi Hamid

机构信息

Department of Radiology, Shahid Beheshti Hospital, Kashan, Iran (S.M.H.T., H.T., F.M.); and Department of Radiology, University of Texas Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 (H.R.).

出版信息

Radiol Cardiothorac Imaging. 2020 Apr 20;2(2):e200130. doi: 10.1148/ryct.2020200130. eCollection 2020 Apr.

Abstract

PURPOSE

To assess whether certain CT chest features of patients with confirmed coronavirus disease 2019 (COVID-19) may have short-term prognostic value.

MATERIALS AND METHODS

One hundred-twenty consecutive symptomatic patients with COVID-19 infection who had undergone chest CT were enrolled in this retrospective study. Patients were categorized into three groups: routine inward hospitalization, intensive care unit admission, and deceased based on a short-term follow-up. Detailed initial CT features and distributional evaluation were recorded.

RESULTS

The mean age in the deceased group was 70.7 years, significantly higher than the other two groups ( < .05). Ninety-four percent (113/120) of the patients had ground-glass opacities (GGO). Peripheral and lower zone predilection was present in most patients. Subpleural sparing and pleural effusion were seen in approximately 23% (28/120) and 17% (20/120) of the patients, respectively. The combined intensive care unit group and deceased patients had significantly more consolidation, air bronchograms, crazy paving, and central involvement of the lungs compared with routinely hospitalized patients (all < .05).

CONCLUSION

This study supports the previously described typical CT appearance of COVID-19 pneumonia with bilateral GGO, in peripheral distribution and lower lung zone predilection. Subpleural sparing and pleural effusion were seen approximately in one-fifth and one-sixth of the patients with COVID-19, respectively. Consolidation, air bronchograms, central lung involvement, crazy paving and pleural effusion on initial CT chest have potential prognostic values, the features more commonly observed in critically ill patients.© RSNA, 2020.

摘要

目的

评估确诊为2019冠状病毒病(COVID-19)患者的某些胸部CT特征是否具有短期预后价值。

材料与方法

本回顾性研究纳入了120例连续的有症状且接受过胸部CT检查的COVID-19感染患者。根据短期随访情况,将患者分为三组:常规入院治疗组、重症监护病房收治组和死亡组。记录详细的初始CT特征和分布评估情况。

结果

死亡组患者的平均年龄为70.7岁,显著高于其他两组(P<0.05)。94%(113/120)的患者有磨玻璃影(GGO)。大多数患者的病变以周边及下肺为主。分别约23%(28/120)和17%(20/120)的患者可见胸膜下 spared和胸腔积液。与常规住院患者相比(均P<0.05),重症监护病房组和死亡患者组肺部实变、空气支气管征、铺路石征及中央受累情况更为明显。

结论

本研究支持先前描述的COVID-19肺炎典型CT表现,即双侧磨玻璃影,呈周边分布且以下肺为主。分别约五分之一和六分之一的COVID-19患者可见胸膜下 spared和胸腔积液。初始胸部CT上的实变、空气支气管征、肺中央受累、铺路石征及胸腔积液具有潜在的预后价值,这些特征在危重症患者中更常见。©RSNA,2020。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fa5/7977947/4bf592d546e5/ryct.2020200130.fig1.jpg

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