Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China.
Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China.
J Med Virol. 2023 Jan;95(1):e28293. doi: 10.1002/jmv.28293. Epub 2022 Nov 17.
To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software (3D Slicer) to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using 3D Slicer software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
评估 COVID-19 患者入院时的胸部计算机断层扫描 (CT) 结果，并将肺浸润与肺气肿的 CT 表现相关联。我们使用肺气肿作为肺炎的等级来分析 COVID-19 肺炎的不同浸润类型。我们使用开源辅助软件 (3D Slicer) 对 66 名 COVID-19 患者的肺部和病变进行建模，这些患者都是回顾性纳入的。我们将 66 名 COVID-19 患者分为以下两组：(A) 12 名低衰减区 (-950 Hounsfield 单位以下) 肺气肿百分比 (%LAA-950) 小于 10%的患者，(B) %LAA-950 中肺气肿百分比大于或等于 10%的 54 名患者。两位作者对影像学结果进行回顾性评估，然后使用 3D Slicer 软件在 CT 上测量肺浸润和肺气肿体积。通过 Kruskal-Wallis 和 Wilcoxon 检验分别评估 CT 表现的肺浸润、肺气肿、塌陷和患者受累程度的差异。统计学意义设为 p<0.05。左肺 (A) 受累左肺 20.00/受累右肺 18.50，(B) 受累左肺 13.00/受累右肺 11.50 是 COVID-19 最常受累的区域。此外，左肺塌陷 (A) 塌陷左肺 4.95/塌陷右肺 4.65，(B) 塌陷左肺 3.65/塌陷右肺 3.15 也比右侧更严重。在每组中，左肺和右肺的 CT 受累百分比均有显著差异（p<0.05），但总充气受累肺（p=0.152）除外。组 A 中左肺塌陷的中位数为 20.00（14.00-30.00），右肺为 18.50（13.00-30.25），总为 19.00（13.00-30.00），而组 B 中左肺塌陷的中位数为 13.00（10.00-14.75），右肺为 11.50（10.00-15.00），总为 12.50（10.00-15.00）。受累左肺百分比是 COVID-19 患者肺气肿的独立预测因子。我们需要关注患者的左肺，因为它受影响更严重。肺气肿水平较低的患者可能有更多的塌陷段。更多的塌陷段可能导致更严重的临床特征。
