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新型冠状病毒肺炎随访中的胸部CT:30例病例系列报道

Chest CT in covid-19 pneumonia's follow-up: A 30 patients case series.

作者信息

Ramdani Hanae, Benelhosni Khadija, Billah Nabil Moatassim, Nassar Ittimade

机构信息

Radiology Department, Ibn Sina University Hospital Center, Lamfadel Cherkaoui Street, Rabat, MA, 10170, Morocco.

出版信息

Ann Med Surg (Lond). 2022 Dec;84:104835. doi: 10.1016/j.amsu.2022.104835. Epub 2022 Nov 7.

Abstract

BACKGROUND

Lung abnormalities do not fully resolve in all Covid-19 survivors and may progress to fibrosis. Understanding post-COVID lung changes helps identify patients susceptible of post-COVID-19 sequelae. We analyzed scannographic residual lung abnormalities and the full resolution percentage on intermediate- and long-term follow-up (3 months or more).

METHODS

Data from 30 RT-PCR positive COVID-19 patients undergoing at least one follow-up chest CT at Ibn Sina Hospital, with a minimal time interval of 3 months between the RT-PCR and the CT performance were gathered retrospectively. The following elements were analyzed: (1) lung opacities, (2) distribution, (3) dominant lung opacity, (4) Sub-pleural bands, (5) Interlobular septal thickening, (6) Vascular dilatation, (7) Bronchiectasis, (8) Honey combing, (9) Architectural distortion, (10) mosaic attenuation, and (11) Additional findings: Enlarged lymph nodes, Pleural and Pericardial fluid. To evaluate the degree of lung opacification, a score founded on visual evaluation of the lung involvement's percentage was employed. Patients were then subdivided into two categories: (1) no residual opacities and (2) remaining pulmonary opacities.

OUTCOMES

30 patients were enrolled. The age ranged between 40 and 87 years. CT was indicated for symptoms or functional impairment. The time range between the positive RT-PCR and Follow-up CT varied between 3 and 12 months. CT severity score ranged between o and 23. Residual lung opacities were present in 24 cases (80%). The dominant lung opacities were Ground glass (46.7%), and linear/curvilinear opacities (23.3%). Signs of fibrosis were present in 9 patients (30%).

CONCLUSION

CT abnormalities following Covid-19 pneumonia's prevalence varies based on the extent of the original lung affection and the time gap since the acute phase. Residual anomalies' effects on respiratory physiology, symptoms, and quality of living are unknown. Maintained monitoring of COVID-19 survivors with clinical examination, iterative pulmonary function tests, and HRCT is advised.

摘要

背景

并非所有新冠肺炎幸存者的肺部异常都能完全消退,且可能进展为肺纤维化。了解新冠后肺部变化有助于识别易患新冠后遗症的患者。我们分析了中期和长期随访(3个月或更长时间)的扫描残留肺部异常及完全消退百分比。

方法

回顾性收集了在伊本·西那医院接受至少一次随访胸部CT的30例RT-PCR阳性新冠肺炎患者的数据,RT-PCR与CT检查之间的最短时间间隔为3个月。分析了以下因素:(1)肺部混浊;(2)分布;(3)主要肺部混浊;(4)胸膜下带;(5)小叶间隔增厚;(6)血管扩张;(7)支气管扩张;(8)蜂窝状改变;(9)结构扭曲;(10)马赛克样衰减;(11)其他发现:淋巴结肿大、胸腔和心包积液。为评估肺部混浊程度,采用基于对肺部受累百分比进行视觉评估的评分。然后将患者分为两类:(1)无残留混浊;(2)仍有肺部混浊。

结果

共纳入30例患者。年龄在40至87岁之间。因症状或功能障碍进行CT检查。RT-PCR阳性与随访CT之间的时间间隔在3至12个月之间。CT严重程度评分在0至23分之间。24例(80%)存在残留肺部混浊。主要肺部混浊为磨玻璃影(46.7%)和线性/曲线状混浊(23.3%)。9例(30%)有肺纤维化迹象。

结论

新冠病毒肺炎后CT异常的发生率因初始肺部病变程度和急性期后的时间间隔而异。残留异常对呼吸生理、症状和生活质量的影响尚不清楚。建议对新冠病毒肺炎幸存者进行持续监测,并进行临床检查、反复肺功能测试和高分辨率CT检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f958/9758292/834facb67677/gr1.jpg

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