So T Y, Yu S C H, Wong W T, Wong J K T, Lee H, Wang Y X
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Hong Kong Med J. 2023 Feb;29(1):39-48. doi: 10.12809/hkmj219291.
This study evaluated the arched bridge and vacuole signs, which constitute morphological patterns of lung sparing in coronavirus disease 2019 (COVID-19), then examined whether these signs could be used to differentiate COVID-19 pneumonia from influenza pneumonia or bacterial pneumonia.
In total, 187 patients were included: 66 patients with COVID-19 pneumonia, 50 patients with influenza pneumonia and positive computed tomography findings, and 71 patients with bacterial pneumonia and positive computed tomography findings. Images were independently reviewed by two radiologists. The incidences of the arched bridge sign and/or vacuole sign were compared among the COVID-19 pneumonia, influenza pneumonia, and bacterial pneumonia groups.
The arched bridge sign was much more common among patients with COVID-19 pneumonia (42/66, 63.6%) than among patients with influenza pneumonia (4/50, 8.0%; P<0.001) or bacterial pneumonia (4/71, 5.6%; P<0.001). The vacuole sign was also much more common among patients with COVID-19 pneumonia (14/66, 21.2%) than among patients with influenza pneumonia (1/50, 2.0%; P=0.005) or bacterial pneumonia (1/71, 1.4%; P<0.001). The signs occurred together in 11 (16.7%) patients with COVID-19 pneumonia, but they did not occur together in patients with influenza pneumonia or bacterial pneumonia. The arched bridge and vacuole signs predicted COVID-19 pneumonia with respective specificities of 93.4% and 98.4%.
The arched bridge and vacuole signs are much more common in patients with COVID-19 pneumonia and can help differentiate COVID-19 pneumonia from influenza and bacterial pneumonia.
本研究评估了构成2019冠状病毒病（COVID-19）肺实质保留形态模式的拱桥征和空泡征，然后研究这些征象是否可用于鉴别COVID-19肺炎与流感肺炎或细菌性肺炎。
共纳入187例患者，其中COVID-19肺炎患者66例、流感肺炎且计算机断层扫描结果阳性患者50例、细菌性肺炎且计算机断层扫描结果阳性患者71例。由两名放射科医生独立阅片。比较COVID-19肺炎、流感肺炎和细菌性肺炎组中拱桥征和/或空泡征的发生率。
拱桥征在COVID-19肺炎患者中（42/66，63.6%）比在流感肺炎患者中（4/50，8.0%；P<0.001）或细菌性肺炎患者中（4/71，5.6%；P<0.001）更常见。空泡征在COVID-19肺炎患者中（14/66，21.2%）也比在流感肺炎患者中（1/50，2.0%；P=0.005）或细菌性肺炎患者中（1/71，1.4%；P<0.001）更常见。这些征象在11例（16.7%）COVID-19肺炎患者中同时出现，但在流感肺炎或细菌性肺炎患者中未同时出现。拱桥征和空泡征预测COVID-19肺炎的特异性分别为93.4%和98.4%。
拱桥征和空泡征在COVID-19肺炎患者中更为常见，有助于鉴别COVID-19肺炎与流感和细菌性肺炎。
