ISSN 1004-4140
CN 11-3017/P
刘梦珂, 张怡梦, 李兴鹏, 等. 不同年龄新冠肺炎患者CT表现及动态分析[J]. CT理论与应用研究, 2023, 32(5): 645-651. DOI: 10.15953/j.ctta.2023.034.
引用本文: 刘梦珂, 张怡梦, 李兴鹏, 等. 不同年龄新冠肺炎患者CT表现及动态分析[J]. CT理论与应用研究, 2023, 32(5): 645-651. DOI: 10.15953/j.ctta.2023.034.
LIU M K, ZHANG Y M, LI X P, et al. The Value of Chest Computed Tomography in the Review of Patients with Novel Coronavirus Pneumonia[J]. CT Theory and Applications, 2023, 32(5): 645-651. DOI: 10.15953/j.ctta.2023.034. (in Chinese).
Citation: LIU M K, ZHANG Y M, LI X P, et al. The Value of Chest Computed Tomography in the Review of Patients with Novel Coronavirus Pneumonia[J]. CT Theory and Applications, 2023, 32(5): 645-651. DOI: 10.15953/j.ctta.2023.034. (in Chinese).

不同年龄新冠肺炎患者CT表现及动态分析

The Value of Chest Computed Tomography in the Review of Patients with Novel Coronavirus Pneumonia

  • 摘要: 目的:回顾性分析胸部平扫CT对不同年龄患者新型冠状病毒感染初次诊断及动态变化的临床价值。材料与方法:收集2022年11月12日至2023年1月6日确诊新冠肺炎并行胸部薄层CT检查患者52例,所有患者1个月内再次行胸部CT复查,并有较完整的临床资料。根据患者年龄(60岁和>60岁)将患者分为两组,比较两组患者的CT表现特征的差异性,同时观察所有患者CT复查的情况。结果:52例患者肺部病变中,24例累及气道(46.2%)、21例累及血道(40.4%)。年龄组间的对比显示病变部位(单/双肺、气道)、树芽、大片形态、纤维条索、间质性改变、胸膜增厚的差异有统计学意义。52例患者中,复查CT显示病变进展者18例,表现为范围增大者18例(100%)、实变加重者7例(38.9%)、GGO加重者14例(77.8%)、胸腔积液增多者6例(33.3%);复查CT显示病变缓解者34例,其中范围减小者31例(91.2%)、密度变淡者6例(17.6%)、纤维机化12例(35.3%)、完全吸收2例(5.9%)、胸腔积液减少4例(11.8%)。结论:新冠肺炎患者CT表现多种多样,不同年龄段患者的影像表现不同,60岁以上患者在累及双肺、气道,大片状GGO形态,合并纤维条索,间质性改变以及胸膜增厚上较60岁以下患者更多。治疗后肺部病变变化较快,多数患者可吸收缩小、密度变淡或纤维机化,少数患者范围增大、实变或GGO加重、并出现胸腔积液等。胸部平扫CT有助于临床医生早期诊断和动态评估新冠肺炎。

     

    Abstract: Objective: To retrospectively analyze the clinical value of chest plain computed tomography (CT) for the initial diagnosis and dynamic changes of early novel coronavirus pneumonia (2019 novel Coronavirus, 2019-nCoV, referred to as new coronavirus pneumonia). Materials and methods: Fifty-two patients with confirmed new coronavirus pneumonia diagnoses and positive chest CT manifestations from November 12, 2022, to January 6, 2023, in the infection department of our hospital were collected. All patients had two chest thin-section CT examinations within 1 month from the onset of the disease and had complete clinical data. Patients were divided into two groups according to their age (60 years and >60 years), and the differences in CT performance characteristics between the two groups were compared. The CT review of all patients was also observed. Results: Among the 52 patients, 52 involved the lungs (100%), 24 involved the airways (46.2%), and 21 involved the bloodways (40.4%). Comparison between age groups showed statistically significant differences in lesion location (single/both lungs, airways), tree-in-bud pattern, large morphology, fibrous striae, interstitial changes, and pleural thickening. Among the 52 patients, review CT showed lesion progression in 18 cases (34.6%), which showed an increase in extent in 18 cases (100%), aggravation of solid changes in 7 (38.9), aggravation of GGO in 14 (77.8%), and increase in pleural effusion in 6 (33.3%); review CT showed lesion remission in 18 cases (34.6%), which showed a decrease in extent in 31 (91.2%), 6 (17.6%) with reduced density, 12 (35.3%) with fibrosis, 2 (5.9%) with complete resorption, and 4 (11.8) with reduced pleural effusion. Conclusion: The CT scan of the chest in neocoronary pneumonia has certain characteristics, and for the first time, it mostly showed multiple patchy signs or large patchy ground glass opacity (GGO) with mainly subpleural distribution in the periphery of both lungs, mostly accompanied by "halo sign," "anti-halo sign," and "paving stone sign." The lung is more susceptible to change following treatment. After treatment, the lung lesions change rapidly, with most patients showing absorption and shrinkage, density fading, or fibrosis and a few patients showing increased extent, solidity or aggravation of GGO, and pleural effusion. Chest plain CT helps clinicians in the early diagnosis and dynamic evaluation of neocoronary pneumonia.

     

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