ISSN 1004-4140
CN 11-3017/P
刘瑞, 武婷婷, 勾少波, 等. 不同时期新型冠状病毒感染胸部CT磨玻璃影的临床意义探讨[J]. CT理论与应用研究, 2023, 32(3): 339-346. DOI: 10.15953/j.ctta.2023.046.
引用本文: 刘瑞, 武婷婷, 勾少波, 等. 不同时期新型冠状病毒感染胸部CT磨玻璃影的临床意义探讨[J]. CT理论与应用研究, 2023, 32(3): 339-346. DOI: 10.15953/j.ctta.2023.046.
LIU R, WU T T, GOU S B, et al. Clinical Application Potentials of Ground Glass Opacities in Different Stages of Coronavirus Disease 2019[J]. CT Theory and Applications, 2023, 32(3): 339-346. DOI: 10.15953/j.ctta.2023.046. (in Chinese).
Citation: LIU R, WU T T, GOU S B, et al. Clinical Application Potentials of Ground Glass Opacities in Different Stages of Coronavirus Disease 2019[J]. CT Theory and Applications, 2023, 32(3): 339-346. DOI: 10.15953/j.ctta.2023.046. (in Chinese).

不同时期新型冠状病毒感染胸部CT磨玻璃影的临床意义探讨

Clinical Application Potentials of Ground Glass Opacities in Different Stages of Coronavirus Disease 2019

  • 摘要: 目的:分析、对比新型冠状病毒感染(COVID-19)不同时期胸部CT磨玻璃影的表现,探讨其对于COVID-19患者分期诊断、疾病管理中的意义。方法:收集、整理内蒙古自治区66例本土性和64例境外输入性COVID-19确诊病例的胸部CT图像,分析、对比早期和恢复期磨玻璃影及其伴随征象的影像特征。结果:77.3% 本土组COVID-19患者(51例)在疾病早期具有磨玻璃影表现,63.7% 本土组COVID-19患者(42例)在恢复期也具有磨玻璃影表现。不同时期的磨玻璃影及其伴随征象具有显著差异,早期磨玻璃影的平均CT值(-329.14±143.66) HU明显高于恢复期磨玻璃影(-616.71±89.82) HU。与恢复期磨玻璃影相比,多数早期磨玻璃影边缘清晰(43例,84.31% vs. 5例,11.90%)、多伴随铺路石征(32例,62.75% vs. 8例,19.05%);血管增粗(33例,64.71% vs. 4例,9.52%)和支气管充气征(19例,37.25% vs. 4例,9.52%)。恢复期较早期更多伴随条索的形成(35例,83.33% vs. 8例,15.69%)。伴随小叶间隔增厚的征象在不同时期组中无显著差异(早期7例,13.72% vs.恢复期2例,4.76%)。境外输入组与本土组结果相一致,早期组磨玻璃影更多表现为边缘清晰,恢复期组磨玻璃影密度更低并更多伴随条索的形成,早期组较恢复期组更多伴随铺路石征、血管增粗、支气管充气征。本土组和境外输入组病例进展期均较早期更多出现实变和条索,两组无统计学差异。结论:COVID-19恢复期较早期磨玻璃影密度较低,边缘不清,较少伴随铺路石征、血管增粗、支气管充气征等征象,但是更多伴有条索形成。该特征对COVID-19病程判定和疾病管理具有临床应用价值。

     

    Abstract: Objective: To analyze and compare the characteristics of ground glass opacities at different stages of coronavirus disease 2019 (COVID-19) on chest computed tomography (CT) images and to discuss its contribution to staging diagnoses and disease management for patients with COVID-19. Methods: Chest CT scans of 66 indigenous and 64 imported cases were collected from patients with COVID-19 in the Inner Mongolia region. Characteristics and the companion signs of ground glass opacities in the early and recovery stages of COVID-19 were analyzed and compared. Results: Of the 66 indigenous COVID-19 cases, 77.3% (51 cases) presented ground glass opacities in the early stage of the disease, while 63.7% (42 cases) had ground glass opacities in the recovery period. Notably, significantly different characteristics and companion signs of ground glass opacities were observed between the early and recovery stages. The average CT value of early-stage ground glass opacities (−329.14±143.66) HU was significantly higher than that of ground glass opacities (−616.71±89.82) HU in the recovery period. Compared with ground glass opacities in the recovery period, most early-stage ground glass opacities displayed clear edges (43 cases, 84.31% vs. 5 cases, 11.90%) and are often accompanied by paving stone signs (32 cases, 62.75% vs. 8 cases, 19.05%); thickened blood vessels (33 cases, 64.71% vs. 4 cases, 9.52%), and bronchial inflation symptoms (19 cases, 37.25% vs. 4 cases, 9.52%). The recovery period is more accompanied by irregular linear shadow than in the early stage (35 cases, 83.33% vs. 8 cases, 15.69%). There was no significant difference in the companion signs of interlobular septal thickening between the two stages (7 cases in the early stage, 13.72% vs. 2 cases in the recovery period, 4.76%). The results of the imported type are consistent with those of the indigenous type. Compared with ground glass opacities in the recovery period, most early-stage ground glass opacities displayed clear edges, while in the recovery group, the density of ground glass opacities was lower and accompanied more by irregular linear shadow. Both local and imported cases of COVID-19 showed more inflammatory consolidation and striation in the advanced stage than in the early stage. Conclusion: Compared with the ground glass opacities in the early stage, the ground glass opacities in the recovery period presented a lower density, unclear edges, and fewer signs of paving stone sign, thickened blood vessels, and bronchial inflation signs, but were more often accompanied by irregular linear shadows which are of great clinical application value for determining the course of COVID-19 and disease management.

     

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