ISSN 1004-4140
CN 11-3017/P
陈辉, 张紫欣, 陈七一, 等. 新型冠状病毒奥密克戎变异株感染者胸部CT表现及动态变化[J]. CT理论与应用研究, 2023, 32(3): 313-322. DOI: 10.15953/j.ctta.2023.051.
引用本文: 陈辉, 张紫欣, 陈七一, 等. 新型冠状病毒奥密克戎变异株感染者胸部CT表现及动态变化[J]. CT理论与应用研究, 2023, 32(3): 313-322. DOI: 10.15953/j.ctta.2023.051.
CHEN H, ZHANG Z X, CHEN Q Y, et al. Imaging Features and Dynamic Changes of Chest Computed Tomography in Patients Infected with SARS-CoV-2 Omicron Variants[J]. CT Theory and Applications, 2023, 32(3): 313-322. DOI: 10.15953/j.ctta.2023.051. (in Chinese).
Citation: CHEN H, ZHANG Z X, CHEN Q Y, et al. Imaging Features and Dynamic Changes of Chest Computed Tomography in Patients Infected with SARS-CoV-2 Omicron Variants[J]. CT Theory and Applications, 2023, 32(3): 313-322. DOI: 10.15953/j.ctta.2023.051. (in Chinese).

新型冠状病毒奥密克戎变异株感染者胸部CT表现及动态变化

Imaging Features and Dynamic Changes of Chest Computed Tomography in Patients Infected with SARS-CoV-2 Omicron Variants

  • 摘要: 目的:探讨新型冠状病毒奥密克戎(Omicron)变异株感染者胸部CT表现及短期动态变化。方法:纳入2022年11月至2023年1月在首都医科大学附属北京地坛医院确诊的200例新型冠状病毒Omicron变异株感染者,根据临床分型分为轻型组、中型组和重型/危重型组,回顾性分析其临床、实验室和胸部CT资料。结果:200例新型冠状病毒Omicron变异株感染者中,临床表现以发热、咳嗽咳痰、咽痛、乏力为主。轻型组与中型组之间、轻型组与重型/危重型组之间外周血白细胞计数值比较差异有统计学意义。轻型组与中型组之间、轻型组与重型/危重型组之间红细胞沉降率值比较差异有统计学意义。轻型组病变以胸膜下分布为主(53.6%),中型组(77.9%)和重型/危重型组(88.9%)病变以混合型分布为主。铺路石征在轻型组和重型/危重型组之间、轻型组和中型组之间差异有统计学意义。支气管充气征在3组之间差异均有统计学意义。发病与首次胸部CT不同间隔时间内磨玻璃密度影(GGO)的出现频率均最高,间隔时间大于4 d的患者肺内GGO伴实变/实变、支气管充气征的比例逐渐增加。铺路石征在间隔时间5~9 d内出现比例最高(95.4%),之后比例下降。间隔时间≥14 d的患者肺内索条影出现频率、胸膜增厚及胸腔积液的比例增加。GGO、GGO伴铺路石征、GGO伴实变或实变和索条出现的中位时间为4 d(2 d,7 d)、9 d(7 d,11 d),13 d(10 d,16 d)和16 d(13 d,19 d)。结论:胸部CT能够反映新型冠状病毒Omicron变异株感染者病变分布、病变形态和动态影像发展和转归,有助于临床治疗决策的制定和疗效评价。

     

    Abstract: Objective: To investigate the chest computed tomography (CT) findings and dynamic changes in patients infected with SARS-CoV-2 Omicron variants. Methods: 200 patients infected with SARS-CoV-2 Omicron variants were collected in Beijing Ditan Hospital, Capital Medical University from November 2022 to January 2023. These patients were divided into mild group, moderate group and severe/critical group according to the clinical classification. All patients’ clinical, laboratory and chest CT data were retrospectively analyzed. Results: Among 200 cases infected with SARS-CoV-2 omicron variant, the main clinical manifestations were fever, cough, sore throat and fatigue. There was a statistically significant difference in white blood cell count between the mild group and the medium group, and between the mild group and the severe/critical group. There were significant differences in erythrocyte sedimentation rate between mild and moderate groups, and between mild and severe/critical groups. Most of the lesions in mild group were subpleural (53.6%), while most of the lesions in moderate group (77.9%) and severe/critical group (88.9%) were mixed. The crazy-paving sign was statistically significant between the mild and severe/critical groups, and between the mild and moderate groups. There were significant differences in air bronchogram sign between the mild and the severe/critical groups, the mild and severe/critical groups , and the mild and moderate groups. The frequency of Ground Glass Opacity (GGO) was the highest at different intervals between the onset and the first chest CT. The proportion of GGO with consolidation/consolidation and air bronchogram sign gradually increased when the interval was more than 4 days. The proportion of GGO with consolidation/consolidation and air bronchogram sign gradually increased when the interval was more than 4 days. The highest proportion (95.4%) of crazy-paving sign appeared within the interval of 5-9 days, after which the proportion decreased. The frequency of irregular linear opacities, the proportion of pleural thickening and pleural effusion increased in patients with an interval more than 14 days. The median times to occurrence of GGO, GGO with crazy-paving sign, GGO with consolidation or consolidation and irregular linear opacities respectively were 4 days (2 days, 7 days), 9 days (7 days, 11 days), 13 days (10 days, 16 days) and 16 days (13 days, 19 days). Conclusions: Chest CT can reflect the distribution, morphology, dynamic imaging development and outcome of lesions in patients infected with SARS-CoV-2 Omicron variant, which is helpful for clinical treatment decision-making and efficacy evaluation.

     

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