ISSN 1004-4140
CN 11-3017/P
范巍, 韩宗宝, 段永利, 等. 数字床旁胸部摄影和胸部CT扫描在重症新型冠状病毒肺炎诊断中的价值探讨[J]. CT理论与应用研究, 2023, 32(3): 403-410. DOI: 10.15953/j.ctta.2023.064.
引用本文: 范巍, 韩宗宝, 段永利, 等. 数字床旁胸部摄影和胸部CT扫描在重症新型冠状病毒肺炎诊断中的价值探讨[J]. CT理论与应用研究, 2023, 32(3): 403-410. DOI: 10.15953/j.ctta.2023.064.
FAN W, HAN Z B, DUAN Y L, et al. The Value of Digital DR Bedside Chest Radiography and Chest CT Scanning in the Diagnosis of Severe Novel Coronavirus Pneumonia[J]. CT Theory and Applications, 2023, 32(3): 403-410. DOI: 10.15953/j.ctta.2023.064. (in Chinese).
Citation: FAN W, HAN Z B, DUAN Y L, et al. The Value of Digital DR Bedside Chest Radiography and Chest CT Scanning in the Diagnosis of Severe Novel Coronavirus Pneumonia[J]. CT Theory and Applications, 2023, 32(3): 403-410. DOI: 10.15953/j.ctta.2023.064. (in Chinese).

数字床旁胸部摄影和胸部CT扫描在重症新型冠状病毒肺炎诊断中的价值探讨

The Value of Digital DR Bedside Chest Radiography and Chest CT Scanning in the Diagnosis of Severe Novel Coronavirus Pneumonia

  • 摘要: 目的:探讨数字床旁胸部摄影(简称床旁胸片)与胸部CT扫描在重症新型冠状病毒肺炎中的影像学表现和临床诊断中的应用价值。方法:回顾性调取分析2022年12月10日至2023年1月10日首都医科大学附属北京世纪坛医院确诊收治的43例新型冠状病毒肺炎患者的影像学与临床资料;依据实验室诊断和临床划分新冠肺炎的标准,多学科专家联合诊断,入组43例患者均为重症新型冠状病毒肺炎感染患者;43例患者均进行床旁胸片摄影,其中6例患者在症状相对平缓的前提下进行胸部CT扫描;床旁胸片复查时间间隔1~5 d,复查次数1~4次;胸部CT扫描复查时间间隔1~4 d,复查次数2次;观察分析受检者胸片和胸部CT扫描的影像学图像表现。结果:43例重症新型冠状病毒肺炎患者首次床旁胸片示双肺斑片状实变影并累计两个肺野以上者25例,双肺胸腔积液6例,单侧肺部渗出实变影18例,单侧胸腔积液4例,心外形增大合并肺水肿7例,疑似肺内肿瘤团块影2例;6例接受胸部CT扫描患者双肺多发磨玻璃影6例,斑片影,网格状影,叶间隔增厚,病变区域内可见肺血管及亚支气管增粗;复查床旁胸片双肺斑片密度增高影面积扩大5例,新增胸腔积液2例;复查胸部CT扫描示磨玻璃影增多转变为不规则斑片状高密度影4例,新增肺不张1例,新增胸腔积液1例。结论:床旁胸片和胸部CT扫描是诊断新型冠状病毒肺炎首要的影像学检查手段,前者在重症患者不能进行胸部CT扫描时起到重要的辅助诊断作用,在后期复查和临床随访病情中提供较大帮助。

     

    Abstract: Objective: To investigate the applicability of DR Bedside chest radiography and chest computed tomography (CT) scanning for the imaging and clinical diagnosis of severe novel coronavirus pneumonia. Methods: Imaging and clinical data of 43 patients with novel coronavirus pneumonia who were admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from December 10, 2022 to January 10, 2023 were retrospectively analyzed. Joint diagnoses by multidisciplinary experts according to the clinical and laboratory diagnosis criteria confirmed that all the 43 enrolled patients were severely infected with novel coronavirus pneumonia. All 43 patients underwent digital DR Bedside chest radiography; of these, 6 patients underwent chest CT scanning as they had relatively mild symptoms. The time interval for chest X-ray reexamination was 1~5 days, with 1~4 reexaminations. The chest CT scan review interval was 1~4 days, with 2 reviews. The imaging findings of chest radiography and chest CT scanning were observed and analyzed. Results: Among 43 patients with severe novel coronavirus pneumonia, 25 cases showed the first digital DR Bedside chest radiographs showing plaques and solid shadows in both lungs, 6 cases of pleural effusion in both lungs, 18 cases of unilateral lung exudation and solid shadows, 4 cases of unilateral pleural effusion, 7 cases of cardiac enlargement combined with pulmonary edema, and 2 cases of suspected pulmonary tumor mass shadows. There were multiple ground glass shadows in both lungs in 6 patients who underwent chest CT scanning. Spot shadows, grid shadows, thickened interlobular septum, and thickened pulmonary vessels and subbronchus were identified in the lesion area. Double lung spot density increased in the chest radiographs; the shadow area expanded in 5 cases and pleural effusion increased in 2 cases. Reexamination of chest CT images showed that 4 cases of increased ground-glass shadow transformed into irregular patchy high CT value shadow, 1 case of new atelectasis and 1 case of new pleural effusion. Conclusion: Digital DR Bedside chest radiography and chest CT scanning are the primary imaging methods for the diagnosis of novel coronavirus pneumonia. In particular, the former plays an important auxiliary diagnostic role when chest CT scan cannot be performed in patients with severe disease, and can greatly assist in the later review and clinical evaluation of the disease during active treatment.

     

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