ISSN 1004-4140
CN 11-3017/P

新型冠状病毒肺炎临床与CT诊断特征的初步研究——东莞地区病例分析

The Initial Study of Clinical and CT Diagnostic Characteristics about Corona Virus Disease 2019: Case Review in Dongguan

  • 摘要: 目的:通过回顾性分析新型冠状病毒肺炎病例临床表现及胸部CT特点,旨在加深对该病的认识,并对疾病诊治起到一定的推动作用。方法:收集东莞市确诊新型冠状病毒肺炎病例70例。所有病例行血常规、C-反应蛋白检查,69例行胸部CT检查,层厚1.25 mm、层距1.25 mm。图像评价主要观察以下指标:肺内病灶部位与数量、分布、外部形态或形状、密度、内部特征、边缘、晕征以及肺外征象。结果:男性37例,女性33例,年龄平均(41.29±17.86)岁。首诊症状发热45例(占比64.29%),血常规提示白细胞总数正常或减低者67例(95.71%),淋巴细胞计数减低52例(74.29%),C-反应蛋白升高43例(61.43%)。胸部CT影像学表现:69例胸部CT检查中肺炎表现者55例,其中单肺病灶21例,双肺多发病灶34例。分布以外周胸膜下为主42例,病灶形态呈现多样性改变,可见片状或斑片状、结节状、条索状。病灶密度多不均匀。病灶边缘模糊者44例,出现晕征改变35例。55例均可见磨玻璃密度影改变,网格样改变37例。病灶内部支气管血管异常52例。胸膜异常改变38例。结论:新型冠状病毒肺炎的临床与CT表现具备一定的特征,结合流行病学史及CT的特征表现诊断不难,但是该病的特殊表现应予以重视并注意鉴别诊断。

     

    Abstract: Objective:The clinical and chest CT features of COVID-19 cases were analyzed retrospectively. To know more deeply about the disease and promote the diagnosis and treatment of the disease. Method:70 cases of COVID-19 in Dongguan were included. Of all cases, the routine blood test and C-reactive protein test were performed. 69 cases underwent chest CT examinations. The thickness and interval of CT examination were 1.25 mm. CT images were evaluated by the following indications:location and number, distribution, shape, density, internal characteristics, margin, halo sign of intra-pulmonary lesion and extra pulmonary signs. Results:There were 37 males and 33 females with an average age of(41.29 ±17.86) years. 45 cases(64.29%) had fever in the first visit, leukocyte count was normal or decreased in 67 cases(95.71%), lymphocyte count was decreased in 52 cases(74.29%), C-reactive protein value was increased in 43 cases(61.43%). Chest CT image findings:55 cases showed pneumonic imaging signs of all 69 patients underwent CT examinations, including 21 unilateral lung lesions and 34 bilatera multiple lesions. 42 cases were mainly distributed under the peripheral pleura, and the shape of the lesions showed various findings, including flaky or patchy exudation, nodular and stripe shaped lesions. The density of the lesions was nonuniform. 44 cases had indistinct edge and 35 cases had halo sign. In all 55 cases, ground-glass opacity lesions were showed. Reticular lesions were showed in 37 cases. There were 52 cases of abnormal bronchovascular bundles findings and 38 cases of abnormal pleural findings. Conclusion:The clinical and CT manifestations of COVID-19 have certain characteristics. It is not difficult to diagnose COVID-19 with the epidemiological history and CT feature. But the special manifestations and differential diagnosis of the disease should be given attention.

     

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