ISSN 1004-4140
CN 11-3017/P

早期新型冠状病毒肺炎的胸部薄层平扫CT表现特征

Imaging Features of Early COVID-19 on Chest Thin-slice Non-Enhanced CT

  • 摘要: 目的:探讨早期新型冠状病毒肺炎(COVID-19)的胸部薄层平扫CT表现特征。材料与方法:收集2022年11月至12月我院感染科确诊COVID-19且胸部CT表现阳性的患者153例,所有患者自发病后1~14天行胸部薄层平扫CT检查和有较完整的临床资料。根据患者年龄(≤60岁和>60岁)和发病与CT检查的时间间隔(≤7天和>7天)将患者各分为两组,比较两组患者的CT表现特征的差异性。结果:153例COVID-19患者中,累及肺部(100%)、血管(93.5%)、气道(73.4%)和胸膜(70.1%),其中年龄组间的对比显示病变数量、部位、大小、容积和束带影的差异有统计学意义;发病与CT检查时间间隔分组患者之间,病变的形态、密度、机化和纤维化以及胸膜受累等差异有统计学意义。结论:胸部薄层平扫CT可明确早期COVID-19的病变位置和范围,对COVID-19的定性诊断和鉴别有一定的特征,即以形态的多样化、胸膜内和血管周分布、肺泡为单元的间质性病变、早期混合性磨玻璃影常伴明显的机化和纤维化、胸膜局限性增厚而胸水极少等有助于COVID-19的诊断和鉴别。

     

    Abstract: Objective: To explore the characteristics findings of early COVID-19 on chest thin-slice non-enhanced CT. Materials and methods: From November to December 2022, data from 153 patients with COVID-19 with positive chest CT findings confirmed by the Department of Infectious Diseases of our hospital were collected. All patients had relatively complete clinical data and underwent chest CT 1-14 days after the onset. The patients were divided into two groups according to their age (≤60 years old and >60 years old) and the time interval between the onset and CT examination (≤7 days old and >7 days old), and the differences in CT features between the two groups were compared. Result: Among 153 patients with COVID-19, the lung (100%), blood vessels (93.5%), airways (73.4%), and pleura (70.1%) were involved. The comparison between the age groups showed statistically significant differences in the number, location, size, volume, and band shadow of the lesions. There were statistically significant differences in the shape, density, organization, fibrosis, and pleural involvement of the lesions between the patients in the time interval between the onset and CT examination. Conclusion: Chest thin-slice CT can clarify the location and scope of early COVID-19. Some characteristics findings can help for accurate diagnosis and differentiation, such as the diversity of morphology, intrapleural and perivascular distribution, interstitial lesions with alveoli as a unit, early mixed ground-glass shadow often accompanied by obvious organization and fibrosis, localized thickening of the pleura, and few pleural effusions.

     

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