ISSN 1004-4140
CN 11-3017/P

COVID-19相关性血管异常的薄层CT特征分析

Analysis of Thin Slice Computed Tomography Features of Coronavirus Disease 2019 Related Vascular Abnormalities

  • 摘要: 目的:探讨胸部薄层CT平扫对新型冠状病毒感染(COVID-19)相关性血管异常的CT特征分析的临床价值。材料与方法:回顾性收集2022年12月5日至2022年12月17日北京世纪坛医院感染科确诊COVID-19且胸部薄层CT平扫图像显示有病变累及血管的患者73例,所有患者有完整的胸部薄层CT平扫资料和有较完整的临床资料。依据年龄>60岁和≤60岁将患者分为老年组和青壮年组,观察所有患者胸部影像学表现,并进行不同年龄组间统计学分析。结果:73例COVID-19患者中,青壮年组和老年组组间对比有统计学意义的影像学指标如下:病变分布中央血管周、病变大小10~30 mm、病变大小>30 mm、病变占肺叶体积百分比≤30%、病变占肺叶体积百分比>50%(白肺)、病变形态大片状、病变优势类型腺泡样、血管扭曲、血管周缘模糊、树芽征、粗大纤维索条。结论:①胸部薄层 CT平扫可明确COVID-19相关性血管异常的病变数量、位置、累及部位、范围、血管异常和病变类型,对COVID-19血管异常的定性诊断和鉴别诊断有一定的意义;②胸部薄层CT平扫检查对于发现临床症状不典型但有COVID-19累及血管的老年患者有重要意义;③COVID-19相关性“血管增粗”既可以是血管本身管径的增粗,也可以由血管周围间质炎性水肿造成。

     

    Abstract: Objective: This study aimed to explore the clinical value of thin slice computed tomography (CT) plain scan in the analysis of CT features of vascular abnormalities associated with coronavirus disease 2019 (COVID-19). Materials and methods: A total of 73 patients with COVID-19 confirmed by the Department of Infection of Beijing Shijitan Hospital from December 5, 2022 to December 17, 2022, were included in the study. Chest thin CT plain scan images showed that the lesions involved blood vessels were retrospectively collected. All patients had complete chest thin CT plain scan and relatively complete clinical data. According to age (>60 and ≤60 years), the patients were divided into the young and elderly groups. The chest imaging manifestations of all patients were observed and statistically analyzed between different age groups. Results: Among the 73 patients with COVID-19, the imaging indexes with statistical significance between the young and elderly groups were as follows: the distribution of the lesion around the central blood vessel, size of the lesion (10~30 mm), size of the lesion (>30 mm), percentage of the lesion to the volume of the lung lobe (≤30), percentage of the lesion to the volume of the lung lobe (>50) (white lung), shape of the lesion was large, the dominant type of the lesion was acinar, vascular distortion, vascular margin fuzzy, and tree-bud sign thick fiber rope. Conclusion: (1) Chest thin-slice CT plain scan can identify the number, location, involved location, scope, vascular abnormality, and pathological type of COVID-19-related vascular abnormality, which has certain significance for the qualitative and differential diagnosis of COVID-19 vascular abnormality. (2) The chest thin CT plain scan is of great significance for finding elderly patients with COVID-19 involving blood vessels. (3) COVID-19-related "blood vessel thickening" can be caused by either the diameter of the blood vessel itself or the inflammatory edema of the perivascular interstitium.

     

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