ISSN 1004-4140
CN 11-3017/P

糖尿病患者肺部新型冠状病毒感染HRCT特点

梁玉红, 钟溪溪, 姚新群, 黄诗淇, 骆丽安, 吕亚萍

梁玉红, 钟溪溪, 姚新群, 等. 糖尿病患者肺部新型冠状病毒感染HRCT特点[J]. CT理论与应用研究, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031.
引用本文: 梁玉红, 钟溪溪, 姚新群, 等. 糖尿病患者肺部新型冠状病毒感染HRCT特点[J]. CT理论与应用研究, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031.
LIANG Y H, ZHONG X X, YAO X Q, et al. High-resolution Computed Tomography (HRCT) Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients with Diabetes[J]. CT Theory and Applications, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031. (in Chinese).
Citation: LIANG Y H, ZHONG X X, YAO X Q, et al. High-resolution Computed Tomography (HRCT) Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients with Diabetes[J]. CT Theory and Applications, 2023, 32(5): 659-665. DOI: 10.15953/j.ctta.2023.031. (in Chinese).

糖尿病患者肺部新型冠状病毒感染HRCT特点

详细信息
    作者简介:

    梁玉红: 女,广西柳州市柳铁中心医院放射科住院医师,主要从事影像诊断工作,E-mail:236693938@qq.com

    通讯作者:

    吕亚萍: 女,广西柳州市柳铁中心医院放射科主任、主任医师,主要从事影像诊断工作,E-mail:13977287067@126.com

  • 中图分类号: R  814;R  563.1

High-resolution Computed Tomography (HRCT) Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients with Diabetes

  • 摘要: 目的:探讨糖尿病患者肺部新型冠状病毒感染(COVID-19)HRCT特点。材料与方法:收集2022年12月14日至2023年1月10日确诊COVID-19且胸部CT表现异常的患者584例,男359例、女225例,年龄范围60~99岁,平均年龄(76±9)岁。其中合并糖尿病225例,非糖尿病359例;比较糖尿病患者COVID-19胸部HRCT与非糖尿病患者COVID-19胸部HRCT表现不同;定义发病与CT检查时间间隔<7d为急性期,363例入组患者,分析急性期糖尿病组与非糖尿病组新型冠状病毒肺炎(COVID-19)HRCT特点。结果:糖尿病患者COVID-19胸部感染与非糖尿病患者COVID-19胸部感染两组肺内病变在发病部位、分布、形态及伴随征象差异无统计学意义。两组病变在密度(细网格、病变密度不均匀)及病变边缘(病变边缘模糊)差异有统计学意义。无糖尿病组的肺部影像网格、不均匀和模糊征象显著高于有糖尿病组。其中细网格影:糖尿病组54例(24%),非糖尿病组127例(35.38%);密度不均匀:糖尿病组181例(80.44%),非糖尿病组313例(87.19%);边缘模糊:糖尿病组205例(91.11%),非糖尿病组344(95.82%)。急性期糖尿病组患者肺内网格影明显少于非糖尿病组患者,糖尿病组35例(24.65%),非糖尿病组82例(37.10%),差异有统计学意义。结论:糖尿病患者肺部新型冠状病毒感染(COVID-19)胸部HRCT病变渗出为主、密度均匀、边缘清晰,较非糖尿病组间质改变不明显。
    Abstract: Objective: To explore the characteristics of high-resolution computed tomography (HRCT) in diabetes complicated with coronavirus disease 2019 (COVID-19)-associated pneumonia. Materials and Methods: This study included 584 patients (359 males and 225 females), aged between 60~99 years old (mean, (76±9) years), with positive chest computed tomography (CT) findings and diagnosed with COVID-19 in our hospital from December 14, 2022, to January 10, 2023. Of these, 225 patients were diabetic and 359 were non-diabetic. The features of the chest HRCT from patients with diabetes mellitus complicated with COVID-19 and those without diabetes mellitus complicated with COVID-19 were compared. Moreover, 363 patients in the acute stage of COVID-19 (defined as the time interval between onset and CT examination <7 days) were selected for subgroup analysis, and the HRCT characteristics of COVID-19 between the diabetes group and the non-diabetic group in the acute stage. Results: The location, distribution, morphology, and concomitant signs of pulmonary lesions between the two groups of patients with COVID-19 did not differ significantly. Conversely, statistically significant differences in density (fine mesh, uneven density) and lesion margin (fuzzy lesion margin) were detected. In particular, the grid, uneven, and fuzzy signs on lung imaging were significantly higher in the non-diabetic group than that in the diabetic group. Additionally, 54 patients (24%) in the diabetic group and 127 patients (35.38%) in the non-diabetic group demonstrated fine mesh shadows. There were 181 patients (80.44%) in the diabetic group and 313 patients (87.19%) in the non-diabetic group with uneven density. Furthermore, 205 patients (91.11%) in the diabetic group and 344 patients (95.82%) in the non-diabetic group had blurred edges. There was significantly less pulmonary grid shadowing in the acute subgroup with diabetes (35, 24.65%) than in the acute subgroup without diabetes (82, 37.10%). Conclusion: The features of chest HRCT in patients with diabetes mellitus and COVID-19 are mainly exudation, uniform density, and a clear edge, while the interstitial changes are not obvious compared with patients in the non-diabetic group.
  • 新型冠状病毒感染(COVID-19)具有较强传染性[1],根据《新型冠状病毒感染诊疗方案(试行第十版)》,将有心血管疾病(含高血压)、慢性肺疾病病、糖尿病、慢性肝病、肾脏疾病、肿瘤等基础病者定义为重型/危重型高危人群[2]

    本文回顾分析柳州市柳铁中心医院收治COVID-19患者584例,其中糖尿病患者肺部COVID-19 225例;无糖尿病患者感染COVID-19 359例,比较两组COVID-19胸部高分辨CT表现特点;定义发病与CT检查间隔7 d为急性期,分析糖尿病患者合并COVID-19感染急性期肺部影像特点。提高糖尿病者感染COVID-19影像学认识,进一步为临床诊断提供依据并改善预后。

    收集2022年12月14日至2023年1月10日期间在柳州市柳铁中心医院以上呼吸道感染就医患者2679例,其中胸部CT表现阳性且抗原或核酸检测阳性的患者1099例,排除图像伪影较重者;无空腹血糖或糖化血红蛋白者;最终纳入584例患者,其中男性359例,女性225例,年龄范围60~99岁,平均年龄(76±9)岁;无糖尿病患者359例;糖尿病患者225例,糖尿病病史不等,本组病例中以病史10年以上者多见,糖尿病病史10年以上102人;225例患者住院期间糖化血红蛋白HbA1c>6.5%。

    本研究经柳州市柳铁中心医院伦理委员会批准,同意开展本项研究(意见号KY2023-056-01),且本研究不需要患者知情。

    采用西门子drive扫描仪,患者仰卧位,头先进或足先进,吸气后屏气,扫描范围从肺尖到膈顶。扫描参数:管电压120 kV,管电流80~120 mA,层间距0.625 mm,层厚1 mm。图像采用高分辨算法重建。

    有两名主治及以上放射科诊断医师独立完成,并由1名主任医师审核,在PACS工作站上分别选择肺窗(窗宽和窗位为1600和 -600),纵隔窗(窗宽和窗位为350和45)观察并分析图像。

    具体指标包括:①病变分布:单叶、单肺和双肺;②病变部位:周围(即胸膜下)、中央(沿支气管血管束)及混合;③病变形态:结节(1 cm以内)、斑片(3 cm)、大片(大于3 cm);④病变密度:磨玻璃样、网格状、实变、混合型、病变密度均匀、不均匀;⑤病变边缘:模糊、清晰;⑥伴随病变:膜增厚、胸腔积液。

    采用SPSS 21.0软件,根据患者有无糖尿病将患者分为两组,比较两组患者相关的HRCT表现特征。定义发病与CT检查时间间隔<7 d为急性期,分析急性期糖尿病合并COVID-19与非糖尿病合并COVID-19两组患者HRCT表现特征。

    组间计数资料统计采用分类变量的卡方检验,定量数据进行独立样本t检验,P<0.05表示差异有统计学意义。

    糖尿病患者感染COVID-19与非糖尿病患者感染COVID-19两组患者肺部病变密度(网格、密度不均匀)、边缘(病灶边缘模糊)比较差异均有统计学意义,糖尿病组肺内病灶实变多见,且病灶密度均匀且边缘清晰(图1图2)。两组病变在发病部位、分布、形态及伴随征象差异无统计学意义;急性期肺内病变在糖尿病患者肺部COVID-19与非糖尿病患者肺部COVID-19两组患者肺部HRCT表现比较,网格影在急性期非糖尿病组患者中更多见。两组具体影像学征象对照及比较结果详见表1表2表3

    图  1  男性,63岁,发热3 d,无糖尿病,HRCT显示双肺外周胸膜下GGO,密度不均匀,部分病灶边缘模糊
    Figure  1.  A 63-year-old man, a patient without diabetes mellitus, presented with a fever for 3 days, HRCT demonstrates peripheral subpleural ground glass opacities (GGO) in both lungs, with some lesions showing uneven density and blurred edges
    图  2  女,65岁,糖尿病病史9年,餐后血糖控制不佳,咳嗽3 d肺内多发实变样,病变边缘清晰
    Figure  2.  A 65-year-old female with a history of diabetes for 9 years and elevated blood sugar after meals, presented with a cough for 3 days. HRCT shows multiple lung lesions with clear lesion edges
    表  1  有无糖尿病两组患者的HRCT表现特征一览表
    Table  1.  HRCT features in patients with and without diabetes mellitus
    项目组别统计检验
    无糖尿病/例(%)有糖尿病/例(%)$\chi^2 $P
    病变数量 多发359(100.00)224(99.50)1.5900.206
    累及部位 单叶3(0.84)0(0.00)1.8900.169
     单肺7(1.95)2(0.89)1.0260.311
     双肺351(97.77)220(97.78)0.0000.996
    病变分布 周围(胸膜下)114(31.75)83(36.89)1.6310.202
     中央(血管周)6(1.67)6(2.67)0.6810.409
     混合性239(66.57)137(60.89)1.9490.163
    病变形态 结节(1 cm)159(44.29)109(48.44)0.9620.327
     斑片状(3 cm)275(76.60)178(79.11)0.5010.479
     大片状(>3 cm)240(66.85)149(66.22)0.0250.875
    病变密度 GGO314(87.47)189(84.00)1.3900.238
     实变41(11.42)37(16.44)3.0170.082
     网格影127(35.38)54(24.00)8.3690.004**
     不均匀313(87.19)181(80.44)4.8230.028**
     均匀77(21.45)59(26.22)1.7640.184
    病变边缘 模糊344(95.82)205(91.11)5.4480.020*
     清晰19(5.29)18(8.00)1.7090.191
    伴随病变 血管增粗26(7.24)25(11.11)2.5970.107
     胸膜增厚203(56.55)130(57.78)0.0860.770
     胸水形成54(15.04)27(12.00)1.0710.301
    注:*-P<0.05,**-P<0.01。
    下载: 导出CSV 
    | 显示表格
    表  2  COVID-19急性期糖尿病患者与非糖尿病患者的临床信息
    Table  2.  Clinical information on patients with and without diabetes in the acute phase of COVID-19
    项目组别统计检验
    无糖尿病(n=221)有糖尿病(n=142)tP
    发病时间/d 4.74±2.12 4.45±2.281.2110.227
    年龄   78.00±9.3775.85±8.632.2030.028*
    注:急性期定义为发病时间<7 d。*-P<0.05。
    下载: 导出CSV 
    | 显示表格
    表  3  COVID-19急性期糖尿病患者与非糖尿病患者的HRCT特征一览表
    Table  3.  HRCT characteristics in patients with and without diabetes in the acute phase of COVID-19
    项目特征组别统计检验
    无糖尿病(n=221)
    /
    例(%)
    有糖尿病(n=142)
    /
    例(%)
    $\chi^2 $P
    病变数量  多发221(100.00)141(99.50)1.5900.206
    累及部位  单肺6(2.71)2(1.41)0.6850.408
      双肺214(96.83)138(97.18)0.0360.849
    病变分布  周围(胸膜下)65(29.41)49(34.51)1.0420.307
      中央(血管周)5(2.26)5(3.52)0.5110.475
      混合性153(69.23)90(63.38)1.3770.248
    病变形态  结节/树丫(1 cm)86(38.91)63(44.37)1.0620.303
      斑片状(3 cm)161(72.85)110(77.46)0.9730.324
      大片状(>3 cm)157(71.04)100(70.42)0.0160.899
    病变密度  GGO190(85.97)121(85.21)0.0410.840
      实变30(13.57)28(19.72)2.4310.119
      网格影82(37.10)35(24.65)6.1410.013*
      不均匀188(85.07)117(82.39)0.4600.497
      均匀49(22.17)38(26.76)0.9990.318
    病变边缘  模糊212(95.93)130(91.55)3.0410.081
      清晰11(4.98)11(7.75)1.1640.281
    伴随病变  血管增粗17(7.69)18(12.68)2.4650.116
      胸膜增厚129(58.37)85(59.86)0.0790.779
      胸水形成35(15.84)20(14.08)0.2070.649
    注:*-P<0.05。
    下载: 导出CSV 
    | 显示表格

    COVID-19是一种基因组结构不同于其他呼吸道病毒且侵袭性和传播性较强的β属特殊毒株,通过S蛋白与人血管紧张素转化酶-2(ACE2)互相作用感染人呼吸道黏膜上皮细胞、Ⅱ型肺泡上皮细胞和肺间质以及微血管血栓形成和多系统脏器受累等改变[3-4]。人群普遍易感,重型及危重型多见于合并基础病者如糖尿病。COVID-19感染主要依靠病毒核酸检测确诊,核酸检测存在时间长和假阴性,HRCT有助于提高COVID-19的检出率和诊断准确率[5],部分患者核酸阴性影像却具有典型病毒性肺炎征象,国家卫生健康委员会《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》中[6],将CT表现纳入临床诊断依据。

    本研究分析了584例新型冠状病毒感染(COVID-19)HRCT表现阳性的患者,统计结果显示多数影像学征象与文献一致[3-4,7-16]。225例糖尿病患者新型冠状病毒感染后双肺HRCT表现在发病部位、分布、形态及伴随征象与常规人群感染COVID-19无明显差异,均表现为双肺多发、周围(胸膜下)分布为主的结节、斑片及大片磨玻璃及实变影;病变密度均匀与否及病变边缘改变差异有统计学意义;发病与CT检查间隔小于7 d分组,糖尿病组患者COVID-19和非糖尿病组患者COVID-19之间,病变密度网格影改变差异有统计学意义。病变的HRCT征象如密度、形态和边缘因其病理特征和病变程度的不同多呈现不均匀磨玻璃、实变影及网格影,边缘多表现为模糊。

    本研究结果显示糖尿病组患者COVID-19肺炎早期病变即出现密度均匀和病变边缘清晰的表现,文献报道较少。尸体解剖证实COVID-19主要是引起深部气道、间质和肺泡损伤为特征的炎性反应[17],糖尿病患者COVID-19感染肺部病变HRCT显示网格影少于非糖尿病组,说明糖尿病患者感染COVID-19时肺泡渗出为主,间质受累少见,有研究显示小叶内间隔增厚是COVID-19肺炎的独立预测因子之一[18-19],而糖尿病合并COVID-19感染,肺内网格影少见,这可能与糖尿病患者自身免疫有关。渗出为主是否是糖尿病患者易发生重症原因,需要进一步研究证实。

    总之,糖尿病患者合并COVID-19肺炎,HRCT表现双肺多发,周围分布为主,渗出为主,网格影少见,病变密度均匀、病变边缘相对清晰。合并或者不合并胸膜改变。基础病是COVID-19感染后发生重症的主要原因之一,熟悉糖尿病患者合并COVID-19肺炎HRCT征象,为临床治疗及评估预后提供依据。

    本研究的局限在性,两组病例未纳入临床指标及氧饱和度与患者影像改变进行相关性分析;糖尿病组患者病史长短及血糖控制情况感染后机体反应是否存在差异;此外糖尿病往往合并心脑血管病变,并发症有无是否与肺内病灶改变及预后的研究尚需进一步研究。

  • 图  1   男性,63岁,发热3 d,无糖尿病,HRCT显示双肺外周胸膜下GGO,密度不均匀,部分病灶边缘模糊

    Figure  1.   A 63-year-old man, a patient without diabetes mellitus, presented with a fever for 3 days, HRCT demonstrates peripheral subpleural ground glass opacities (GGO) in both lungs, with some lesions showing uneven density and blurred edges

    图  2   女,65岁,糖尿病病史9年,餐后血糖控制不佳,咳嗽3 d肺内多发实变样,病变边缘清晰

    Figure  2.   A 65-year-old female with a history of diabetes for 9 years and elevated blood sugar after meals, presented with a cough for 3 days. HRCT shows multiple lung lesions with clear lesion edges

    表  1   有无糖尿病两组患者的HRCT表现特征一览表

    Table  1   HRCT features in patients with and without diabetes mellitus

    项目组别统计检验
    无糖尿病/例(%)有糖尿病/例(%)$\chi^2 $P
    病变数量 多发359(100.00)224(99.50)1.5900.206
    累及部位 单叶3(0.84)0(0.00)1.8900.169
     单肺7(1.95)2(0.89)1.0260.311
     双肺351(97.77)220(97.78)0.0000.996
    病变分布 周围(胸膜下)114(31.75)83(36.89)1.6310.202
     中央(血管周)6(1.67)6(2.67)0.6810.409
     混合性239(66.57)137(60.89)1.9490.163
    病变形态 结节(1 cm)159(44.29)109(48.44)0.9620.327
     斑片状(3 cm)275(76.60)178(79.11)0.5010.479
     大片状(>3 cm)240(66.85)149(66.22)0.0250.875
    病变密度 GGO314(87.47)189(84.00)1.3900.238
     实变41(11.42)37(16.44)3.0170.082
     网格影127(35.38)54(24.00)8.3690.004**
     不均匀313(87.19)181(80.44)4.8230.028**
     均匀77(21.45)59(26.22)1.7640.184
    病变边缘 模糊344(95.82)205(91.11)5.4480.020*
     清晰19(5.29)18(8.00)1.7090.191
    伴随病变 血管增粗26(7.24)25(11.11)2.5970.107
     胸膜增厚203(56.55)130(57.78)0.0860.770
     胸水形成54(15.04)27(12.00)1.0710.301
    注:*-P<0.05,**-P<0.01。
    下载: 导出CSV

    表  2   COVID-19急性期糖尿病患者与非糖尿病患者的临床信息

    Table  2   Clinical information on patients with and without diabetes in the acute phase of COVID-19

    项目组别统计检验
    无糖尿病(n=221)有糖尿病(n=142)tP
    发病时间/d 4.74±2.12 4.45±2.281.2110.227
    年龄   78.00±9.3775.85±8.632.2030.028*
    注:急性期定义为发病时间<7 d。*-P<0.05。
    下载: 导出CSV

    表  3   COVID-19急性期糖尿病患者与非糖尿病患者的HRCT特征一览表

    Table  3   HRCT characteristics in patients with and without diabetes in the acute phase of COVID-19

    项目特征组别统计检验
    无糖尿病(n=221)
    /
    例(%)
    有糖尿病(n=142)
    /
    例(%)
    $\chi^2 $P
    病变数量  多发221(100.00)141(99.50)1.5900.206
    累及部位  单肺6(2.71)2(1.41)0.6850.408
      双肺214(96.83)138(97.18)0.0360.849
    病变分布  周围(胸膜下)65(29.41)49(34.51)1.0420.307
      中央(血管周)5(2.26)5(3.52)0.5110.475
      混合性153(69.23)90(63.38)1.3770.248
    病变形态  结节/树丫(1 cm)86(38.91)63(44.37)1.0620.303
      斑片状(3 cm)161(72.85)110(77.46)0.9730.324
      大片状(>3 cm)157(71.04)100(70.42)0.0160.899
    病变密度  GGO190(85.97)121(85.21)0.0410.840
      实变30(13.57)28(19.72)2.4310.119
      网格影82(37.10)35(24.65)6.1410.013*
      不均匀188(85.07)117(82.39)0.4600.497
      均匀49(22.17)38(26.76)0.9990.318
    病变边缘  模糊212(95.93)130(91.55)3.0410.081
      清晰11(4.98)11(7.75)1.1640.281
    伴随病变  血管增粗17(7.69)18(12.68)2.4650.116
      胸膜增厚129(58.37)85(59.86)0.0790.779
      胸水形成35(15.84)20(14.08)0.2070.649
    注:*-P<0.05。
    下载: 导出CSV
  • [1]

    ZHU N, ZHANG D Y, WANG W L, et al. A novel coronavirus from patients with pneumonia in China, 2019[J]. The New England Journal of Medicine, 2020, 382(8): 727−733. doi: 10.1056/NEJMoa2001017

    [2] 国家卫生健康委办公厅, 国家中医药局综合司. 《新型冠状病毒感染诊疗方案(试行第十版)》[EB/OL].(2023-01-05)[2023-01-06]. http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a/files/02ec13aadff048ffae227593a6363ee8.pdf.
    [3]

    WU R, GUAN W, GAO Z, et al. The arch bridge sign: A newly described CT feature of the coronavirus disease-19 (COVID-19) pneumonia[J]. Quantitative Imaging in Medicine And Surgery 2020, 10(7): 1551-1558.

    [4]

    YOON S H, LEE J H, KIM B N. Chest CT findings in hospitalized patients with SARS-CoV-2: Delta versus Omicron variants[J]. Radiology, 2023, 306(1): 252−260. doi: 10.1148/radiol.220676

    [5] 郑颖彦, 马昕, 王慧英, 等. 新型冠状病毒肺炎的薄层高分辨率计算机断层扫描征象[J]. 上海医学, 2020,43(5): 261−265.

    ZHENG Y Y, MA X, WANG H Y, et al. Thin high-resolution computed tomography findings of novel coronavirus pneumonia[J]. Shanghai Medical Science, 2020, 43(5): 261−265. (in Chinese).

    [6] 国家卫生健康委办公厅, 国家中医药管理局办公室. 《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》[EB/OL]. (2020-02-05) [2020-02-10]. http://bgs.satcm.gov.cn/zhengcewenjian/2020-02-06/12847.html.
    [7]

    LIU Y, ZHOU X, LIU X, et al. Systematic review and meta-analysis of the CT imaging characteristics of infectious pneumonia[J]. Annals of Palliative Medicine, 2021, 10(10): 10414−10424. doi: 10.21037/apm-21-2101

    [8]

    TANG Y, LIAO H, WU Q, et al. Chest CT imaging characteristics and their evolution of 48 patients with COVID-19 in Hengyang, China[J]. American Journal of Translational Research, 2021, 13(9): 9983−9992.

    [9]

    PAKDEMIRLI E, MANDALIA U, MONIB S. Characteristics of chest CT images in patients with COVID-19 pneumonia in London, UK[J]. Cureus, 2020, 12(9): e10289.

    [10]

    MARCHIORI E, NOBRE L F, HOCHHEGGER B, et al. CT characteristics of COVID-19: Reversed halo sign or target sign?[J]. Diagnostic and Interventional Radiology, 2021, 27(2): 306−307. doi: 10.5152/dir.2020.20734

    [11]

    HUANG C, WANG Y, LI X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223): 497−506. doi: 10.1016/S0140-6736(20)30183-5

    [12] 黄益龙, 张振光, 李翔, 等. CT影像组学联合征象鉴别新型冠状病毒肺炎与其他病毒性肺炎的价值[J]. 中华放射学杂志, 2022,56(1): 36−42. doi: 10.3760/cma.j.cn112149-20201220-01318

    HUANG Y L, ZHANG Z G, LI X, et al. Value of CT imaging combined signs in distinguishing novel coronavirus pneumonia from other viral pneumonia[J]. Chinese Journal of Radiology, 2022, 56(1): 36−42. (in Chinese). doi: 10.3760/cma.j.cn112149-20201220-01318

    [13] 赵小二, 邓克学, 王朋. 不同阶段新型冠状病毒肺炎的CT影像演变分析[J]. 实用放射学杂志, 2021,37(8): 1254−1257. doi: 10.3969/j.issn.1002-1671.2021.08.008

    ZHAO X E, DENG K X, WANG P. CT imaging evolution analysis of novel coronavirus pneumonia at different stages[J]. Journal of Practical Radiology, 2021, 37(8): 1254−1257. (in Chinese). doi: 10.3969/j.issn.1002-1671.2021.08.008

    [14] 李声鸿, 曾献军, 鄢海蓝, 等. 新型冠状病毒肺炎薄层CT评价[J]. 实用放射学杂志, 37(7): 1074-1076, 1130.

    LI S H, ZENG X J, YAN H L, et al. Thin-slice CT evaluation of novel coronavirus pneumonia[J]. Journal of Practical Radiology, 37(7): 1074-1076, 1130. (in Chinese).

    [15] 张庆, 熊浩, 彭婕, 等. 胸部CT对新型冠状病毒肺炎的诊断价值[J]. 中国医学影像学杂志, 2020, 28(12): 896-898.

    ZHANG Q, XIONG H, PENG J, et al. Diagnostic value of chest CT in the diagnosis of novel coronavirus pneumonia[J]. Chinese Journal of Medical Imaging, 2020, 28(12): 896-898. (in Chinese).

    [16] 纪丙军, 齐庆梅, 王聪, 等. 新型冠状病毒肺炎与其他社区获得性肺炎不同病期的CT表现及动态分析[J]. 实用放射学杂志, 2021, 37(8): 1266-1270.

    JI B J, QI Q M, WANG C, et al. CT findings and dynamic analysis of novel coronavirus pneumonia and other community-acquired pneumonia at different stages[J]. Journal of Applied Radiology, 2021, 37(8): 1266-1270. (in Chinese).

    [17] 刘茜, 王荣帅, 屈国强, 等. 新型冠状病毒肺炎死亡尸体系统解剖大体观察报告[J]. 法医学杂志, 2020,36(1): 1−3. DOI: 10.12116/j.issn.1004-5619.2020.01.00.

    LIU Q, WANG R S, QU G Q, et al. A report on the general observation of the systematic autopsy of the deceased from novel coronavirus pneumonia[J]. Journal of Forensic Medicine, 2020, 36(1): 1−3. DOI: 10.12116/j.issn.1004-5619.2020.01.00. (in Chinese).

    [18]

    SHI H, HAN X, JIANG N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: A descriptive study[J]. Lancet Infectious Diseases, 2020, 20(4): 425−434. DOI: 10.1016/S1473-3099(20)30086-4.

    [19]

    TANG X, DU R H, WANG R, et al. Comparison of hospitalized patients with ARDS caused by COVID-19 and H1N1[J]. Chest, 2020, 158(1): 195−205. DOI: 10.1016/J.chest.2020.03.032.

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出版历程
  • 收稿日期:  2023-02-28
  • 修回日期:  2023-04-26
  • 录用日期:  2023-04-27
  • 网络出版日期:  2023-05-30
  • 发布日期:  2023-09-21

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