COVID-19不同时间段CT影像学动态变化及临床相关性

【摘要】 目的 探讨新型冠状病毒肺炎(COVID-19)不同时间阶段CT影像学动态变化特征及其临床相关性。方法 回顾性分析2020年1月至2月69例经核酸检查确诊的COVID-19患者的临床资料和CT平扫图像,最终入组60例,记录并分析患者不同阶段(1～4d、5～13d)的病变部位、分布、形态、数目、密度、细网格征、结节伴晕征、反晕征、支气管空气征、血管增粗征等影像特征的动态变化过程。结果 CT影像显示,疾病好发于左肺下叶、右肺下叶以及外带胸膜下,23.3%的患者累及5个肺叶,当疾病进展到第二阶段时,病灶进展迅速,病灶数量快速增加,且双肺受累患者明显增加,且50%的患者出现累及5个肺叶;在第一阶段病灶多沿支气管血管束生长,最常见的形态为小斑片状或条状影,大片状影相对较少,进展至第二阶段,病灶呈大片的患者数量明显增多,且实变病灶也显著增加;在第一阶段63.3%患者呈现细网格征,40%出现血管增粗征象,33.3%患者出现空气支气管征,进展至第二阶段后,发现患者细网格征和空气支气管征显著增多。进展至第三阶段时,81.6%的患者出现病灶吸收,病情逐渐恢复,但其中13.3%的患者变化不大,3例患者(5%)疾病进展为重型COVID-19肺炎,双肺弥漫性病变,呈“白肺“表现。结论 CT动态影像学征象可以准确反映病变演变及转归过程,客观评估病程进展,在新冠肺炎的病情监测、治疗和出院判断中起至关重要的作用。更多还原

【Abstract】 Objective To explore the dynamic changes of imaging features and clinical correlation of CT in different time stages of COVID-19.Methods 60 COVID-19 patients were retrospectively collected on January 7,2020 to February 21,2020 from three different hospitals in Lishui Central Hospital,Jinhua Central Hospital and Huanggang Central Hospital who were diagnosed by clinical nucleic acids,Finally,60 cases were enrolled in the group,and their clinical data and CT images at different stages(1～4 d,5～13 d) were record and analyzed,including lesion site,distribution,morphology,number,density,fine mesh sign,nodule with halo sign,anti-halo sign,bronchial air sign, vascular thickening sign.Results According to CT signs,the disease was found to occur in the left lower lobe,right lower lobe,and the outer pleura.23.3% of patients involved 5 lung lobes.When the disease progressed to the second stage,the lesions progressed rapidly and the number of lesions increased rapidly,and the number of patients with bilateral lung involvement increased significantly,and 50% of patients had 5 lobe involvement.In the first stage,the lesions mostly grow along the bronchial vascular bundle,and the most common form was small patchy or strip-shaped shadows,and relatively large patches were relatively small.When the disease progresses to the second stage,the number of patients with large lesions increases significantly,and consolidation lesions also increased significantly.In the first stage,63.3% of patients showed fine grid signs,40% showed signs of vascular thickening,and 33.3% of patients showed air bronchial signs.After progressing to the second stage,patients with fine grid signs and air bronchus signs were found to be significant increase.When the disease progressed to the third stage,the study found that 81.6% of patients had lesion absorption and gradually recovered,but 13.3% of them had little change,and 3 patients(5%) had disease progression to severe COVID-19 pneumonia.Diffuse lesions in the two lungs were "white lung".Conclusion The dynamic imaging signs of CT can accurately reflect the evolution and outcome of the lesion,and objectively evaluate the progress of the disease.It plays a vital role role in COVID-19’s condition monitoring,treatment and discharge judgment.更多还原