【摘要】 目的探讨低剂量CT复查在新型冠状病毒肺炎病情监测中的应用价值。方法选取42例新型冠状病毒肺炎患者治疗后采取低剂量CT复查并与首诊常规剂量CT对比,分析病变影像学变化并进行影像评估。结果 1)首次低剂量CT复查显示4例首诊CT阴性患者仍为阴性表现。首诊CT检查阳性患者中磨玻璃影最常见(38/38),其次为实变(25/38)、纤维条索(17/38),典型影像学特征包括病变内血管增粗(31/38)、"支气管充气征"(23/38)、"铺路石征"(14/38)。低剂量CT复查对磨玻璃影、实变及纤维条索均清晰显示,与首诊常规剂量CT检查对比,二者于同层面具有较好的可对比性。38例阳性患者磨玻璃影均仍可见,26例病灶范围缩小,5例变化不明显,7例范围增大,5例内部新增实变。25例首诊实变者复查范围出现变化,其中17例范围缩小或内部密度减低,余变化不明显或范围增大。新型冠状病毒肺炎的一些典型影像学特征如病变内血管增粗、"铺路石征"、"支气管充气征"等亦可显示,由于患者入院治疗后病情变化较快,相关影像学特征显示呈下降趋势;2)首次低剂量CT复查影像评估好转30例,无明显变化5例,进展7例。统计学分析显示有无基础病/手术史、临床分型为其影响因素(P<0.05)。结论新型冠状病毒肺炎患者短期内影像变化较快,低剂量CT与常规剂量CT检查相比在病变显示方面一致性较好,在保证图像质量的同时,能有效的减低患者所受的辐射伤害。更多还原

【Abstract】 Objective This study aims to analyze the novel coronavirus COVID-19 pneumonia clinical prognosis in Cangzhou area, and to explore the application value of low dose CT in the monitoring and evaluation of patients’ condition. Methods 42 patients with novel coronavirus pneumonia were treated with low-dose CT and compared with the first routine dose CT. The imaging changes were analyzed and the clinical therapeutic effects were evaluated. Results 1) 42 patients were divided into 4 light patients, 30 ordinary patients, 5 severe patients and 3 critical patients according to clinical classification. The influence factors were statistically significant(P<0.05); 2) Low dose CT images could show the normal structure, lesion range, density difference and related imaging characteristics of the lung, which was consistent with the same layer ratio of the first routine dose CT examination; 3) After short-term treatment, the evaluation results of low-dose CT images were in good agreement with the clinical evaluation results. The therapeutic effect of the patients was improved in 30 cases, no significant change was found in 5 cases and progress in 7 cases. Statistical analysis showed that age, basic disease, operation history and clinical classification were the prognostic factors(P<0.05). Conclusion Most of the novel coronavirus pneumonia patients showed good prognosis. The elderly, patients with underlying diseases and history of operation, and severe clinical patients were the influencing factors of poor prognosis. Low dose CT had a high consistency between the image evaluation results of disease changes and clinical evaluation. It could effectively reduce the radiation injury of patients while ensuring the image quality and providing reliable image diagnosis.更多还原