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    周辉, 刘长林, 李磊, 谢宗玉. 新型冠状病毒肺炎首诊的影像学特征分析[J]. 蚌埠医科大学学报, 2020, 45(4): 433-436. DOI: 10.13898/j.cnki.issn.1000-2200.2020.04.004
    引用本文: 周辉, 刘长林, 李磊, 谢宗玉. 新型冠状病毒肺炎首诊的影像学特征分析[J]. 蚌埠医科大学学报, 2020, 45(4): 433-436. DOI: 10.13898/j.cnki.issn.1000-2200.2020.04.004
    shu
    ZHOU Hui, LIU Chang-lin, LI Lei, XIE Zong-yu. Analysis of the imaging characteristics of COVID-19 at the first diagnosis[J]. Journal of Bengbu Medical University, 2020, 45(4): 433-436. DOI: 10.13898/j.cnki.issn.1000-2200.2020.04.004
    Citation: ZHOU Hui, LIU Chang-lin, LI Lei, XIE Zong-yu. Analysis of the imaging characteristics of COVID-19 at the first diagnosis[J]. Journal of Bengbu Medical University, 2020, 45(4): 433-436. DOI: 10.13898/j.cnki.issn.1000-2200.2020.04.004
    shu

    新型冠状病毒肺炎首诊的影像学特征分析

    Analysis of the imaging characteristics of COVID-19 at the first diagnosis

      摘要
    • 摘要:
      目的 分析新型冠状病毒肺炎（COVID-19）首诊的临床特征及影像学特征。
      方法 回顾性分析46例确诊COVID-19病人的临床资料，均进行薄层CT扫描，分析病人病灶分布累及肺段数、累及肺叶情况、分布情况和征象表现，并按照首次症状出现至第一次CT检查的时间间隔长短，将病人分为病程早期（≤3 d）18例、病程中期（4~7 d）14例和病程晚期（>7 d）14例，对影像学表现进行归纳分析。
      结果 46例COVID-19病人中，45例（97.8%）有直接或间接武汉接触史，临床症状以咳嗽（28/46，68.6%）和发热（40/46，87.0%）最为常见。影像学方面，COVID-19病人病灶分布以同时累及双侧肺叶（39/46，84.8%）为主，以散在分布（27/46，58.7%）为主，多数累及肺段达7个以上（27/46，58.7%）；在CT征象方面，以单纯磨玻璃影（23/46，50.0%）、磨玻璃影伴实变（32/46，69.6%）、铺路石征（41/46，89.1%）、血管增粗影（41/46，89.1%）、晕征（34/46，73.9%）、空气支气管征（38/46，82.6%）较为常见。病程早期病人单纯磨玻璃影较病程中、晚期多见；而病程晚期病人实变征象较病程早期、中期多见，累及>7个肺段比例高于病程早期和中期。
      结论 COVID-19病人的临床症状及影像学征象表现多样，但具有一定特征性，CT征象具有一定的演变规律，CT检查结合临床症状对COVID-19的早期诊断有重要价值。

       

      Abstract:
      Objective To analyze the initial clinical features and imaging finding of corona virus disease 2019 (COVID-19).
      Methods The clinical data of 46 patients with COVID-19 were retrospectively analyzed.The thin-slice CT scan in all cases were performed to analyze the number of pulmonary segments and lobes, distribution and signs of lesion involvement.According to the time interval between the first symptom and CT examination, the course of disease was divided into the early stage(18 cases, ≤ 3d), middle stage(14 cases, 4-7d) and advanced stage (14 cases, >7d), and the imaging findings were analyzed.
      Results Among 46 cases with COVID-19, the history of direct or indirect exposure to Wuhan in 45 cases(97.8%) were identified, and the most common clinical symptoms were cough(28/46, 68.6%) and fever (40/46, 87.0%).In terms of clinical symptoms, the lesions were mainly distributed in bilateral lungs(39/46, 84.8%), the diffused distribution was main, and the number of involved lung segments was more than 7(27/46, 58.7%).The thin-section CT images were mainly characterized by pure ground grass opacity (23/46, 50.0%), ground grass opacity complicated with glass grinding consolidation(32/46, 69.6%), paving stone sign(41/46, 89.1%), vascular thickening(41/46, 89.1%), halo sign(34/46, 73.9%) and air bronchogram(38/46, 82.6%).In the early stage of disease, the patients with pure ground grass opacity were more common compared with patients at the middle or late stage of disease.The signs of consolidation in the advanced patients were more common compared with patients at the early and middle stages of disease, and the proportion of the involve lung segment more than 7 in the advanced patients was higher than that in the early and middle stages of disease.
      Conclusions The clinical and imaging signs of COVID-19 patients are complex and changeable, but which has the certain characteristics, and the CT signs have a certain evolution law.The CT examination combined with clinical symptoms has important clinical significance and value in the early diagnosis of COVID-19.

       

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