摘要
目的:探讨2019冠状病毒病(COVID-19)患者病程中胸部CT影像学表现的变化规律。方法:收集在浙江大学医学院附属第一医院集中收治的COVID-19确诊患者52例。所有患者病程中持续胸部CT复查,人均共行4次胸部CT检查,每次检查间隔时间2~7 d。回顾性分析诊疗过程中患者CT影像学特点及随时间变化的特点。结果:除2例患者首次胸部CT影像无异常,其余50例患者均发现肺部有不同程度的阴影。其中,表现为磨玻璃样密度影(GGO)48例(92.3%),斑片状实变、亚实变19例(36.5%),17例(32.7%)伴随出现空气支气管征,小叶间隔增粗41例(78.8%)。病程中COVID-19患者肺部GGO病变逐渐减少,纤维索条影逐渐增多,成为最常见的影像学表现。39例患者(75.0%)在入院第6~9天肺部病灶变化最明显,在入院第10~14天40例(76.9%)患者肺部病灶明显吸收。结论:COVID-19患者的胸部CT影像学表现具有一定的特征和变化规律,这在疫情防控和临床治疗决策中具有较大价值。
Objective:To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019(COVID-19).Methods:Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine.The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization.The shortest interval between each scan was 2 days and the longest was 7 days.The shape,number and distribution of lung shadows,as well as the characteristics of the lesions on the CT images were reviewed.Results:The obvious shadows infiltrating the lungs were shown on CT images in 50 cases,for other 2 cases there was no abnormal changes in the lungs during the first CT examination.Ground-glass opacities(GGO)were found in 48 cases(92.3%),and 19 cases(36.5%)had patchy consolidation and sub-consolidation,which were accompanied with air bronchi sign in 17 cases(32.7%).Forty one cases(78.8%)showed a thickened leaflet interval,4 cases(7.6%)had a small number of fibrous stripes.During hospitalization,GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation.The lesions rapidly progressed in 39 cases(75.0%)within 6-9 days after admission.On days 10-14 of admission,the lesions distinctly resolved in 40 cases(76.9%).Conclusion:The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes,which are of value for monitoring disease progress and clinical treatment.
作者
王锦程
刘锦鹏
王园园
刘伟
陈小群
孙超
沈晓勇
汪启东
吴亚平
梁文杰
阮凌翔
WANG Jincheng;LIU Jinpeng;WANG Yuanyuan;LIU Wei;CHEN Xiaoqun;SUN Chao;SHEN Xiaoyong;WANG Qidong;WU Yaping;LIANG Wenjie;RUAN Lingxiang(Radiology Department,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2020年第2期191-197,共7页
Journal of Zhejiang University(Medical Sciences)
基金
国家重点研发计划(2016YFC0104510)。
作者简介
第一作者:王锦程(1990-),男,硕士,住院医师,主要从事胸腹部影像学研究,E-mail:1517018@zju.edu.cn,https://orcid.org/0000-0003-4676-309X;通信作者:阮凌翔(1968-),男,硕士,主任医师,主要从事胸腹部影像学研究,E-mail:1190026@zju.edu.cn,orcid.org/0000-0002-1745-3941。
