摘要
目的:探讨新型冠状病毒肺炎(COVID-19)的临床表现和CT影像学特点,为临床早发现、早诊断、早隔离、早治疗提供理论依据。方法:分析64例确诊的COVID-19患者的临床症状、实验室检查及CT影像学早期、进展期、吸收期影像学特点。结果:COVID-19患者平均年龄54.55岁,临床症状以发热为主(84.37%),常伴有咳嗽等呼吸道症状;患者白细胞计数正常或减少(98.44%),淋巴细胞计数正常及下降(100%),超敏C反应蛋白增高(79.69%),血沉加快(75%)。COVID-19的CT表现多为双肺多叶磨玻璃影,磨玻璃影伴实变,实变及条索影,以双肺胸膜下分布为主。肺部病变CT早期显示磨玻璃影(61.53%),磨玻璃影伴实变(19.23%),斑片状实变(8.97%),大片实变影(10.25%);进展期磨玻璃影(4.58%),磨玻璃影伴实变(38.17%),斑片状实变(12.21%),大片实变影(20.61%),纤维条索影(23.66%);吸收期CT表现磨玻璃影(3.22%),磨玻璃影伴实变(23.03%),斑片状实变(9.68%),大片实变影(23.39%),纤维条索影(34.68%)。结论:COVID-19的CT影像学表现早期双肺胸膜下多发淡薄的局限性磨玻璃影,进展期双肺多发、弥漫磨玻璃影伴实变,进一步发生实变,病变严重者出现"白肺"表现,部分患者可出现纤维条索影,吸收期病变由多发、弥漫转变为局限,见较多纤维条索影,部分可完全吸收。
Objective:To explore the clinical manifestations and CT characteristics of corona virus disease 2019(COVID-19),and so as to provide theoretical basis for clinical early detection,early diagnosis,early isolation,and early treatment.Methods:Clinical symptoms,laboratory examinations and CT characteristics with early,advanced,and absorption stage of 64 patients with COVID-19 were retrospectively analyzed.Results:The average onset age of patients with COVID-19 was 54.55 years old.Fever was mainly the primary symptom(84.37%),and often accompanied by respiratory symptoms such as cough.The features of laboratory examinations were as following:leukocyte count was normal or decreased(98.44%),lymphocyte count was normal and decreased(100%),hypersensitivity C response protein was increased(79.69%),and the erythrocyte sedimentation rate was increased(75%).CT findings were mostly multiple subpleural ground glass opacities(GGOs)in both lungs,GGOs with consolidation,consolidations and with fibrosis.CT findings in early stage were GGOs(61.53%),GGOs with consolidation(19.23%),patchy consolidations(8.97%),large range of consolidations(10.25%).In the advanced stage CT showed GGOs(4.58%),GGOs with consolidation(38.17%),patchy consolidations(12.21%),large range of consolidations(20.61%),and fibrosis(23.66%).In the absorption stage CT presented GGOs(3.22%),GGOs with consolidation(23.03%),patchy consolidations(9.68%),large range of consolidations(23.39%),and fibrosis(34.68%).Conclusion:The CT findings of COVID-19 have certain characteristics in different stages.In early stage it is characterized by multiple subpleural light focal ground-glass opacities.As the disease progresses,diffuse ground glass shadow accompanied by consolidations appears in both lungs in the advanced stage.Along with progressive consolidation in severe cases"white lung"appeared,some with fibrosis.During the absorption stage,the lesions may become localized with more fibrosis,or some may be even completely absorbed.
作者
陈志勇
程正银
张旭辉
徐海林
陈宏才
余洪涛
尹畅
周国锋
陆红艳
CHEN Zhiyong;CHENG Zheng-yin;ZHANG Xu-hui(Department of Radiology,Wuhan Dongxihu District People's Hospital,430040Wuhan,China)
出处
《放射学实践》
北大核心
2020年第3期286-290,共5页
Radiologic Practice
