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轻型、普通型新型冠状病毒肺炎患者高分辨率CT影像学特征及短期演变

High-resolution CT Imaging Features of Mild and Common Type of Novel Coronavirus Pneumonia and Short-term Evolution
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摘要 目的探讨新型冠状病毒肺炎(corona virus disease 2019, COVID-19)轻型、普通型患者首次及短期(3~5 d)复查胸部高分辨率CT(high resolution CT, HRCT)影像学表现及短期演变的特征变化。方法回顾性搜集2020年1月24日-2月17日经临床及两次COVID-19实时荧光定量聚合酶链式反应检测确诊的12例轻型、普通型COVID-19患者,分析12例前后两次胸部HRCT影像学特征。结果 12例中首次胸部HRCT检查2例(16.67%)无异常,6例(50.00%)双侧肺叶受累,4例(33.33%)单侧肺叶受累,其中左侧肺叶受累1例、右侧肺叶受累3例;以左肺下叶、右肺下叶受累为主[各7例(58.33%)];以右肺下叶背段、左肺下叶前内基底段受累为主[分别为7例(58.33%)、6例(50.00%)]。短期复查肺叶、肺段受累数较首次检查均有增加,但肺叶受累数比较差异无统计学意义(P>0.05),肺段受累数比较差异有统计学意义(P<0.05)。12例首次胸部HRCT检查影像学特征包括:病变仅位于胸膜下3例、仅位于支气管血管束周围2例、同时位于胸膜下及支气管血管束周围5例,病变仅表现磨玻璃影3例、仅表现实变影2例,伴发胸腔积液1例;短期复查胸部HRCT,明显进展2例,4例病灶吸收好转,1例新见少量胸腔积液。结论胸部HRCT检查方便快捷,COVID-19影像学表现多样化,随时间变化,影像学特征演变快;短期复查胸部HRCT可动态评估COVID-19患者肺组织损伤程度,可为临床诊治提供重要的影像学依据。 Objective To investigate the imaging features and short-term evolution of chest high-resolution CT(HRCT) in patients with mild and common type of corona virus disease 2019(COVID-19). Methods Retrospective collection of 12 mild and common COVID-19 patients diagnosed by clinical and twice COVID-19 real-time fluorescence RT-PCR from January 24 to February 17, 2020. And analyze the imaging features of the chest HRCT twice in 12 COVID-19 patients. Results Among the 12 COVID-19 patients, 2 cases(16.67%) had no obvious abnormality in chest HRCT, 6 cases(50.00%) had bilateral lobe involvement, 4 cases(33.33%) had unilateral lobe involvement, of which 1 case had left lobe involvement and 3 cases had right lobe involvement. Of the 12 COVID-19 patients, 7 cases(58.33%) were involved in the left lower lobe and 7 cases(58.33%) in the right inferior lobe. Of the 12 COVID-19 patients, 6 cases(50.00%) were involved in the anterior inner basal segment of the left lower lobe and 7 cases(58.33%) in the dorsal segment of right inferior lobe. There were no significant differences in the numbers of lung lobe involvements in the two chest HRCT(P>0.05). There was a statistically significant difference in the number of lung segment involvements in the two chest HRCT(P<0.05). The imaging features of 12 COVID-19 patients were as follows: Only 3 cases the lesions were under the pleura, 2 cases were around the bronchial hemodynamic bundle, and 5 cases were located under the pleura and around the bronchial hemodynamic bundle, 3 cases of lesions were characterized by glass-grinding, 2 cases by solid change, and 1 case by pleural effusion. The chest HRCT was reviewed in a short period, with obvious progress in 2 cases, 1 case progressed from unilateral lobe involvement to bilateral lobe involvement, 4 cases had improved absorption, and 1 case had a small amount of pleural effusion. Conclusion Chest HRCT examination is convenient and fast, the imaging manifestations of COVID-19 are diverse, and the imaging features evolve quickly. Short-term ree
作者 张欲翔 王琳 宋彦芳 张泽坤 桑辉 刘明 ZHANG Yu-xiang;WANG Lin;SONG Yan-fang;ZHANG Ze-kun;SANG Hui;LIU Ming(Department of Radiology,Hebei Provincial Hospital of Chinese Medicine,Shijiazhuang 050011,China;Department of Respiration,Hebei Provincial Hospital of Chinese Medicine,Shijiazhuang 050011,China;Department of Radiology,Hejian Municipal People's Hospital,Hejian,Hebei 062450,China)
出处 《临床误诊误治》 2020年第7期23-26,共4页 Clinical Misdiagnosis & Mistherapy
关键词 新型冠状病毒肺炎 诊断 体层摄影术 螺旋计算机 影像学特征 Corona virus disease 2019 Diagnosis Tomography spiral computed Imaging features
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