新型冠状病毒肺炎的CT征象研究

目的:研究新型冠状病毒肺炎(COVID-19)的CT特征。方法:回顾性分析26例确诊为COVID-19患者的病例资料(男14例,女12例),分析其胸部高分辨CT表现,重点观察病变形态、分布以及病变区有无肺血管增粗、支气管充气征、小叶间隔增厚。结果:26例COVID-19患者中病变分布于肺周围区20例,其中17例胸膜下区;18例累及双肺,8例累及一侧肺;单个肺叶受累6例,2～4叶受累10例,5叶受累10例;单发病灶3例,多发病灶23例;以单纯磨玻璃密度影(pGGO)为主要表现19例,混合性磨玻璃密度影(mGGO)11例,肺实变伴周围磨玻璃密度影(GGO)4例;1例初次CT检查表现为直径3mm大小的磨玻璃密度影,4天后复查CT时病灶明显增大,呈斑片状混合磨玻璃密度影;病变区血管增粗17例,占65.4%;支气管充气征15例,占57.7%;小叶间隔增厚16例,占61.5%;以铺路石征为主要表现8例,占30.8%。单侧少量胸腔积液3例,纵隔淋巴结增大1例。结论:COVID-19的高分辨CT表现具有一定特征,双肺多发磨玻璃密度影伴病变区血管增粗、支气管充气征及小叶间隔增厚提示临床诊断。

Study of Chest CT Features of COVID-19

Objective:To investigate the imaging features of novel coronavirus pneumonia(COVID-19) on chest CT. Methods:26 patients with COVID-19(14 males and 12 females) were finally diagnosed, the chest high-resolution CT was performed, and the clinical data and HRCT manifestations were retrospectively analyzed, focusing on observing the morphology and distribution of the lesions, as well as the signs of pulmonary vascular thickening, air bronchogram, interlobular septal thickening in the lesions. Results:Abnormal findings were seen in all of the 26 patients with COVID-19, among them, 18 cases had bilateral involvement and 8 had unilateral involvement in the lungs; single pulmonary lobe was involved in 6 cases, 2 lobes to 4 lobes involved in 10 cases,and 5 lobes involved in 10 cases; the lesions located in the peripheral area of the lungs in 20 cases, in the subpleural area of the lungs in 17 cases; the main HRCT manifestations were pure ground glass opacity(pGGO) in 19 cases, mixed ground glass opacity(mGGO) in 11 cases, consolidative lesions with ground glass opacity(GGO) surrounding in 4 cases, and 1 case of high-resolution CT showed a single tiny ground-glass opacity lesion(3 mm in diameter size); there were 17 cases of pulmonary vascular thickening(65.4%), 15 cases of air bronchogram(57.7%), 16 cases of interlobular septal thickening(61.5%), 8 cases of paving stones(30.8%) in the lesion areas. Unilateral small amount of pleural effusion in 3 cases and mediastinal lymph nodes enlargement in 1 case were seen also. Conclusion:Chest HRCT findings of COVID-19 have certain characteristics, multiple ground glass opacities in peripheral pulmonary areas accompanied by local pulmonary vascular thickening, air bronchogram, and interlobular septal thickening suggested clinical diagnosis.