文章摘要
王翅鹏,吴 艳,张树桐,王 曦.普通型与重型新型冠状病毒肺炎的HRCT征象对照研究[J].南京医科大学学报,2020,(5):631~634
普通型与重型新型冠状病毒肺炎的HRCT征象对照研究
A comparative study of findings in high⁃resolution CT between mild and severe in patients with COVID⁃19
投稿时间:2020-03-23  
DOI:10.7655/NYDXBNS20200503
中文关键词: 新型冠状病毒肺炎  肺炎  体层摄影
英文关键词: corona virus disease 2019  pneumonia  tomography
基金项目:
作者单位
王翅鹏 武汉平安好医医学影像诊断中心放射科湖北 武汉 430014 
吴 艳 华中科技大学同济医学院附属武汉市中心医院放射科湖北 武汉 430014 
张树桐 华中科技大学同济医学院附属武汉市中心医院放射科湖北 武汉 430014 
王 曦 华中科技大学同济医学院附属武汉市中心医院放射科湖北 武汉 430014 
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中文摘要:
      目的:探讨普通型与重型新型冠状病毒肺炎(coronavirus disease 2019,COVID?19)患者的一般资料及胸部CT征象在鉴别诊断中的价值。方法:回顾性分析2020年1月1日—2月20日武汉市中心医院127例COVID?19确诊患者的一般资料、胸部CT征象及随访CT影像变化规律。其中普通型101例(79.53%)、重型26例(20.47%)。一般资料、胸部CT征象的组间比较采用χ2或Fisher确切概率法统计分析,并总结各型COVID?19患者的随访CT影像演变规律。结果:127例中,男73例(57.48%),女54例(42.52%),性别差异无统计学意义(χ2=1.847,P=0.174)。与普通型患者比较,重型患者发病年龄偏高(χ2=4.547,P=0.033)。合并基础性疾病者32例(25.20%),普通型15例(14.85%),重型17例(65.38%),组间差异有统计学意义(χ2=28.014,P<0.001)。CT表现中,普通型患者CT征象以磨玻璃密度影(67例)、混合磨玻璃密度影(45例)为主,重型患者CT征象以混合磨玻璃密度影(19例)、铺路石征(10例)为主,组间差异有统计学意义(χ2=11.330,P=0.010)。重型患者发现纵隔淋巴结肿大1例(3.85%)(P=0.205),胸腔积液4例(15.38%)(P=0.001)。重型患者病灶CT评级普遍高于普通型,其病程较普通型更长且肺部受累高峰时间较普通型延后。结论:COVID?19患者胸部CT征象演变规律存在差异,其不仅能评估病情严重程度,还能对重型COVID?19做出早期预警。
英文摘要:
      Objective:This study aims to explore the value of general information and chest CT features in the differential diagnosis between mild and severe corona virus disease 2019(COVID?19). Methods:The general information,chest CT features and CT image changes of follow?up of confirmed 127 patients with NCP from January 1 to February 20,2020,were retrospectively analyzed in Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,with 101 mild cases(79.53%)and 26 severe cases(20.47%). The general information and chest CT features of different clinical subtypes were compared using χ2 test or Fisher’s exact probability,and the CT image changes of follow?up were summarized. Results:In 127 COVID?19 patients,73 males(57.48%)and 54 females(42.52%). There was no significant difference in gender(χ2=1.847,P=0.174). Compared with the mild cases,the average age of severe cases was older(χ2=4.547,P=0.033. Thirty?two(25.20%)patients had underlying disease,including 15 mild cases(14.85%)and 17 severe cases(65.38%),and there were significant differences in underlying disease between two groups(χ2=28.014,P<0.001. In terms of CT features,mild cases mainly showed ground glass opacity(67 cases)and mixed ground glass opacity(45 cases),severe cases mainly showed mixed ground glass opacity(19 cases)and crazy paving(10 cases). There were significant differences in chest CT features between two groups(χ2=11.330,P=0.010). Mediastinal lymph node enlargement was found in 1 case(3.85%)(P=0.205)and pleural effusion in 4 cases(15.38%)(P=0.001)among severe cases. Compared with the mild cases,the CT grade of lesions in severe cases was generally higher,and the peak of lung involvement was later. Conclusion:There were different chest CT features and CT image changes in COVID?19 patients. Chest CT scan can not only evaluate its clinical course and severity,but also make early warning of severe COVID?19.
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