摘要
目的采用Meta分析评价患新型冠状病毒肺炎(COVID-19)的各类人群的CT征象,首次为COVID-19的影像诊断提供不同人群的荟萃分析。方法检索PubMed、Cochrane Library、Elsevier、CNKI中国期刊全文数据库,检索时间限定为2019年12月1日—2020年4月21日。搜集国内外关于普通成人、儿童及妊娠期确诊COVID-19者的胸部CT影像表现的文献并进行筛选。采用STATA 11软件进行Meta分析,采用Cochrane’s Q检验对纳入研究的各文献进行异质性检验,并根据I2评估研究之间的异质性。计算纳入研究中各CT征象的发生率及95%置信区间(CI),绘制森林图。采用Egger’s漏斗图分析发表偏倚。结果纳入60项研究共3 822例COVID-19病人。普通成人病人主要有16个征象,最多见的3个CT征象为肺磨玻璃影(GGO)(60.5%,95%CI:0.515~0.694)、血管增粗影(55.5%,95%CI:0.333~0.777)和胸膜增厚(49.7%,95%CI:0.323~0.672),肺部病灶分布特征以外带及胸膜下(67.1%,95%CI:0.589~0.752)、双肺分布(77.6%)最多见。其他少见胸部影像表现包括胸腔积液(4.9%)和淋巴结肿大(10.7%)。儿童病人主要有8个征象,最多见的3个征象为GGO合并实变(71.2%,95%CI:0.580~0.844)、GGO(39.2%,95%CI:0.270~0.513)和结节(39.1%,95%CI:-0.115~0.896),肺部病灶分布特征以外带及胸膜下(58.0%,95%CI:0.287~0.873)、双肺分布(35.4%)最多见。少见胸部影像表现为胸腔积液(6.2%,95%CI:-0.008~0.132)。妊娠期病人主要有5个征象,最多见的征象为GGO(71.0%,95%CI:0.510~0.910),其余为GGO合并实变、网格影、实变影及胸膜增厚,少见胸部影像表现为胸腔积液(38.0%)。部分CT表现漏斗图提示存在发表偏倚。结论 COVID-19的CT征象有一定的特征,普通成人及妊娠期病人的胸部CT表现比较典型,儿童病人胸部CT表现不典型并且其胸部CT改变可能早于临床症状。
Objective To provide an evidence-based proof of diagnosis for COVID-19 by analyzing all the published studies on the CT imaging features of COVID-19 in different populations of patients. Methods Studies on the CT imaging features of COVID-19 were searched in PubMed, Cochrane Library, Elsevier, and CNKI databases from December1 st in 2019 to April 21 th in 2020. World-wide CT studies on COVID-19 in adults, children and pregnant women, were screened. Meta-analysis was conducted by using Stata 11. Cochrane’s Q test was used to test the heterogeneity of each study,and the heterogeneity between studies was evaluated according to I2. The combined incidence rate of CT features and the corresponding 95% confidence interval(CI) were calculated. Forest plots were plotted. I2 was used to assess statistical heterogeneity between studies. Results A total of 60 studies including 3 822 cases were collected. In the adult group, there are mainly 16 signs, and the most common 3 CT signs are: pulmonary ground glass shadow(GGO)(60.5%, 95%CI: 0.515-0.694), thickened blood vessels(55.5%, 95%CI: 0.333-0.777), and pleural thickening(49.7%, 95%CI: 0.323-0.672). The distribution of lung lesions are mainly pericardial and subpleural(67.1%, 95% CI: 0.589-0.752), and the distribution of bilateral pulmonary(77.6%). Other rare chest imaging findings include: pleural effusion(4.9%) and lymphadenopathy(10.7%);In the children group, there are mainly 8 signs, and the most common 3 CT signs are GGO combined consolidation(71.2%, 95%CI: 0.580-0.844), GGO(39.2%, 95%CI: 0.270-0.513), and nodular lesions(39.1%, 95%CI:-0.115-0.896).The distribution of lung lesions are mainly pericardial and subpleural(58.0%, 95%CI: 0.287-0.873), and the distribution of bilateral pulmonary(35.4%). The other rare chest imaging findings include: pleural effusion(6.2%, 95%CI:-0.008-0.132);In the pregnant group, there are 5 main signs, and the most common sign is GGO(71.0%, 95%CI: 0.510-0.910), followed by GGO combined consolidation, grid shadow, consolidation shadow and pl
作者
周莹
冯洪燕
涂宁
王科
卜丽红
ZHOU Ying;FENG Hongyan;TU Ning;WANG Ke;BU Lihong(Center of PET,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《国际医学放射学杂志》
北大核心
2020年第4期420-429,共10页
International Journal of Medical Radiology
