摘要
目的探讨新型冠状病毒肺炎(COVID-19)胸部高分辨率CT(HRCT)影像分期与鉴别。方法回顾性分析50例临床确诊为COVID-19患者的临床资料及胸部HRCT图像,HRCT图像分析内容包括:病灶分布、范围、形态、密度、实变、磨玻璃影、支气管血管束增厚等。结果COVID-19胸部HRCT主要表现可分为早期、进展期、重症期、恢复期:1)早期双肺散在、多发斑片状、节段或亚段性磨玻璃密度影(GGO),以肺外周或胸膜下分布为主,可见空气支气管征及血管增粗穿行;2)进展期病灶范围融合增大,累及多个肺段、肺叶呈“反蝶翼”征,可见小叶间隔增厚呈“铺路石”征;少数出现胸膜增厚、胸腔积液、淋巴结肿大或小空洞;3)重症期:双肺弥漫GGO合并实变影,见支气管充气征,可至“白肺”;4)恢复期病灶范围缩小,实变灶逐渐消失,部分残留纤维条索影。结论COVID-19患者胸部HRCT具有特征性表现,其中以双肺外周、胸膜下散在磨玻璃影(GGO)最具特征,可进展至双肺实变或“白肺”,治疗后病灶可吸收或残留条索影。
Objective To identify the high resolution CT(HRCT)features of imaging staging and differentiation for patients with the novel coronavirus pneumonia(COVID-19).Methods The data of 50 consecutive patients with confirmed COVID-19 were analyzed retrospectively.We mainly focused on distribution,range,morphology,density,consolidation,ground glass opacity(GGO),thickening of bronchus and blood vessels of HRCT images.Results The HRCT findings of the patients with COVID-19 can be divided into early stage,progressive stage,severe stage and convalescent stage 1)In early stage,segmental or subsegmental ground glass opacity(GGO)distributed along the peripheral or subpleural area of both lungs,among which vascular thickening and air bronchogram can be seen;2)In progressive stage,the lesions were enlarged,and multiple pulmonary segments and lobes were involved,showing the"anti-sphenoid wing"sign.Interlobular septal thickening showed the"paving stone"sign.Pleural thickening,pleural effusion,lymph node enlargement and small voids were rare;3)In severe stage,diffuse GGO with pulmonary consolidation and air bronchogram in both lungs can up to"white lung";and 4)In convalescent stage,lesions were diminished,and pulmonary consolidation was gradually absorbed with fiber strip remained.Conclusion The HRCT findings of COVID-19 are typical and characterized by bilateral subpleural GGO,which may progress to bilateral consolidation or"white lung".Lesions can be gradually absorbed with residual fiber strip after treatment.
作者
蔡冠晖
陈文波
曾玉蓉
蓝博文
曾裕镜
李林蔚
CAI Guanhui;CHEN Wenbo;ZENG yurong;LAN Bowen;ZENG Yujing;LI Linwei(Department of Radiology, Huizhou Municipal Central Hospital, Huizhou 516001, P.R.China)
出处
《医学影像学杂志》
2020年第8期1380-1383,共4页
Journal of Medical Imaging
