摘要
目的:通过对新型冠状病毒肺炎(COVID-19)与细菌性肺炎患者的胸部CT影像特点进行对比分析,提高临床工作中两种肺炎鉴别能力。方法:回顾性分析40例COVID-19病例CT资料,收集本院40例2017年1月1日至2020年3月1日细菌性肺炎CT资料进行对比分析。结果:COVID-19肺炎小叶内间隔增厚占比82.5%,明显高于细菌性肺炎10%(P<0.001);小叶中心结节及树芽征占比5%、7.5%,明显低于细菌性肺炎20%、25%(P<0.05)。COVID-19肺段占比8.2±2.7,细菌性肺炎占比4.7±1.8,病灶面积评分分别为6.2±1.3、7.6±2.4,下肺层面占比较高。胸膜下区病灶分布比例分别为65%、20%;两者密度特征单发磨玻璃密度(groumd gluss opacity,GGO)分别为32.5%、12.5%,多发GGO分别为37.5%、15%具有统计学意义(P<0.05)。结论:COVID-19肺炎以胸膜下区分布为主,累及肺段较多;COVID-19肺炎患者小叶内间隔增厚、GGO明显高于细菌性肺炎,而小叶中心结节、树芽征明显低于细菌性肺炎。
Objective:To compare the features of chest CT findings between coronavirus disease 2019(COVID-19)and bacterial pneumonia,and to improve the ability to differentiate between the two diseases in clinical practice.Methods:We retrospectively analyzed the CT data of 40 cases of COVID-19,and compared them with the CT findings of 40 patients with bacterial pneumonia who attended our hospital from January 1,2017 to March 1,2020.Results:COVID-19 showed significantly more frequent intralobular septal thickening(82.5%vs 10%,P<0.001)and significantly less frequent centrilobular nodules(5%vs 20%,P<0.05)and tree-in-bud sign(7.5%vs 25%,P<0.05)compared with bacterial pneumonia.The proportions of lung segment involvement were 8.2±2.7 and 4.7±1.8 for COVID-19 and bacterial pneumonia,respectively.The involvement area score was 6.2±1.3 for COVID-19 and 7.6±2.4 for bacterial pneumonia,and there was a predominance in the inferior lobes.The subpleural area was involved in 65%and 20%of patients with COVID-19 and bacterial pneumonia,respectively.Compared with bacterial pneumonia,COVID-19 had significantly higher percentages of single ground glass opacity(GGO)(32.5%vs 12.5%,P<0.05)and multiple GGOs(37.5%vs 15%,P<0.05).Conclusion:COVID-19 mainly involves the subpleural area,and frequently affects the lung segments.It shows more frequent intralobular septal thickening and GGO but less frequent centrilobular nodules and tree-in-bud sign than bacterial pneumonia.
作者
向刚
徐凤
文亚
IANG Gang;XU Feng;WEN Ya(Department of Medical Imaging,the Affiliated TCM Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Medical Imaging,The People's Hospital of Guang'an District)
出处
《西南医科大学学报》
2020年第5期503-506,518,共5页
Journal of Southwest Medical University
关键词
新型冠状病毒肺炎
细菌性肺炎
胸部CT
鉴别诊断
Coronavirus disease 2019
Bacterial pneumonia
Chest CT
Differential diagnosis
