摘要
目的:探讨2019新型冠状病毒肺炎(COVID-19)患者出院前后的胸部CT影像学变化。方法:收集2020年1—2月在我院集中收治的59例达到出院标准的COVID-19患者在出院前后复查的CT影像学资料,对其病灶的分布、形态及吸收变化情况进行回顾性分析。结果:(1)病变分布:发生于左肺上叶尖后段、左肺舌段、右肺上叶尖段、两肺下叶背段及下叶基底段的病灶较出院前明显吸收,差异均有统计学意义(P<0.05);(2)病灶形态:实变、斑片状、纤维条索状、淡片状、磨玻璃+实变影、磨玻璃+条索影、磨玻璃+网格影、胸膜增厚、小叶间隔增厚、胸膜下线及铺路石征的征象明显少于出院前,两组差异均有统计学意义(P<0.05);(3)随访:出院后15~30d复查CT表现,12例(20.34%)病灶已完全吸收,47例(79.66%)病灶吸收变淡。结论:COVID-19患者两肺下叶及肺外带或胸膜下的病灶吸收较快,且与有无基础疾病相关。胸部CT影像动态变化对临床随访、预后判断和疫情监控具有重要的参考价值。
Objective:To investigate the changes of chest CT imagings of patients with 2019 coronavirus pneumonia(COVID-19)before and after hospitalization.Methods:From January to February 2020,59 patients with COVID-19 who met the discharge standards in our hospital were treated centrally.CT imaging data reviewed before and after discharge.Retrospective analysis was made on the changes of the distribution,morphology,and absorption of the lesions.Results:(1)Lesion distribution:the lesions occurred in the posterior segment of the upper lobe tip of the left lung,the left tongue segment,the right upper lobe tip segment,the dorsal segment of the lower lobe of the two lungs and the basal segment of the lower lobe of the right lung were significantly absorbed compared with those before hospitalization,and the differences were statistically significant(P<0.05).(2)The forma of the lesion:consolidation,patchy,fibrous cord,light flake,ground glass+consolidation shadow,ground glass+cable shadow,ground glass+mesh shadow,pleural thickening,interlobular septal thickening,subpleural and paving stone signs were significantly less than before discharge,and the differences were statistically significant(P<0.05).(3)Follow-up:Review of CT findings 15~30 days after discharge,12 cases(20.34%)of lesions were completely absorbed,and 47 patients(79.66%)had decreased the lesion absorption.Conclusion:Patients with COVID-19 in the lower lobe and extrapulmonary bands or subpleural lesions absorb faster and are related to the presence of underlying disease.The dynamic changes of chest CT images have important reference value for clinical follow-up,prognosis judgment and epidemic surveillance.
作者
任荣
李敏
刘荣荣
程晰
刘静
任砚
周碧霞
姚文妍
袁功玲
REN Rong;LI Min;LIU Rongrong(Department of Radiology,the Affiliated Infectious Diseases Hospital of Soochow University,the Fifth People’s Hospital of Suzhou,Jiangsu City,Suzhou Province 215000)
出处
《医学理论与实践》
2021年第11期1807-1809,1816,共4页
The Journal of Medical Theory and Practice
基金
苏州市卫生健康委员会感染性疾病临床医学中心建设项目(szzx201508)
苏州市新型冠状病毒感染应急防治科技专项(SYS2020019)
苏州市科技局民生科技项目(SS201880、SYS2018096、SS2019010、SS2019074)。
