广州医药 ›› 2020, Vol. 51 ›› Issue (3): 5-8.DOI: 10.3969/j.issn.1000-8535.2020.03.002

• 论著 • 上一篇    下一篇

COVID-19 肺炎影像学诊断价值

罗素金   

  1. 广州市第一人民医院放射科(广州 510180)
  • 收稿日期:2020-03-05 出版日期:2020-05-20 发布日期:2021-11-28

The imaging diagnostic value of COVID-19 pneumonia

LUO Sujin   

  1. Department of Imaging, Guangzhou First People's Hospital, Guangzhou 510180, China
  • Received:2020-03-05 Online:2020-05-20 Published:2021-11-28

摘要: 目的 分析2019新型冠状病毒(COVID-19)肺炎的肺部影像表现,提高对该病的影像学诊断认识。方法 回顾性分析2020年1月20日—2020年2月20日在我院就诊并最终经临床确诊的COVID-19肺炎患者的影像学及临床资料,所有患者均在入院后三天内行胸部X线检查或高分辨率CT平扫,分别记录每位患者两种影像检查方式的影像学表现,包括病灶累及的肺叶、磨玻璃影(GGO)、实变影、铺路石征、纤维索条及小叶间隔增厚等征象。结果 共22例确诊为COVID-19肺炎,其中男:女为1:1,年龄范围20~82岁;平均年龄为(52.9±16.2)岁。21例行胸部X线检查,其中有3例患者同时行肺部CT平扫检查;1例患者仅行胸部CT平扫检查。21例X线检查中16例(76%)胸片表现为斑片状、絮状致密影,余5例(24%)检查双肺未见异常征象。4例CT扫描患者中均可以见到病灶(100%),其中有3例(75%)累及5个肺叶,1例(25%)仅累及1个肺叶;均表现为胸膜下磨玻璃影、斑片状实变影、铺路石征、小叶间隔增厚、小血管增粗及支气管气象;其中1例(25%)出现淋巴结肿大;2例(50%)出现纤维索条影。结论 影像学检查对COVID-19的诊断和病情评估具有重要价值,其中X线检查对于部分病灶显示欠佳, 胸部CT平扫对于病变的检查较为准确,可作为COVID-19首选的影像学检查方法,为临床上早期诊断及治疗提供依据。

关键词: COVID-19, 计算机断层, X线, 影像学表现

Abstract: Objective To analyzed the pulmonary imaging manifestations of 2019 novel coronavirus (COVID-19) pneumonia, in order to improve the imaging diagnosis of the disease. Methods Retrospective analysis of the imaging and clinical data of 22 patients infected with the 2019 Novel Coronavirus (COVID-19) were reviewed, which all the patients took the X-ray or CT scan, and to record the images in the two types of inspection for each patient, including the involvement of the consolidation of the lung, ground-glass opacification, consolidation, paving stone chippings, fiber cable and interlobular septal thickening and so on. Results A total of 22 patients were diagnosed with COVID-19, and the ratio of male to female was 1:1, age range is 20~82, mean age is (52.9±16.2.21) patients received chest X-ray examination, including 3 patients received the non-contrast CT examination at the same time; 1 patient received chest CT plain examination only. 16 (76%) among the 21 patients with X-ray showed patchy and flocculent dense shadows, while the remaining 5 patients (24%) showed no abnormal signs in both lungs. 4 patients with CT scan can find the lesions. Among the 4 patients with detect CT scan, 3 patients (75%) involved 5 pulmonary lobes, and 1 patient (25%) only involved 1 pulmonary lobe. All of them showed subpleural ground-glass opacification, consolidation, paving stone chippings, fiber cable and interlobular septal thickening, including lymph node enlargement occurred in 1 case (25%), fiber strip shadows were observed in 2 cases (50%). Conclusion The imaging examination is of great value for the diagnosis and disease evaluation of COVID-19, among which X-ray examination is not good for some lesions, and CT plain scan is relatively accurate for the examination of lesions, which can be used as the preferred imaging method of COVID-19, providing further theoretical basis for early clinical diagnosis and treatment.

Key words: COVID-19, NCCT, X-ray, Diagnostic imaging