Temporal relationship between serial RT-PCR results and serial chest CT imaging, and serial CT changes in coronavirus 2019 (COVID-19) pneumonia: a descriptive study of 155 cases in China
Temporal relationship between serial RT-PCR results and serial chest CT imaging, and serial CT changes in coronavirus 2019 (COVID-19) pneumonia: a descriptive study of 155 cases in China
复制标题
DOI：
10.1007/s00330-020-07268-9
复制
发表时间：
2020-09-15
影响因子：
5.9
通讯作者：
Su, Dajian
中科院分区：
文献类型：
--
作者：
Gu, Jinfeng;Yang, Li;Su, Dajian
目的探讨CT在新冠肺炎肺炎早期发现及病程动态变化中的作用。方法对2020年1月21日至2月18日期间所有疑似新型冠状病毒感染并经RT-PCR检测确诊的患者进行回顾性研究。所有患者均接受了系列RT-PCR检测和系列CT成像。研究序列RT-PCR结果(阴性转化为阳性、阳性转化为阴性)与序列CT成像之间的时间关系，并评估序列CT的变化。结果共对155例确诊为新冠肺炎肺炎的患者进行了评价。胸部CT检出新冠肺炎肺炎的时间比RT-PCR法提前2.61d(p=0.000)。肺部CT改善时间明显短于逆转录聚合酶链式反应阴转率(p=0.000)。从最初症状开始，可分为三个阶段：阶段1(0-3天)、阶段2(4-7天)和阶段3(8-14天及以后)。第1期以磨玻璃影(GGO)为主，第2期实变和疯狂铺路征象明显增多，第3期纤维性病变迅速增多。不同分期在主要CT征象(p=0.000)、累及肺叶数目(p=0.001)和病变分布(p=0.000)方面有显著差异。结论胸部CT对新冠肺炎肺炎的检出早于逆转录聚合酶链式反应，可用于监测病程。影像特征结合流行病学、病史和临床资料有助于新冠肺炎肺炎的早期诊断。
Objective To determine CT's role in the early detection of COVID-19 infection and serial CT changes in the disease course in patients with COVID-19 pneumonia. Methods From January 21 to February 18, 2020, all of the patients who were suspected of novel coronavirus infection and verified by RT-PCR tests were retrospectively enrolled in our study. All of the patients underwent serial RT-PCR tests and serial CT imaging. The temporal relationship between the serial RT-PCR results (negative conversion to positive, positive to negative) and serial CT imaging was investigated, and serial CT changes were evaluated. Results A total of 155 patients with confirmed COVID-19 pneumonia were evaluated. Chest CT detection time of COVID-19 pneumonia was 2.61 days earlier than RT-PCR test (p = 0.000). The lung CT improvement time was significantly shorter than that of RT-PCR conversion to negative (p = 0.000). Three stages were identified from the onset of the initial symptoms: stage 1 (0-3 days), stage 2 (4-7 days), and stage 3 (8-14 days and later). Ground glass opacity (GGO) was predominant in stage 1, then consolidation and crazy paving signs were dramatically increased in stage 2. In stage 3, fibrotic lesions were rapidly increased. There were significant differences in the main CT features (p = 0.000), number of lobes involved (p = 0.001), and lesion distribution (p = 0.000) among the different stages. Conclusion Chest CT detected COVID-19 pneumonia earlier than the RT-PCR results and can be used to monitor disease course. Combining imaging features with epidemiology history and clinical information could facilitate the early diagnosis of COVID-19 pneumonia.