Radiographic findings in 240 patients with COVID-19 pneumonia: time-dependence after the onset of symptoms
Radiographic findings in 240 patients with COVID-19 pneumonia: time-dependence after the onset of symptoms
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DOI：
10.1007/s00330-020-06967-7
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发表时间：
2020-05-30
影响因子：
5.9
通讯作者：
Preda, Lorenzo
中科院分区：
文献类型：
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作者：
Vancheri, Sergio Giuseppe;Savietto, Giovanni;Preda, Lorenzo
目的 分析 COVID-19 肺炎最常见的影像学特征，并评估胸部 X 线（CXR）检测肺部改变的有效性。材料和方法 对 240 名经 RT-PCR 确诊为 SARS-CoV-2 感染的有症状患者（70% 男性，平均年龄 65 +/- 16 岁）的 CXR 进行回顾性评估。根据症状出现和 CXR 之间的天数，将患者分为四组：A 组（0-2 天），49 名患者；A 组（0-2 天），49 名患者； B组（3-5），75例； C组（6-9），85例； D组(>9)，31例。记录改变的类型（网状/毛玻璃样混浊（GGO）/实变）和分布（双侧/单侧、上/中/下视野、周围/中央）。使用卡方检验检验统计显着性。结果 240 例接受 CXR 的患者中，180 例（75%）出现改变（A 组，63.3%；B 组，72%；C 组，81.2%；D 组，83.9%）。 124/180 名患者（68.8%）观察到 GGO，113/180 名患者（62.7%）观察到网状改变，71/180 名患者（39.4%）观察到实变。合并的频率显着降低（p < 0.01）。各组间分布如下：网状改变（A组，70.9%；B组，72.2%；C组，57.9%；D组，46.1%），GGO（A组，67.7%；B组，62.9%；C组，71%；D组，76.9%），以及实变（A组，35.5%；B组， 31.4%；C 组，47.8%；D 组，38.5%）。 73.3% 的改变是双侧的。上、中、下田涉案率分别为36.7%、79.4%、87.8%。 49.4% 的病变位于周围，11.1% 的病变位于中央，39.4% 的病变位于周围。上部区域和中心区域的参与程度明显较低（p < 0.01）。结论 COVID-19患者最常见的病变是GGO（中/晚期）和网状改变（早期），而实变随着时间的推移逐渐增加。最常见的分布是双侧、周围、中/下为主。总体 CXR 阴性率为 25%，随着时间的推移逐渐下降。
Objective To analyze the most frequent radiographic features of COVID-19 pneumonia and assess the effectiveness of chest X-ray (CXR) in detecting pulmonary alterations. Materials and methods CXR of 240 symptomatic patients (70% male, mean age 65 +/- 16 years), with SARS-CoV-2 infection confirmed by RT-PCR, was retrospectively evaluated. Patients were clustered in four groups based on the number of days between symptom onset and CXR: group A (0-2 days), 49 patients; group B (3-5), 75 patients; group C (6-9), 85 patients; and group D (> 9), 31 patients. Alteration's type (reticular/ground-glass opacity (GGO)/consolidation) and distribution (bilateral/unilateral, upper/middle/lower fields, peripheral/central) were noted. Statistical significance was tested using chi-square test. Results Among 240 patients who underwent CXR, 180 (75%) showed alterations (group A, 63.3%; group B, 72%; group C, 81.2%; group D, 83.9%). GGO was observed in 124/180 patients (68.8%), reticular alteration in 113/180 (62.7%), and consolidation in 71/180 (39.4%). Consolidation was significantly less frequent (p < 0.01). Distribution among groups was as follows: reticular alteration (group A, 70.9%; group B, 72.2%; group C, 57.9%; group D, 46.1%), GGO (group A, 67.7%; group B, 62.9%; group C, 71%; group D, 76.9%), and consolidation (group A, 35.5%; group B, 31.4%; group C, 47.8%; group D, 38.5%). Alterations were bilateral in 73.3%. Upper, middle, and lower fields were involved in 36.7%, 79.4%, and 87.8%, respectively. Lesions were peripheral in 49.4%, central in 11.1%, or both in 39.4%. Upper fields and central zones were significantly less involved (p < 0.01). Conclusions The most frequent lesions in COVID-19 patients were GGO (intermediate/late phase) and reticular alteration (early phase) while consolidation gradually increased over time. The most frequent distribution was bilateral, peripheral, and with middle/lower predominance. Overall rate of negative CXR was 25%, which progressively decreased over time.