Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists
Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists
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DOI：
10.1007/s11547-020-01237-4
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发表时间：
2020-06-04
影响因子：
8.9
通讯作者：
Giovagnoni, Andrea
中科院分区：
文献类型：
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作者：
Carotti, Marina;Salaffi, Fausto;Giovagnoni, Andrea
COVID-19是由一种新型冠状病毒引起的新发感染，其传播速度如此之快，以至于世界卫生组织于2020年1月30日宣布此次疫情为国际关注的突发公共卫生事件，并于2020年3月11日宣布为大流行。COVID-19的早期诊断对于疾病治疗和控制疾病传播至关重要。实时逆转录聚合酶链反应（RT-PCR）敏感性低；因此，胸部计算机断层扫描（CT）不仅在早期发现和诊断，特别是在RT-PCR假阴性检测中，而且在监测临床病程和评估疾病严重程度方面发挥着关键作用。本文报道病程中CT表现及时间变化提示：新冠肺炎的CT特征为双侧肺后部及周围磨玻璃样混浊伴或不伴实变分布，但后期主要表现为实变、线状混浊、“疯狂铺路”征、“倒转晕”征及血管扩张。COVID-19的CT表现与其他疾病的CT表现重叠，特别是病毒性肺炎，包括流感病毒、副流感病毒、腺病毒、呼吸道合胞病毒、鼻病毒、人偏肺病毒等。新冠肺炎与严重急性呼吸综合征的CT表现既有相似之处，也有不同之处。本文的目的是回顾COVID-19患者的典型和非典型CT表现，以帮助放射科医生和临床医生更加熟悉这种疾病。
COVID-19 is an emerging infection caused by a novel coronavirus that is moving so rapidly that on 30 January 2020 the World Health Organization declared the outbreak a Public Health Emergency of International Concern and on 11 March 2020 as a pandemic. An early diagnosis of COVID-19 is crucial for disease treatment and control of the disease spread. Real-time reverse-transcription polymerase chain reaction (RT-PCR) demonstrated a low sensibility; therefore chest computed tomography (CT) plays a pivotal role not only in the early detection and diagnosis, especially for false negative RT-PCR tests, but also in monitoring the clinical course and in evaluating the disease severity. This paper reports the CT findings with some hints on the temporal changes over the course of the disease: the CT hallmarks of COVID-19 are bilateral distribution of ground glass opacities with or without consolidation in the posterior and peripheral lung, but the predominant findings in later phases include consolidations, linear opacities, "crazy-paving" pattern, "reversed halo" sign and vascular enlargement. The CT findings of COVID-19 overlap with the CT findings of other diseases, in particular the viral pneumonia including influenza viruses, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, etc. There are differences as well as similarities in the CT features of COVID-19 compared with those of the severe acute respiratory syndrome. The aim of this article is to review the typical and atypical CT findings in COVID-19 patients in order to help radiologists and clinicians to become more familiar with the disease.