Time Course of Lung Changes a Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19 )
Time Course of Lung Changes a Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19 )
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DOI：
10.1148/radiol.2020200370
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发表时间：
2020-06-01
期刊：
影响因子：
19.7
通讯作者：
Zheng, Chuansheng
中科院分区：
文献类型：
--
作者：
Pan, Feng;Ye, Tianhe;Zheng, Chuansheng
背景资料：胸部CT用于评估冠状病毒病肺部受累的严重程度2019（COVID-19）。目的：确定从最初诊断到患者康复期间与COVID-19相关的胸部CT表现的变化。材料和方法：这项回顾性审查包括2020年1月12日至2月6日期间出现的实时聚合酶链反应证实的COVID-19患者，2020.排除了在疾病过程中任何时间有严重呼吸窘迫和/或需氧的患者。每隔约4天进行一次重复胸部CT。对5个肺叶中的每一个进行视觉评分，评分范围为0 - 5，0表示无受累，5表示受累超过75%。结果：对21例确诊COVID-19的患者（6名男性和15名女性，年龄25-63岁）进行了评估。在这些患者中共获得82次胸部CT扫描，平均间隔（+/-标准差）为4天+/- 1（范围，1-8天）。所有患者均在平均住院17天+/- 4天（范围：11-26天）后出院。最大肺部受累在初始症状发作后约10天达到峰值（计算的总CT评分为6）（R-2 = 0.25，P <0.001）。基于从第0天到第26天的胸部CT扫描的四分位数，定义了肺部CT表现的四个阶段。第1阶段获得的CT扫描（0-4天）显示磨玻璃样阴影（24次扫描中的18次[75%]），平均总CT评分为2 +/- 2;在第2阶段获得扫描（5-8天）显示了增加，在这两个疯狂铺路模式（17次扫描中的9次[53%]）和总CT评分（平均值，6 +/- 4; P =.002）;第3阶段获得的扫描（9-13天）显示巩固（21次扫描中的19次[91%]）和总CT评分的峰值（平均值，7 +/- 4）;以及在阶段4中获得的扫描（>= 14天）显示巩固逐渐消退（20次扫描中的15次[75%]）和总CT评分降低（平均值，6 +/- 4）无疯狂铺路模式。在2019年从冠状病毒病中康复的患者中（在疾病过程中没有严重的呼吸窘迫），胸部CT扫描的肺部异常在症状最初发作后约10天显示出最严重的程度。(C)RSNA，2020年
Background: Chest CT is used to assess the severity of lung involvement in coronavirus disease 2019 (COVID-19).Purpose: To determine the changes in chest CT findings associated with COVID-19 from initial diagnosis until patient recovery.Materials and Methods: This retrospective review included patients with real-time polymerase chain reaction-confirmed COVID-19 who presented between January 12, 2020, and February 6, 2020. Patients with severe respiratory distress and/or oxygen requirement at any time during the disease course were excluded. Repeat chest CT was performed at approximately 4-day intervals. Each of the five lung lobes was visually scored on a scale of 0 to 5, with 0 indicating no involvement and 5 indicating more than 75% involvement.The total CT score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement).Results: Twenty-one patients (six men and 15 women aged 25-63 years) with confirmed COVID-19 were evaluated. A total of 82 chest CT scans were obtained in these patients, with a mean interval (+/- standard deviation) of 4 days +/- 1 (range, 1-8 days). All patients were discharged after a mean hospitalization period of 17 days +/- 4 (range, 11-26 days). Maximum lung involved peaked at approximately 10 days (with a calculated total CT score of 6) from the onset of initial symptoms (R-2 = 0.25, P < .001). Based on quartiles of chest CT scans from day 0 to day 26 involvement, four stages of lung CT findings were defined. CT scans obtained in stage 1 (0-4 days) showed ground-glass opacities (18 of 24 scans [75%]), with a mean total CT score of 2 +/- 2; scans obtained in stage 2 (5-8 days) showed an increase in both the crazy-paving pattern (nine of 17 scans [53%]) and total CT score (mean, 6 +/- 4; P =.002); scans obtained in stage 3 (9-13 days) showed consolidation (19 of 21 scans [91%]) and a peak in the total CT score(mean, 7 +/- 4); and scans obtained in stage 4 (>= 14 days) showed gradual resolution of consolidation (15 of 20 scans [75%]) and a decrease in the total CT score (mean, 6 +/- 4) without crazy-paving pattern.Conclusion: In patients recovering from coronavirus disease 2019 (without severe respiratory distress during the disease course), lung abnormalities on chest CT scans showed greatest severity approximately 10 days after initial onset of symptoms.(C) RSNA, 2020