Coronavirus disease 2019: initial chest CT findings
Coronavirus disease 2019: initial chest CT findings
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DOI：
10.1007/s00330-020-06816-7
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发表时间：
2020-03-24
影响因子：
5.9
通讯作者：
Zeng, Wenbing
中科院分区：
文献类型：
--
作者：
Zhou, Zhiming;Guo, Dajing;Zeng, Wenbing
目的系统分析2019冠状病毒病自然病程早期和进展期的CT表现，探讨这两个阶段肺实质异常的可能变化。方法回顾性分析中国重庆2020年1月21日至2月4日期间未接受任何抗病毒治疗的62例确诊冠状病毒病2019患者（男性34例，女性28例，年龄20-91岁）的初始胸部CT数据。将患者分为早期组（4天内出现症状）和进展期组（4-7天内出现症状）进行分析。评估肺实质异常的CT表现及分布、大小及CT评分。结果2019冠状病毒病的主要特征为磨玻璃影（61.3%），其次为磨玻璃影合并实变（35.5%）、圆形影（25.8%）、疯狂铺路样（25.8%）、支气管空气征（22.6%）。无患者出现空化、网状或支气管壁增厚。进展期组CT评分明显高于早期组（p = 0.004）。结论肺周围多发磨玻璃影伴实变是2019冠状病毒病的主要CT特征。CT评分可用于评价疾病的严重程度。如果发现这些典型的改变，那么必须考虑2019冠状病毒病的鉴别诊断。
Objectives To systematically analyze CT findings during the early and progressive stages of natural course of coronavirus disease 2019 and also to explore possible changes in pulmonary parenchymal abnormalities during these two stages. Methods We retrospectively reviewed the initial chest CT data of 62 confirmed coronavirus disease 2019 patients (34 men, 28 women; age range 20-91 years old) who did not receive any antiviral treatment between January 21 and February 4, 2020, in Chongqing, China. Patients were assigned to the early-stage group (onset of symptoms within 4 days) or progressive-stage group (onset of symptoms within 4-7 days) for analysis. CT characteristics and the distribution, size, and CT score of pulmonary parenchymal abnormalities were assessed. Results In our study, the major characteristic of coronavirus disease 2019 was ground-glass opacity (61.3%), followed by ground-glass opacity with consolidation (35.5%), rounded opacities (25.8%), a crazy-paving pattern (25.8%), and an air bronchogram (22.6%). No patient presented cavitation, a reticular pattern, or bronchial wall thickening. The CT scores of the progressive-stage group were significantly greater than those of the early-stage group (p = 0.004). Conclusions Multiple ground-glass opacities with consolidations in the periphery of the lungs were the primary CT characteristic of coronavirus disease 2019. CT score can be used to evaluate the severity of the disease. If these typical alterations are found, then the differential diagnosis of coronavirus disease 2019 must be considered.