结核病与肺部健康杂志 ›› 2020, Vol. 9 ›› Issue (1): 11-15.doi: 10.3969/j.issn.2095-3755.2020.01.004

• 专家论坛 • 上一篇    下一篇

新型冠状病毒肺炎的临床特点与CT诊断价值

彭鹏, 余辉山(), 周新华()   

  1. 430030 武汉市肺科医院(彭鹏、余辉山);首都医科大学附属北京胸科医院医学影像科(周新华)
  • 收稿日期:2020-03-05 出版日期:2020-03-30 发布日期:2020-04-17
  • 通信作者: 余辉山,周新华 E-mail:yuhuishan1957@163.com;jysct@126.com

Clinical features and CT imaging diagnosis of novel coronavirus pneumonia

PENG Peng, YU Hui-shan(), ZHOU Xin-hua()   

  1. *Wuhan Pulmonary Hospital, Wuhan 430030,China
  • Received:2020-03-05 Online:2020-03-30 Published:2020-04-17
  • Contact: YU Hui-shan,ZHOU Xin-hua E-mail:yuhuishan1957@163.com;jysct@126.com

摘要:

新型冠状病毒肺炎(简称“新冠肺炎”;按照WHO命名其英文缩写为“COVID-19”)是一种具有很强传染性的肺部炎症病变。作者从武汉肺科医院2020年1月20—30日确诊的COVID-19患者采取整群抽取法抽取了核酸检测阳性的185例进行统计分析,并将COVID-19的发现与命名、核酸检测、临床表现、CT表现特点与诊断价值等进行综合分析。185例COVID-19确诊患者中发热157例(84.9%),以中低型发热为主,39.0℃以上高热仅8例(4.3%);乏力、两下肢关节酸、胀、痛感患者58例(31.4%);不同程度的间断咳嗽、少痰、胸闷不适者142例(76.8%)。在同期整群COVID-19疑似患者364例中,核酸检查阳性185例(50.8%)。CT扫描主要表现为肺部多发斑片状、片状、大片状多形态的磨玻璃样密度影及间质改变,分布于两肺下叶及两肺外带为多,病灶内增粗的肺血管纹理明显、病灶进展较快等。依据CT扫描特点,在185例中以CT首诊第一诊断意见为COVID-19患者161例(87.0%的准确率)。因此,CT检查对COVID-19的诊断具有重要的实用价值,同时在评价肺部病变的严重程度、治疗过程中的动态变化,以及康复期患者的随访观察中均发挥了不可替代的作用。

关键词: 新型冠状病毒肺炎, 疾病特征, 体层摄影术,X线计算机, 诊断显像, 评价研究(主题)

Abstract:

Novel coronavirus pneumoia, also named by corona virus disease 2019 (COVID-19) according to WHO, is a highly infectious pulmonary inflammatory disease. The author adopted the cluster sampling method to collect 185 positive cases of nucleic acid from the patients diagnosed with COVID-19 in Wuhan Pulmonary Hospital for statistical analysis. The discovery and naming of COVID-19, nucleic acid detection, clinical manifestations, CT characteristics and diagnostic value were to be comprehensively analyzed. The data in this group showed that 157 (84.9%) of the 185 patients with fever were mainly low-grade fever, and only 8 (4.3%) of those with high fever above 39.0 ℃. Weakness, joint acidity, swelling, and pain in both lower limbs were presented in 58 patients (31.4%); There were 142 cases (76.8%) with discontinuous cough with less phlegm and chest distress. The main CT imaging features were multiple patchy, patchy and large patches ground-glass shadows and interstitial changes. Most of the lesions were distributed in the lower lobe and in the outer zone of both lungs. The thickened pulmonary vascular marking was obvious in lesions and the lesion was progressing rapidly. According to the characteristics of CT imaging,the accuracy of imaging diagnosis of COVID-19 was as high as 87.0% when as a first diagnostic tool. Therefore, CT examination has a very important value in the diagnosis of COVID-19. Meanwhile, it plays an irreplaceable role in evaluating the severity of pulmonary lesions, dynamic changes during treatment, and follow-up observation of patients in recovery phase.

Key words: Coronavirus disease 2019(COVID-19), Disease attributes, Tomography, X-Ray computed, Diagnostic imaging, Evaluation studies as topic