Objective: To investigate the correlation between the clinical classification of coronavirus disease 2019 (COVID-19) and the imaging characteristics of multislice spiral computed tomography (MSCT) volume scanning of the lungs.
Methods: The clinical data and thoracic MSCT volume scanning data were analyzed retrospectively for 102 patients with COVID-19 diagnosed and hospitalized in the First Affiliated Hospital of Bengbu Medical College between January 18 and February 26, 2020. According to the Fifth Edition of the Diagnosis and Treatment Guidelines by the National Health Commission, the patients were divided into common type, severe type and critical type. The imaging characteristics including the lung sides of the lesions, lung segment involved, lesion distribution, and lesion number and density were compared among the patients with different clinical types of COVID-19.
Results: Seventy-seven of the patients had common type, 18 had severe type and 7 had critical type of COVID-19. The main clinical manifestations included fever, cough and fatigue. Severe and critical types were more frequently seen in elderly patients, who were more prone to show such symptoms as asthenia, breathing difficulty and dyspnea. Two patients presented with no obvious abnormality in the first CT examinations; in the remaining 100 patients, 89.0% had bilateral lung lesions, 16.0% had diffuse lesions, involving a mean of 6.56±4.22 lung segments. Compared with the patients with the common type, the severe and critical patients had a significantly greater number of lung segments involved (P < 0.05), and were also more likely to show diffuse lesions (P < 0.05). The lesion side, lesion number or lesion density did not differ significantly among the patients with different clinical types of COVID-19 (P > 0.05).
Conclusions: MSCT volume scanning not only allows early diagnosis of COVID-19 but also provides evidence for evaluating the severity of COVID-19 to assist in the clinical treatment of the patients.
目的: 探讨新型冠状病毒肺炎(COVID-19)不同的临床分型与多层螺旋计算机体层摄影术(MSCT)容积扫描图像特点间的相关性。
方法: 回顾性分析蚌埠医学院第一附属医院2020年1月18日~2月26日期间收治的102例COVID-19确诊患者的临床资料和胸部MSCT容积扫描资料, 根据国家卫生健康委员会印发的第5版诊疗方案, 将所有患者分为普通型、重型和危重型, 比较临床分型与CT图像中病灶侧别、累及肺段、分布、数目和密度等表现间的相关性。
结果: 共有普通型77例、重型18例和危重型7例, 临床表现以发热、咳嗽、乏力症状为主。重型和危重型患者更常见于老年患者, 更容易表现为乏力、呼吸困难和胸闷症状。有2例患者CT首诊未见明显异常, 余100例中, 89.0%为双肺病灶, 16.0%为弥漫性病变, 累及肺段(6.56±4.22)个; 与普通型相比较, 重型和危重型患者病变累及的肺段数目更多(P < 0.05), 更容易表现为弥漫性病变(P < 0.05)。各型患者的病变侧别、病变数目和病变密度并未显示有统计学差异(P > 0.05)。
结论: MSCT不仅能够早期诊断COVID-19, 并能够评估患者病情的严重程度, 从而指导临床进行有效治疗。
Keywords: COVID-19; clinical classification; computed tomography; volume scanning.