胸部CT检查在新型冠状病毒肺炎患者筛查中的应用

doi:10.3969/j.issn.2095-9400.2020.03.002

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Abstract Objective: To explore the application and importance of chest CT in screening COVID-19 patients. Methods: A total of 35 COVID-19 patients from the First Affiliated Hospital of Wenzhou Medical University and the Second Affiliated Hospital of Wenzhou Medical University between January 19th and February 1st, 2020 were divided into CT-positive group (with lung exudation, n=31) and CT-negative group (no lung exudation, n=4). The epidemiological history, clinical symptoms, white blood cell count, and lymphocyte count abnormality in each patient were prospectively recorded, and their clinical features were evaluated. The location, distribution and morphological characteristics of lesions in CT positive group were investigated. Results: Of 35 COVID-19 patients, CT-positive patients accounted for 88.6% (31/35), with a history of the endemic center Wuhan contact accounting for 31.4% (11/35), local confirmed patients contact 31.4% (11/35), no clear epidemiological history 37.1% (13/35), fever 88.6% (31/35), gastrointestinal symptoms 11.4% (4/35), decreased white blood cell count 17.1% (6/35) and decreased lymphocyte count 37.1% (13/35). The median onset time in the CT-positive group was 4 (2, 7) d, significantly longer than CT-negative group of 2 (1, 2) d (P=0.027). Among the 31 COVID-19 patients with CT-positive, 29 (93.5%) had bilateral lung distribution. There were 471 lesions in 31 COVID-19 patients, including 67.3% (318/471) lesions located in the lower lung, and 36.7 % (173/471) in other lung lobes; 75.4% (355/471) in the lung peripheral field, and 76.4% (360/471) in the posterior lung. Of all lesions, 4.9% (23/471) had halo sign, 1.9% (9/471) reverse-halo sign, 2.5% (12/471) paving stone sign. In addition, 12.9% (4/31) of the patients were accompanied by a small amount of pleural effusion (2 cases bilateral and 2 cases unilateral). Conclusion: Chest CT examination is of great significance for the screening of patients with new type of coronavirus pneumonia, but chest CT examination of early symptoms with fever ≤2 d may be negative.

Key words： COVID-19 tomography, X-ray computed screening

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	FU Gangze
	XU Chongyong
	SUN Houchang
	CAO Guoquan
	HUANG Dingpin
	TAO Jiejie
	CHEN Shuangli
	LIN Liaoyi
	ZHANG Zirui
	YANG Yunjun
	WANG Meihao
	XIA Jinglin

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2020.03.002 OR https://xb.wmu.edu.cn/EN/Y2020/V50/I3/177

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