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输入性与二代感染新型冠状病毒肺炎的临床与CT特征
曹金明,王唯成,陈天武,吴玉平,李睿,景春燕,张小明,张福洲,母其文,蒋炳虎
0
(四川大学华西医院呼吸与危重症医学科;川北医学院附属医院放射科·医学影像四川省重点实验室;南部县人民医院放射科;南充市中心医院影像科)
摘要:
【摘要】 目的 探讨输入性与二代感染新型冠状病毒肺炎(COVID19)的临床与CT特征。 方法 纳入四川省南充地区2020年1月21日~2月18经RTPCR检测核酸阳性确诊的COVID19患者25例,根据有无武汉暴露史分为A组(有暴露史,16人)和B组(无暴露史,9人)。分析纳入患者流行病学史、入院时的临床症状和首次胸部CT影像资料。对比A、B两组患者的临床症状和胸部CT表现,并作统计分析。 结果 25例患者中男12例、女13例,年龄10~77岁,两组患者年龄、性别比较差异无统计学意义(P>0.05)。入院时有临床症状人数,A组15例(93.8%)、B组4例(44.4%),A组患者较B组早出现临床症状,且A组临床症状较B组重,两组比较差异有统计学意义(P<0.05)。大部分患者首次胸部CT主要表现为磨玻璃影和/或小实变影。A组患者入院时的CT影像分期较B组患者的分期更晚,两组比较差异有统计学意义(P<0.05)。 结论 具有武汉暴露史的输入性病例较二代感染患者的临床和CT表现更明显。二代病例可表现为无症状感染及胸部CT阴性,核酸检测阳性在诊断中至关重要。
关键词:  COVID-19  体层摄影术  X线计算机  输入性肺炎  二代感染
DOI:
基金项目:
Comparative study on CT manifestations in COVID 19 between imported patients and the second generation cases
CAO Jinming,WANG Weicheng,CHEN Tianwu,WU Yuping,LI Rui,JING Chunyan,ZHANG Xiaoming,ZHANG Fuzhou,MU Qiwen,JIANG Binghu
(Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College;Department of Radiology, The Second Clinical College of North Sichuan Medical College;Department of Radiology, Nanchong Central Hospital,Nanbu People′s Hospital of Sichuan)
Abstract:
【Abstract】 Objective To investigate the differences of clinical symptoms and chest CT manifestations in coronavirus disease 2019 (COVID19) between imported patients and secondgeneration infection cases. Methods We collected the epidemiological history, clinical symptoms on admission and initial chest CT images of 25 patients with COVID19 confirmed by the positive nucleic acid test from Jan 21, 2020 to Feb 18, 2020 in Nanchong,Sichuan. According to the history of exposure to Wuhan, the patients were divided into group A (16 cases) with a history of exposure to Wuhan and group B (9 cases) without the previous history. The clinical symptoms and chest CT manifestations of patients in groups A and B were statistically compared. Results Among the 25 patients, there were 12 males and 13 females, aged range from 10 to 77 years. There was no significant difference between the two groups (P>0.05). 15 patients in group A (93.8%) and 4 patient in group B (44.4%) were presented with clinical symptoms on admission. The clinical symptoms of patients in group A were more early than those in group B, and the difference between groups was statistically significant (P<0.05). Ground glass opacities and / or consolidation were mainly observed on the initial chest CT images. There was a significant difference in CT image staging between groups A and B (P<0.05). Conclusion The imported cases with a history of exposure in Wuhan have more obvious clinical manifestations and CT manifestations and a faster process than those with the secondgeneration infection. The secondgeneration cases may show asymptomatic infection and negative chest CT, so nucleic acid test is essential in the diagnosis of suspected cases.
Key words:  COVID-19  Tomography, X ray Computed  Imported patients  the Second generation cases

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