输入性与二代感染新型冠状病毒肺炎CT特征对比研究

输入性与二代感染新型冠状病毒肺炎CT特征对比研究(2020年第32卷第五期)

曹金明1,2 王唯成1 陈天武 吴玉平1  1 景春燕3 张小明1 张福洲2 母其文蒋炳虎2

1.川北医学院附属医院放射科/医学影像四川省重点实验室,四川 南充 637000;2.川北医学院第二临床医学院/南充市中心医院影像科,四川 南充 637000;3.四川省南部县人民医院放射科,四川 南部 637330)

  【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特征差异性。方法 纳入四川南充地区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例的流行病学史、入院时的临床症状和首次胸部CT影像资料。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,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(P0.05)。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(P0.05)。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组患者的分期晚,两组比较差异有统计学意义(P0.05)。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。二代感染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】冠状病毒;肺炎;感染;体层摄影术,X线计算机

  【中图分类号】R563.1            【文献标志码】A

Comparative study on CT manifestations in COVID-19 between Imported Patients and Second-Generation Cases

CAO Jinming1,2, WANG Weicheng1, CHEN Tianwu1, WU Yuping1, LI Rui1, JING Chunyan3, ZHANG Xiaoming1, ZHANG Fuzhou2, MU QIwen2JIANG Binghu2

(1.Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China;2.Department of Radiology, Second School of Clinical Medicine / Nanchong Central Hospital, North Sichuan Medical College, Nanchong, Sichuan, China;3.Department of Radiology, Nanbu County Peoples Hospital of Sichuan Province, Nanchong, Sichuan, China)

  【AbstractObjective  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 City of Sichuan. According to the history of exposure to Wuhan, 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). (3) Ground glass opacities and / or consolidation were mainly observed on the initial chest CT images. In group A, 5 cases (31.2%) and 11 cases (68.8%) were in early and progress stage, respectively, while in group B, 3 cases (33.3%) and 2 cases(22.2%) were in early and progress stage respectively, and 4 cases (44.5%) had no abnormalities on initial CT. 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 second-generation infection. 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 Coronavirus; Pneumonia; Infection; Tomography, X-ray Computed

 

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