新型冠状病毒肺炎的CT检查与核酸检测的对比

新型冠状病毒肺炎的CT检查与核酸检测的对比(2020年第32卷第五期)

邱世香1, 3 魏剑林2 胡鸿赵佳魏欣蒲嘉琪李亚1,3 宋桂芹刘康钟立明3 

1.川北医学院·医学影像学院,四川 南充 637000;2. 川北医学院第二临床医学院·医学检验科,四川 南充 637000; 3. 南充市中心医院·川北医学院第二临床医学院介入放射科,四川 南充 637000;4. 川北医学院·基础医学院,四川 南充 637000;5. 南充市中心医院·川北医学院第二临床医学院组织工程与干细胞研究所,四川 南充 637000)

  【摘要目的 探讨计算机断层扫描( CT) 与病毒核酸检测在2019 新型冠状病毒肺炎( COVID-19) 诊断及疗效评判中的应用价值。方法  纳入南充市中心医院确诊并收治的18 例 COVID-19 患者行回顾性分析。将患者核酸检测结果、CT检查结果及CT 表现进行汇总,探讨其在COVID-19诊断及疗效评判中的应用价值。结果 18 例确诊病例中,首诊核酸检测和胸部CT检查中,核酸阳性14 例,阴性4 例;胸部CT 有肺炎表现15 例,无肺炎表现3例。核酸阳性病例中,均在胸部CT上有病毒肺炎表现。CT表现为胸膜下区域见片状、絮状、结节状的渗出影,往往以双下肺为主,病灶中以磨玻璃密度影(GGO)为主要表现,危重症者GGO 大片融合及网格状改变,亦有典型的“白肺“征象。结论  CT检查不仅在早期临床诊断中占有重要地位,在疗效的评判中也是不可替代的。因此有机的结合核酸检测及CT检查,普及胸部CT检查对COVID-19疑似患者的筛查,能够实现COVID-19防治的早发现,可有效的控制疫情的蔓延。

  【关键词 新型冠状病毒肺炎;CT扫描;核酸检测;COVID-19;诊断

  【中图分类号】R563.1;R816.4        【文献标志码】A

Comparative Analysis of Novel Coronavirus Pneumonia with CT and Nucleic Acid Detection

QIU shixiang1,3, WEI jianlin2, HU hong3, ZHAO jia2, WEI xin3, PU jiaqi3, LI ya1,3, SONG guiqin4, LIU kang5, ZHONG liming3

School of Medical Imaging, North Sichuan Medical College, Nanchong, 63700, Sichuan, China;2. Department of Medical laboratory,Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College

(1. Nanchong, 63700, Sichuan, China; 3.Department of Interventional Radiology, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong, 63700, Sichuan, China;4. School of Basic Medicine, North Sichuan Medical College, Nanchong, 63700, Sichuan, China; 5. Institute of Tissue Engineering and Stem Cell Research, Nanchong Central Hospital,The Second Clinical College of North Sichuan Medical College, Nanchong, 63700, Sichuan, China)

  【Abstract Objective  To explore computed tomography (CT) and viral nucleic acid detection in the diagnosis and curative effect evaluation of 2019 new coronavirus pneumonia (COVID-19). Methods 18 patients with COVID-19 were selected, the results of nucleic acid detection, CT examination and CT manifestations were analyzed. Results In the 18 confirmed cases, the nucleic acid of throat swab and chest CT were detected. The positive result of nucleic acid detection was in 14 cases, while 4 cases was negative in the first detection. Similarly, 15 cases with positive results and 3 cases with negative results for the first time of CT scan were found. In the nucleic acid positive cases, all cases had imaging features of pneumonia on CT. Flake, flocculent and nodular exudative shadows in the subpleural region imaging features of pneumonia were found in the image of CT, which distributed mainly in bilateral lower lungs. In the lesions, GGO is the main manifestation. In seriously ill patients, there are large fusion and grid like changes of GGO, as well as typical "white lung" signs. Conclusion CT not only plays an important role in early clinical diagnosis, but also in the evaluation of curative effect. Therefore, organic combination of nucleic acid detection and CT examination,and popularization of chest CT examination for the screening of suspected patients with COVID-19 can achieve the early detection, which will contribute to the control of COVID-19 epidemic.

  【Key words Novel Coronavirus Pneumonia; CT scanning; Nucleic Acid Detection; COVID-19; Diagnosis

 

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