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        1. 当前位置: 代写一篇论文多少钱 > 医学论文 > 40例新冠病毒感染患者的胸部CT影像特征探析

          40例新冠病毒感染患者的胸部CT影像特征探析

          时间:2019-02-27 10:44作者:余小添 叶慧 杨守峰
          本文导读:这是一篇关于40例新冠病毒感染患者的胸部CT影像特征探析的文章,新型冠状病毒感染肺炎胸部CT主要特点表现为: (1) 随机分布的磨玻璃影和实变影, 两者多同时出现; (2) 多肺叶累及常见, 易累及5个肺叶, 病变多位于肺野周边, 单发病变少见。胸部CT表现有其特点, 在早期筛查疑似病例时

            摘    要:棋牌大全下载安装 目的 探讨新型冠状病毒感染的肺炎胸部CT影像表现及其在诊断中的作用。方法 经确诊的40例COVID-19患者行胸部CT检查, 并分析病变的密度、位置、分布情况。结果 患者最常见的影像学表现为磨玻璃影 (90%) , 部分与实变影混合 (55%) , 病变累及多肺叶 (97.5%) , 部分累及5肺叶 (57.5%) , 且病灶多分布于外周 (50%) 或同时累及中央和外周 (47.5%) 。结论 新型冠状病毒感染肺炎胸部CT主要特点表现为: (1) 随机分布的磨玻璃影和实变影, 两者多同时出现; (2) 多肺叶累及常见, 易累及5个肺叶, 病变多位于肺野周边, 单发病变少见。胸部CT表现有其特点, 在早期筛查疑似病例时起到重要作用。

            关键词: 新型冠状病毒感染的肺炎; 新型冠状病毒; CT;

            Abstract: Objective To evaluate the chest CT features of Coronavirus Disease 2019 (COVID-19) and itsrole in diagnosis. Methods Forty patients with COVID-19 had chest CT scans and then further analyzed the lesionsin terms of the density and location. Results The most common findings were ground-glass opacification (GGO) (90%) and mixed lesions of GGO with consolidation (55%) . The lesions involved multiple lobes (97.5%) andsome 5 lobes (57.5%) .Typically the lesions were located in the periphery of the lung (50%) , or both central andperipheral lung (47.5%) , but very rare in a pure central location. Conclusions Common radiologic findings ofCOVID-19 are ground-glass opacification and mixed lesions of GGO with consolidation, involvement multiple lobesand peripheral distribution.The chest CT features of COVID-19 is characteristic, indicating that chest CT scan playsa very important role in the early screening suspected cases.

            Keyword: COVID-19; SARS-CoV-2; CT;

          棋牌大全下载安装   2019NIAN12YUE, HUBEISHENGWUHANSHICHUXIANLEDUOQIBUMINGYUANYINDEFEIYAN, LINCHUANGBIAOXIANHEBINGDUXINGFEIYANJIWEIXIANGSI, HOUZHENGSHIGAIFEIYANYOUYIZHONGXINXINGGUANZHUANGBINGDUGANRANSUOZHI[1], YIQINGJINYIBUMANYANQUANGUO, JIEZHI2020NIAN1YUE28RI24SHI, QUANGUOLEIJIBAOGAOQUEZHENBINGLI5 974LI, LEIJISIWANGBINGLI132LI[2]。TONGSHI, TAIGUO、RIBEN、HANGUO、JIMEIGUOJUNCHUXIANQUEZHENBINGLI[3,4,5,6]。2020NIAN2YUE1RI, SHIJIEWEISHENGZUZHIZHENGSHIMINGMINGWEICoronavirus Disease 2019 (COVID-19) , TONGRI, GUOJIBINGDUFENLEIWEIYUANHUIJIANGGAIXINXINGGUANZHUANGBINGDUMINGMINGWEISevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 。XIANYOUZHENGJUZHENGMING, SARS-CoV-2ZHUYAOTONGGUOHUXIDAOFEIMOHEJIECHUCHUANBO, QIRONGJIAOHEXIAOHUADAOCHUANBOTUJINGSHANGDAIMINGQUE, CHUANRANXINGQIANG, SUOYI“ZAOFAXIAN、ZAOGELI、ZAOZHILIAO”KEBURONGHUAN。DUIYUDADUOSHUFEIYANHUANZHE, XIONGBUYINGXIANGXUENENGGOUTIGONGZUGOUDEXINXI, YINCI, RENSHICOVID-19HUANZHEXIONGBUCTDEBIAOXIANJUYOUZHONGYAOYIYI。

            BENWENDUIBENYUANZAOQISHOUZHIDE40LIHUANZHEDEXIONGBUCTYINGXIANGJINXINGLEFENXI, JIEHELINCHUANGZILIAO, TANTAOCTYINGXIANGBIAOXIANJIQIZAIZHENDUANZHONGDEZUOYONG。

            1、 材料与方法

            1.1 、一般资料

            收集2020年1月17日至1月28日40例2019-nCoV肺炎患者, 符合《新型冠状病毒感染的肺炎诊疗方案 (试行第四版) 》[7]确诊标准, 其中男22例, 女18例, 年龄23~67岁, 平均45.9岁, 其中41~60岁者26例, 占65%。早期临床症状包括发热33例 (37.5~39.6℃) , 平均38.5℃, 咳嗽27例, 胸闷5例、腹泻6例, 无症状1例。
           

          40例新冠病毒感染患者的胸部CT影像特征探析
           

            1.2、 方法

            SUOYOUHUANZHEFABING2~14 dNEIRUZHUWOYUANXINGXIONGBUCTJIANCHA, CAIYONGMEIGUOGEGONGSILightSpeed Pro 16, 1.25 mmCENGHOU, LIANXUSAOMIAO, FENBIESHEFEICHUANGHEZONGGECHUANG。FENXIBINGBIANDEXINGTAIJIFENBU。GENJUCTPIANSHANGFEIBINGBIANMIDUDEGAODI, FENWEIMOBOLIYANGGAIBIANHESHIBIAN。JINGXIANXIAOYU35 mmWEIXIAOPIANZHUANGYING, JINGXIANDAYU35 mmWEIDAPIANZHUANGYING, BINGBIANZHIJINGXIAOYU20 mmQIECHENGSHIBIANMIDUDINGYIWEIJIEJIEYING, GUANCHAYOUWUTIAOSUOYING。BINGZAOWEIZHIGENJUYUFEIMENDEGUANXI, FENWEIZHONGXINHEZHOUBIAN, BINGQUEDINGBINGBIANFASHENGDEFEIYE。

            2、 结果

            2.1、 病变位置

          棋牌大全下载安装   20LI (50%) BINGZAOYUANLIFEIMENQUYU, WEIYUZHOUBIANBUWEI, 19LI (47.5%) TONGSHILEIJIZHONGXINJIZHOUBIANBUWEI, JINYOU1LI (2.5%) BINGZAOWEIYUZHONGXINWEIZHI。

            2.2、 病变密度

          棋牌大全下载安装   BINGZAOMIDUYIMOBOLIGAIBIANZUIWEIDUOJIAN, YOU36LI (90%) CHUXIANMOBOLIYING, QIZHONG22LI (55%) CHUXIANSHIBIANYING, 4LI (10%) JINCHUXIANSHIBIANYING。QIZHONG18LI (45%) PIANZHUANGYINGNEIMIDUBUJUNYUNERCHENGXIWANGZHUANGGAIBIAN, 12LI (30%) YOUZHIQIGUANCHONGQIZHENG, WEIJIANZHIQIGUANKUOZHANGZHENGXIANG。JUEDABUFENBINGZAOJINFEICHUANGKEJIAN, ZAIZONGGECHUANGBUKEJIANHUOFANWEIMINGXIANBIANXIAO。

            2.3、 病变形态

          棋牌大全下载安装   (1) PIANZHUANGMIDUZENGGAOYING:31LI (77.5%) JIANXIAOPIANZHUANGYING, QIZHONG12LIXIAOPIANZHUANGYINGZHONGXINMIDUJIAOGAO, BIANYUANCHENGYUNZHUANGMOBOLIYING, 22LIJIANDAPIANZHUANGYING; (2) JIEJIEYING:7LI (17.5%) CHUXIANJIEJIEYING, JUNYUPIANZHUANGYINGTONGSHICHUXIAN, WEIFAXIANDANFAJIEJIEYING; (3) TIAOSUOYING:15LI (37.5%) CHUXIANTIAOSUOYING,

            2.4 、病变分布

          棋牌大全下载安装   BINGBIANLEIJISHUANGCEFEIBU38LI (95%) , YICEFEIBU2LI (5%) , JUNWEIZUOFEI。BINGBIANJUXIANYU1GEFEIYEZHE1LI (2.5%) , 2GEFEIYEZHE5LI (12.5%) , 3GEFEIYEZHE3LI (7.5%) , 4GEFEIYEZHE8LI (20%) , 5GEFEIYEZHE23LI (57.5%) 。DANYEJIDUOYEBINGZAOFENBUJIANBIAO1, LEIJIFEIXIAYE39LI (97.5%) , LEIJIFEISHANGYE35LI (87.5%) 。

            表1 COVID-19患者病变的CT表现
          表1 COVID-19患者病变的CT表现

            3、 讨论

          棋牌大全下载安装   XINXINGGUANZHUANGBINGDUGANRANDEFEIYAN, CHUANRANXINGQIANG, ZHUYAOJINGHUXIDAOFEIMOCHUANBO, YEKETONGGUOJIECHUCHUANBO, TONGSHIRENQUNPUBIANYIGAN, JIYUMUQIANDELIUXINGBINGXUEDIAOCHA, QIANFUQIYIBANWEI3~7 d, ZUIZHANGBUCHAOGUO14 d[7], BENBINGDUOYIFAREWEISHOUFAZHENGZHUANG, BENZUHUANZHEYOU33LI (82.5%) , BUFENBANYOUKESOU、XIONGMEN、FUXIEDENGZHENGZHUANG, DANLINCHUANGSHANGBUFENHUANZHEMEIYOUMINGQUEDELIUXINGBINGXUESHI, LINCHUANGZHENGZHUANGJIXUEXIBAOJIANCHAQUEFATEYIXING, QIEBENZUYOU1LI (2.5%) WUZHENGZHUANGGANRAN, SUOYIXIONGBUYINGXIANGXUEZAISHAICHAYISIBINGLIZHONGQIDAOZHONGYAOZUOYONG。

            HUANGCHAOLINDENG[8]BAODAOLEWUHAN41LICOVID-19BINGLIDELINCHUANGTEZHENG, HUANZHEJUNWEIBINGYUANXUEZHENDUAN, WENZHANGZHICHU41LIHUANZHEXIONGBUCTJUNYOUFEIYANBIAOXIAN, QIEYILIANGFEILEIJIWEIZHU, BENZU40LIHUANZHEXIONGBUYINGXIANGBIAOXIAN, YUWENXIANXIANGFU。

            JIEHEWENXIANHEBENZUBINGLI, COVID-19XIONGBUCTZHUYAOTEDIANBIAOXIANWEI: (1) SUIJIFENBUDEMOBOLIYINGHESHIBIANYING, LIANGZHEDUOTONGSHICHUXIAN; (2) DUOFEIYELEIJICHANGJIAN, YILEIJI5GEFEIYE, BINGBIANDUOWEIYUFEIYEZHOUBIAN, DANFABINGBIANSHAOJIAN。YUSARSYINGXIANGBIAOXIAN (MOBOLIYANGMIDU, BUFENHEBINGSHIBIAN, DUOFENBIEYUXIAYEHEWAIZHOUFEIYE) [9]XIANGSI, ZHEIYUSARS-CoV-2、SARS-CoVGANRANJIZHIXIANGGUAN, LIANGZHEJUNTONGGUOS-DANBAIYURENACE2XIANGHUZUOYONGDEFENZIJIZHI, LAIGANRANRENDEHUXIDAOSHANGPIXIBAO[1], SUOYIDUIYUBIAOXIANWEILIANGFEIMIMANDEMOBOLIMIDUYINGDEBINGDUXINGFEIYAN, YOUQISHISARS, LIUXINGBINGXUEDIAOCHAYOUTISHIZUOYONG, QUEZHENRENGXUTONGGUOBINGYUANXUEJIANCHA。QITAGANRANYUFEIGANRANXINGJIBINGJIANBIE: (1) JUNTUANJUNFEIYAN。KECHUXIANMOBOLIYINGJISHIBIANYING, QIEDUOFEIYELEIJI, DANJUNTUANJUNFEIYANFEINEIDUOJIANKONGDONG, QIEBANXIONGQIANGJIYEHUOXIONGMOFEIHOU; (2) GUOMINXINGFEIYAN。CTBIAOXIANBINGBIANMIDUJIAODAN, CHENGDUOFAXINGHEYOUZOUXING, DANBINGZAOYIFEIZHONGDAIWEIZHU, ZHOUBIANSHAOJIAN; (3) JIANZHIXINGFEIYAN。KEYOUXIJUNHUOBINGDUGANRANSUOZHI, ZHUYAOYIJIANZHIBINGBIANWEIZHU, BIAOXIANWEIWANGGEZHUANGYINYING, BINGBANMOBOLIGAIBIAN, DANBINGBIANYIFEIMENZHOUWEIGAIBIANWEIZHU; (4) FEISHISUANXINGLIXIBAOJINRUNZHENG。BINGBIANKECHENGGUANGFANFEISHIZHIJIJIANZHIJINRUN, CHUXIANPIANZHUANGYING、MOBOLIYING, CHUXIANXIAOYEJIANGEZENGHOU, DANFEINEIKECHUXIANSULIYING, QIEWAIZHOUXUESHISUANXINGLIXIBAOSHENGGAO。

            ZONGSHANG, XIONGBUCTDEBIAOXIANYOUZHUYUCOVID-19DEJISHIZHENDUAN, JIEHELIUXINGBINGXUEFENXI, KEZUOWEISHAICHAYISIBINGLIDEZHONGYAOSHOUDUAN。

            参考文献

            [1]XU X T, CHEN P, WANG J F, et al.Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission[J/OL].SCI-ENCE CHINA Life Sciences, https://www.baidu.com/link?url=qtKiUIlwDNyrFpfnuIvnbCBLSUMhW82FAOIQTMk3f9OQ8NsdsD1iKO0QjWAEdIDWctuclF53nwd3il0ir5usKEO3F19OwxZS2DS-QHKPB8_8Se0TgBmIDQ9ISMBP9ENQI9pH4zwEX-DUMqo5BadYwVK&wd=&eqid=c3250e0c0003357b000000065e4cf1c3, 2019-01-21.
            [2] 中华人民共和国国家卫生与健康委员会.截至1月28日24时新型冠状病毒感染的肺炎疫情最新情况[EB/OL].http://www.gov.cn/xinwen/2020-01/29/content_5472829.htm, 2019-01-28.
            [3]WHO.Novel coronavirus-Thailand (ex-China) [EB/OL].https://www.who.int/csr/don/14-january-2020-novel-coronavirusthailand/en/,2019-01-14.
            [4]WHO.Novel coronavirus-Japan (ex-China) [EB/OL].https://www.who.int/csr/don/17-january-2020-novel-coronavirus-japan-ex-china/en/,2019-01-17.
            [5]O.Novel coronavirus-Republic of Korea (ex-China) [EB/OL].https://www.who.int/csr/don/21-january-2020-novel-coronavirusrepublic-of-korea-ex-china/en/,2020-1-21.
            [6]CDC.First travel-related case of 2019 novel coronavirus detected in United States[EB/OL].https://www.cdc.gov/media/releases/2020/p0121-novel-coronavirus-travel-case.html, 2020-1-21.
            [7] 中华人民共和国国家卫生与健康委员会.新型冠状病毒感染的肺炎诊疗方案(试行第四版)[EB/OL].http://www.nhc.gov.cn/yzygj/s7653p/202001/4294563ed35b43209b31739bd0785e67/files/7a9309111267475a99d4306962c8bf78.pdf, 2019-01-27.
            [8]HUANG C L, WANG Y M, LI X W, et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J].Lancet, 2020, 395 (10223) :497-506.
          棋牌大全下载安装   [9]WONG K T, ANTONIO G E, HUI D S, et al.Thin-section CT of severe acute respiratory syndrome:evaluation of 74 patients exposed to or with the Disease[J].Radiology, 2003, 228 (2) :395-400.

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