[1]陈静,于勇,段海峰,等.基于定量CT对新型冠状病毒肺炎肺部改变的纵向研究[J].中国医学物理学杂志,2020,37(4):445-449.[doi:DOI:10.3969/j.issn.1005-202X.2020.04.009]
　CHEN Jing,YU Yong,DUAN Haifeng,et al.Longitudinal study of lung changes induced by COVID-19 based on quantitative CT[J].Chinese Journal of Medical Physics,2020,37(4):445-449.[doi:DOI:10.3969/j.issn.1005-202X.2020.04.009]
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基于定量CT对新型冠状病毒肺炎肺部改变的纵向研究()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第4期
页码:
445-449
栏目:
医学影像物理
出版日期:
2020-04-29

文章信息/Info

Title:
Longitudinal study of lung changes induced by COVID-19 based on quantitative CT
文章编号:
1005-202X（2020）04-0445-05
作者:
陈静1; 于勇1; 段海峰1; 金晨望2; 沈聪2; 于楠1
1.陕西中医药大学附属医院医学影像科， 陕西 咸阳 712000； 2.西安交通大学第一附属医院医学影像科， 陕西 西安 710061
Author(s):
CHEN Jing1;  YU Yong1;  DUAN Haifeng1;  JIN Chenwang2;  SHEN Cong2;  YU Nan1
1.Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; 2. Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
关键词:
新型冠状病毒; 肺炎; 定量CT; 磨玻璃密度
Keywords:
Keywords: novel corona virus;  pneumonia;  quantitative CT;  ground glass opacity
分类号:
R814.42；R563.1
DOI:
DOI:10.3969/j.issn.1005-202X.2020.04.009
文献标志码:
A
摘要:
目的：探讨新型冠状病毒感染引起肺部改变的CT定量参数变化，为新型冠状病毒肺炎患者提供影像定量依据。方法：回顾性分析已确诊新型冠状病毒感染者17例，对其初次及随访胸部CT图像进行定量分析。CT定量评价指标包括肺总体积（TV）、病变总体积（TLV）、病变占总肺体积百分比（TLV/TL%）、最高密度区（HLD）、最低密度区（LLD）、磨玻璃密度百分比（GGO%）。结果：17例确诊患者共进行42次胸部CT扫描，平均间隔时间为（4±1） d。按照发病时间将病程分为4个阶段：第1阶段第0~3天，第2阶段第4~7天，第3阶段第8~14天和第4阶段第15~21天。其中第2阶段（第4~7天）和第3阶段（第8~14天）的患者TLV和TLV/TL%最高，而TV和GGO%最低（P=0.001）。TLV/TL%在第4~7天进展最快。快速进展患者（2次随访CT发现TLV进展超过50%）具有高龄（P<0.05）、淋巴细胞计数降低（P<0.001），首次CT扫描GGO%更低而TLV/TL%较高（P<0.05）的特点。结论：胸部定量CT相关指标提示，病变在第4~7天进展最快；高龄、淋巴细胞减低，初检时胸部CT病灶范围大且密度高的患者更容易出现病变的快速进展。 【关键词】新型冠状病毒；肺炎；定量CT；磨玻璃密度
Abstract:
Abstract: Objective To investigate the changes in CT quantitative parameters because of the lung changes induced by 2019 novel coronavirus (COVID-19) for providing quantitative imaging basis for patients with COVID-19. Methods A retrospective analysis of 17 patients with confirmed COVID-19 was carried out. The initial and follow-up chest CT images were analyzed quantitatively. The quantitative CT indexes included total lung volume (TV), total lesion volume (TLV), the percentage of lesion volume in total lung volume (TLV/T%), the highest lesion density region (HLD), the lowest lesion density region (LLD), percentage of ground glass opacity (GGO%). Results A total of 42 chest CT scans were conducted in 17 patients with confirmed COVID-19, and the average interval was (4±1) days. According to the time of onset, the course of disease was divided into 4 stages, namely day 0-3 (stage 1), day 4-7 (stage 2), day 8-14 (stage 3) and day 15-21 (stage 4). TLV and TLV/TL% reached the highest in stage 2 (day 4-7) and stage 3 (day 8-14), while TV and GGO% were the lowest (P=0.001). The fastest progression of TLV/TL% was found in stage 2 (day 4-7). Patients with rapid disease progression (with more than 50% TLV progression in 2 follow-up CT scans) had the characteristics of elder age (P<0.05), decreased lymphocyte count (P<0.001), and lower GGO% but higher TLV/TL% in the first CT scan (P<0.05). Conclusion Chest quantitative CT related indicators suggest that the fastest disease progression is on day 4-7. The patients with elder age, low leukocyte count, large lesion volume and high lesion density in initial CT are more likely to have rapid disease progression.

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备注/Memo

备注/Memo:
【收稿日期】2020-04-02 【基金项目】国家自然科学基金（81701691）；陕西中医药大学创新团队（2019-QN09） 【作者简介】陈静，主治医师，研究方向：中枢神经系统功能磁共振影像，E-mail: 345717558@qq.com 【通讯作者】于楠，副教授，研究方向：胸部影像学，E-mail: yunan0512 @sina.com
更新日期/Last Update: 2020-04-29