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2019新型冠状病毒(2019-nCoV)肺炎的CT影像

已有 170 次阅读2020-2-5 01:13 |个人分类:医学影像|系统分类:医学科学| CT影像

2019新型冠状病毒(2019-nCoV)肺炎的CT影像。胸部CT平扫主要表现为双肺多发磨玻璃样密度影,主要位于肺周边部,并累及胸膜下区
双侧肺周边磨玻璃样密度影,并累及胸膜下区 是2019年新型冠状病毒性肺炎的常见CT表现。

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

  A 33-year-old woman presented to the hospital with a 5-day history of fever and cough of unknown cause. She indicated that she worked in Wuhan, China (the center of novel coronavirus outbreak) but had traveled to Lanzhou, China, 6 days before presentation to the hospital.

  患者基本情况:女性,33岁,因不明原因发烧和咳嗽5天到医院就诊。主诉在中国武汉(新型冠状病毒爆发中心)工作,但在就诊前六天去了中国兰州。

  At admission, her body temperature was elevated to 39.0°C (102.2°F) and coarse breath sounds of both lungs were heard at auscultation. Laboratory studies showed leucopenia (white blood cell count: 2.91 × 10^9/L). The white blood cell differential count showed 70.0% neutrophils and 0.1% eosinophils. There were elevated blood levels for C-reactive protein (16.16 mg/L; normal range, 0–10 mg/L), erythrocyte sedimentation rate (29 mm/h; normal range, <20 mm/h), and D-dimer (580 ng/mL; normal range, 500 ng/mL). Unenhanced chest CT showed multiple peripheral ground-glass opacities in both lungs (Figure,A) that did not spare the subpleural regions. Real-time fluorescence polymerase chain reaction of the patient’s sputum was positive for the 2019 novel coronavirus (2019-nCoV) nucleic acid.

  入院时,患者体温升高到39.0°C(102.2°F(华氏度)),听诊可闻及双肺粗糙呼吸音。实验室检查示白细胞降低(白细胞计数:2.91×10^9 / L)。白细胞差异计数示70.0%的中性粒细胞和0.1%的嗜酸性粒细胞。 C反应蛋白(16.16 mg / L;正常范围,0-10 mg / L),红细胞沉降率(29 mm/h;正常范围,<20 mm/h),D-二聚体血药浓度升高(580 ng / mL;正常范围,500 ng / mL)。胸部CT平扫示双肺均可见多发毛玻璃样密度影,主要位于肺周边部(图A),并累及胸膜下区。患者痰液实时荧光聚合酶链反应对2019新型冠状病毒(2019-nCoV)核酸呈阳性。

  On the basis of epidemiologic characteristics, clinical manifestations, chest images, and laboratory findings, the diagnosis of 2019-nCoV pneumonia was made. After receiving 3 days of treatment, combined with interferon inhalation, the patient was clinically worse with progressive pulmonary opacities found at repeat chest CT (Figure,B).

  根据流行病学特征、临床表现、胸部影像和实验室检查结果,诊断为2019-nCoV肺炎。接受3天治疗并联合吸入干扰素后,患者复查胸部CT发现肺部磨玻璃样密度影范围扩大,因此病情恶化(图B)。

Unenhanced CT images in a 33-year-old woman.A,Image shows multiple ground-glass opacities in bilateral lungs. Ground-glass opacities are seen in the posterior segment of right upper lobe and apical posterior segment of left superior lobe.B, Image obtained 3 days after follow-up shows progressive ground-glass opacities in the posterior segment of right upper lobe and apical posterior segment of left superior lobe. The bilateralism of the peripheral lung opacities, without subpleural sparing, are common CT findings of the 2019 novel coronavirus pneumonia.

一名33岁妇女的胸部CT平扫图像。 A,图像显示双侧肺部有多发磨玻璃样密度影,病变位于右肺上叶后段和左肺上叶尖后段。 B,随访3天后CT图像显示右肺上叶后段和左肺上叶尖后段磨玻璃样密度影范围扩大。双侧肺周边磨玻璃样密度影,并累及胸膜下区是2019年新型冠状病毒性肺炎的常见CT表现。

  Radiology杂志2020年2月4日在线了最新关于2019新冠状病毒CT影像特征的第二篇报道,详细见Radiology官网


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回复 hyc3140 2020-2-5 16:33
第二篇报道的21例患者均未见空洞,结节,胸膜腔积液等病变,有助于鉴别

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