Objectives: To analyze the imaging features of coronavirus disease 2019 (COVID-19) in different periods, and summarize the characteristics with itsdevelopment.
Methods: We retrospectively analyzed the CT image data of COVID-19 patients diagnosed by nucleic acid test and CT examination in 57 patients in Zhuzhou Central Hospital and Zhuzhou First People's Hospital, and summarized the characteristics of CT imaging and the development of lesions.
Results: Most of the cases were characterized by peripheral distribution of lesions. A total of 37 cases (64.91%) were purely peripherally distributed, 16 cases (28.07%) coexisted with peripheral and mid-internal distribution, and 4 cases (7.02%) had simple mid-inner band distribution. In peripherally distributed cases, the long axis of the lesion was mostly parallel to the pleura in 36 cases (63.16%). In the case of inner-middle zone distribution, the long axis of the lesion was mostly parallel and surrounded the bronchial vascular bundle, or distributed along the lung lobules (31.58%). All cases had ground-glass-density foci, 31 cases (54.38%) had fine grid shadows in the lesions, 46 cases (80.70%) had thick vascular shadows in the lesions, and 23 cases (40.35%) showed signs of bronchial inflation. Among the 10 cases of "wrinkling shape" lesions in the first CT examination, except for 1 case without reexamination, the remaining 9 cases had different degrees of absorption in the second CT examination. Among the 26 cases of "wrinkling shape" lesions in the second CT examination, except for 11 cases without reexamination, the other 15 patients had different degrees of absorption in the third CT examination.
Conclusions: The early CT manifestations of COVID-19 are mostly ground-glass-density foci distributed in the subpleural region, some of which are distributed near the bronchial blood vessel bundle and in the central area of the lobule. As the course of the disease progresses, there may be varying degrees of solid components in the lesion. When the lesions show a "wrinkling shape", it is often suggested that the lesions will evolve towards the direction of absorption. These characteristics are of great value in assisting clinical diagnosis and dynamically observing changes undersuch condition.
目的: 分析2019冠状病毒病不同时期的影像学表现特点，并总结其演变特征。方法: 回顾性分析株洲市中心医院及株洲市渌口区人民医院经核酸检测及CT检查确诊的57例2019冠状病毒病患者的CT影像学资料，分析并总结其CT影像学表现及病灶演变特征。结果: 大部分病例表现为以病灶外周分布为主的特点，病灶单纯以外周分布者37例(64.91%)，外周分布与中内带分布共存者16例(28.07%)，单纯中内带分布者4例(7.02%)。在外周分布的病例中，有36例(63.16%)病灶长轴多与胸膜平行。在中内带分布的病例中，有18例(31.58%)病灶长轴多平行包绕支气管血管束或沿小叶中心区分布。病例均有磨玻璃影，31例(54.38%)伴有病灶内细小网格影，46例(80.70%)病灶内可见增粗的小血管影，23例(40.35%)可见支气管充气征。在第1次CT检查的10例“皱缩状”病灶中，除1例未复查外，其余9例均在第2次CT检查中有不同程度的吸收。在第2次CT检查的26例“皱缩状”病灶中，除11例未复查外，其余15例均在第3次CT检查中有不同程度的吸收。结论: 2019冠状病毒病的CT影像学表现早期多以胸膜下区分布的磨玻璃影为主，部分分布在支气管血管束旁、小叶中心区。随着病程进展，可出现不同程度的实变影。当病灶呈现“皱缩状”时，多提示病灶将朝吸收方向演变。这些特点对协助临床进行诊断及动态观察病情变化具有重要价值。.
Keywords: characteristics of lesion evolution; coronavirus disease 2019; pulmonary CT imaging performance.