ABSTRACT
目的 探讨2019冠状病毒病（COVID-19）患者病程中胸部CT影像学表现的变化规律。 方法 收集在浙江大学医学院附属第一医院集中收治的COVID-19确诊患者52例。所有患者病程中持续胸部CT复查，人均共行4次胸部CT检查，每次检查间隔时间2~7 d。回顾性分析诊疗过程中患者CT影像学特点及随时间变化的特点。 结果 除2例患者首次胸部CT影像无异常，其余50例患者均发现肺部有不同程度的阴影。其中，表现为磨玻璃样密度影（GGO）48例（92.3%），斑片状实变、亚实变19例（36.5%），17例（32.7%）伴随出现空气支气管征，小叶间隔增粗41例（78.8%）。病程中COVID-19患者肺部GGO病变逐渐减少，纤维索条影逐渐增多，成为最常见的影像学表现。39例患者（75.0%）在入院第6~9天肺部病灶变化最明显，在入院第10~14天40例（76.9%）患者肺部病灶明显吸收。 结论 COVID-19患者的胸部CT影像学表现具有一定的特征和变化规律，这在疫情防控和临床治疗决策中具有较大价值。
ABSTRACT
BACKGROUND: Though chest computed tomography (CT) and digital radiography (DR) is important in the diagnosis and treatment of COVID-19, for patients with COVID-19 who may need magnetic resonance imaging (MRI) due to other complications, we proposed the MRI procedures for patients and medical staff to reduce the risk of infection between them. METHODS: Combining two cases in our hospital and other literature, a solution about the procedure and necessary preventive and protective measures for MRI examination of COVID-19 patients is proposed for peer reference with the help of experts from our hospital infection-control department. The solution that meets the hospital infection-control regulations covers five aspects including the layout requirements for the MRI room in the radiology department, preparation before admission, preparation of medical staff, preparation of patients, and terminal disinfection after MRI examination. Radiology personnel should strictly abide by the regulations on infection prevention and control. MRI technicians who have been in close contact with COVID-19 patients should receive strict medical observation for two weeks. Each step should be performed carefully to minimize the risk of hospital infection. RESULTS: A solution that includes five aspects was formulated to prevent the potential contamination during the MRI scan for COVID-19 patients. These five aspects are layout requirements in the MRI room, preparation before admission, preparation of medical staff, preparation of patients, and terminal disinfection after an examination. MRI technicians who have been in close contact with COVID-19 patients should receive strict medical observation for two weeks. CONCLUSIONS: To prevent and control the potential hospital infection during the MRI examination for COVID-19 patients, a solution including five aspects was initially proposed.
ABSTRACT
OBJECTIVE: To investigate the CT findings of patients with different clinical types of coronavirus disease 2019 (COVID-19). METHODS: A total of 67 patients diagnosed as COVID-19 by nucleic acid testing were collected and divided into 4 groups according to the clinical stages based on Diagnosis and treatment of novel coronavirus pneumonia (trial version 6). The CT imaging characteristics were analyzed among patients with different clinical types. RESULTS: Among 67 patients, 3(4.5%) were mild, 35 (52.2%) were moderate, 22 (32.8%) were severe, and 7(10.4%) were critical ill. No significant abnormality in chest CT imaging in mild patients. The 35 cases of moderate type included 3 (8.6%) single lesions, the 22 cases of severe cases included 1 (4.5%) single lesion and the rest cases were with multiple lesions. CT images of moderate patients were mainly manifested by solid plaque shadow and halo sign (18/35, 51.4%); while fibrous strip shadow with ground glass shadow was more frequent in severe cases (7/22, 31.8%). Consolidation shadow as the main lesion was observed in 7 cases, and all of them were severe or critical ill patients. CONCLUSIONS: CT images of patients with different clinical types of COVID-19 have characteristic manifestations, and solid shadow may predict severe and critical illness.