摘要
目的探讨新型冠状病毒肺炎(COVID-19)患者胸部计算机断层成像(computed tomography,CT)的特征性表现及其临床诊断价值。方法回顾性分析2020年1月1日至2月14日上海中医药大学附属曙光医院及同济大学附属东方医院诊断为疑似COVID-19的35例患者的临床资料。其中经2次2019新型冠状病毒(2019 novel coronavirus,2019-nCoV)核酸检测呈阳性17例,阴性18例,分别纳入阳性组和阴性组。观察阳性组和阴性组患者胸部CT的特征性影像,统计磨玻璃密度影(ground-glass opacities,GGO)、铺路石征、不均匀实变、胸膜下多发病灶4种特异性征象出现的频数,分别计算其诊断COVID-19的灵敏度、特异度、阳性预测值和阴性预测值。结果阳性组中,胸部CT检查结果主要表现为GGO者11例,铺路石征7例,不均匀实变征象6例,胸膜下多发病灶16例。阴性组中,胸部CT检查结果主要表现为GGO者7例,铺路石征1例,不均匀实变征象6例,胸膜下多发病灶5例。以胸膜下多发病灶单一特征或任意2种影像学特征作为指标时,诊断效能较高;其灵敏度分别为94.12%和88.24%,特异度分别为72.22%和77.78%,阳性预测值分别为76.19%和78.95%,阴性预测值分别为98.86%和87.50%,约登指数皆为0.66。结论胸部CT检查结果对于COVID-19具有较高的临床诊断价值,以出现GGO、铺路石征、不均匀实变征象、胸膜下多发病灶4种特异性征象中的任意2种或以胸膜下多发病灶为单一特征时,其诊断效能较高。
Objective To investigate the specific chest computed tomography(CT)features of corona virus disease 2019(COVID-19)and to evaluate its clinical diagnostic value.Methods The clinical data of 35 cases with suspected COVID-19 from Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine and Shanghai East Hospital Affiliated to Tongji University from January 1 to February 14,2020 were retrospectively analyzed.A total of 17 cases with positive results of two times of real time polymerase chain reaction(RT-PCR)for 2019 novel coronavirus(2019-nCoV)were evaluated as the case group,and the remaining 18 cases with negative results of two times of RT-PCR for 2019-nCoV were evaluated as the control group.The features of chest CT images of 35 cases were obtained.The frequencies of four CT imaging indicators including ground glass opacities(GGO),crazy paving,heterogeneous consolidation and mutiple subpleural lesions were analyzed.The sensitivity,specificity,positive predictive values(PPV)and negative predictive value(NPV)for COVID-19 were calculated.Results In the case group,there were 11 cases with GGO,seven cases with crazy paving,six cases with heterogeneous consolidation,and 16 cases with mutiple subpleural lesions,while in the control group,there were seven cases with GGO,one case with crazy paving,six cases with heterogeneous consolidation,and five cases with mutiple subpleural lesions.When multiple subpleural lesions or any two of the CT imaging indicators were used as the characteristic indicators,the diagnosis efficiencies were better,with the sensitivity,specificity,PPV,NPV and Youden index of 94.12%,72.22%,76.19%,98.86%and 0.66,respectively,and 88.24%,77.78%,78.95%,87.50%and 0.66,respectively.Conclusions Chest CT indictors are of high clinical diagnostic value for COVID-19.Any two of the four CT indicators(GGO,crazy paving,heterogeneous consolidation and mutiple subpleural lesions)or the single characteristics(mutiple subpleural lesions)are of high diagnostic efficacy.
作者
吴瑜
窦娅芳
詹松华
初曙光
程爱兰
张冬晴
Wu Yu;Dou Yafang;Zhan Songhua;Chu Shuguang;Cheng Ailan;Zhang Dongqing(Department of Radiology,Shanghai Shuguang Hospital Affliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;Department of Radiology,Shanghai East Hospital Affiliated to Tongji University,Shanghai 200120,China)
出处
《中华传染病杂志》
CAS
CSCD
2020年第4期211-214,共4页
Chinese Journal of Infectious Diseases
