Analysis of CT Findings of 82 Cases of Novel Coronavirus Pneumonia in Wuhan

Zhong-xiang ZHU; Qing ZHANG; Wei XU; Xi CAI; Da-ming DONG; Xiong-feng CHEN

doi:10.13718/j.cnki.xdzk.2020.05.005

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Objective To analyze the CT imaging manifestations and clinical features of early novel coronavirus pneumonia (NCP) in Wuhan area at the onset of the plague. Methods A retrospective analysis was made of 82 patients with NCP diagnosed by nucleic acid testing of Puren Hospital affiliated to Wuhan University of Science and Technology from January 30 to February 30, 2020. All the patients were asymptomatic at the first consultation or had clinical symptoms (fever, cough, muscle soreness, abdominal pain, etc.) for the first time within 1 week, and none of them had received any treatment. Then they had a chest CT examination at the first consultation. Two senior diagnostic imaging doctors reviewed the images and analyzed the CT features of the chest in the early stage of the disease and tried to find out whether there was any difference in the distribution of CT-positive lesions in each lung lobe in the early stage of NCP patients. Results Of the 82 NCP patients, 38 were males with an average age of 45.13±14.28 and 44 were females with an average age of 48.33±15.24; and 6 were negative in the first chest CT and 76 were positive. The main manifestations were ground-glass opacity (GGO) in 70 cases (70/76, 92.11%), GGO distribution in both lungs in 55 cases (55/76, 72.37%), GGO distribution under the pleura and lung field band in 58 cases (58/70, 82.86%), thickened vascular bundles in GGO lesions in 64 cases (64/70, 91.43%) and patchy shadows and others in 6 cases (6/76, 7.9%). A total of 224 positive lesions were involved in the lobes, of which 70 were located in the right lower lung (70/224, 31.25%) and 68 in the left lower lung (68/224, 30.36%); patchy shadows and 6 others (6/76, 7.9%)). There was no significant difference in the number of lung lobes involved in early-onset lesions in patients with mild, general, severe, and critical illness (F=2.317, p > 0.05). Conclusion The early CT images of patients with NCP in Wuhan showed multiple ground-glass opacities and thickened vascular bundles, which were commonly located in double lungs, subpleural and outer zone of lung fields. Some patients with negative chest CT for the first time should be reviewed in a timely manner. The number of lung lobes involved in the early stages of mild, normal, severe and critically ill patients has no relationship with the severity of the disease.

Corresponding author: Qing ZHANG ;

Received Date: 18/03/2020

Available Online: 20/05/2020

Key words:

Abstract: Objective To analyze the CT imaging manifestations and clinical features of early novel coronavirus pneumonia (NCP) in Wuhan area at the onset of the plague. Methods A retrospective analysis was made of 82 patients with NCP diagnosed by nucleic acid testing of Puren Hospital affiliated to Wuhan University of Science and Technology from January 30 to February 30, 2020. All the patients were asymptomatic at the first consultation or had clinical symptoms (fever, cough, muscle soreness, abdominal pain, etc.) for the first time within 1 week, and none of them had received any treatment. Then they had a chest CT examination at the first consultation. Two senior diagnostic imaging doctors reviewed the images and analyzed the CT features of the chest in the early stage of the disease and tried to find out whether there was any difference in the distribution of CT-positive lesions in each lung lobe in the early stage of NCP patients. Results Of the 82 NCP patients, 38 were males with an average age of 45.13±14.28 and 44 were females with an average age of 48.33±15.24; and 6 were negative in the first chest CT and 76 were positive. The main manifestations were ground-glass opacity (GGO) in 70 cases (70/76, 92.11%), GGO distribution in both lungs in 55 cases (55/76, 72.37%), GGO distribution under the pleura and lung field band in 58 cases (58/70, 82.86%), thickened vascular bundles in GGO lesions in 64 cases (64/70, 91.43%) and patchy shadows and others in 6 cases (6/76, 7.9%). A total of 224 positive lesions were involved in the lobes, of which 70 were located in the right lower lung (70/224, 31.25%) and 68 in the left lower lung (68/224, 30.36%); patchy shadows and 6 others (6/76, 7.9%)). There was no significant difference in the number of lung lobes involved in early-onset lesions in patients with mild, general, severe, and critical illness (F=2.317, p > 0.05). Conclusion The early CT images of patients with NCP in Wuhan showed multiple ground-glass opacities and thickened vascular bundles, which were commonly located in double lungs, subpleural and outer zone of lung fields. Some patients with negative chest CT for the first time should be reviewed in a timely manner. The number of lung lobes involved in the early stages of mild, normal, severe and critically ill patients has no relationship with the severity of the disease.

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1. 资料与方法

1.1. 一般资料

回顾性搜集2020年1月30日-2月30日因身体不适(发热、咳嗽、胸闷等)或与武汉NCP患者有密切接触而就诊于武汉科技大学附属普仁医院的患者82例.参考国家卫生健康委员会《新型冠状病毒肺炎诊疗方案(试行第七版)》^[1]，通过医院影像归档和通信系统(Picture Archiving and Communication Systems，PACS)工作站调取82例患者临床资料，将所有患者分为轻型、普通型、重症型及危重型3组.

纳入标准：①新型冠状病毒核酸检测阳性；②发生临床症状1周内患者. ③未经治疗的初诊患者. ④所有患者均有实验室检查(外周血白细胞计数、淋巴细胞比率、C反应蛋白)结果.

排除标准：就诊前曾治疗的患者.

1.2. 检查方法

采用美国GE Optima 660 CT扫描仪，患者取仰卧位，吸气后屏气，扫描范围从肺尖到膈顶.采用胸部CT扫描技术.扫描参数：管电压120 kV，管电流50~400 mA，层间距5 mm，层厚0.625 mm.

由2名具有丰富工作经验的放射诊断医师在PACS工作站进行阅片，统计病灶在每个肺叶分布的数量，若病灶同时累及多个肺叶时，则每个肺叶分别各算1个病灶.当2名医师诊断结果不一致时，由第3名高年资医师裁定.

1.3. 统计学方法

所有数据应用SPSS 17.0软件进行统计分析.阳性病灶分布特点为计数资料，采用百分率表示；年龄采用中位数(上、下四分位数)表示.计量资料作正态性检验和方差齐性检验，各组数据均用均数±标准差(x±s)表示，多组间的两两比较采用单因素方差分析，p < 0.05为差异有统计学意义.

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Analysis of CT Findings of 82 Cases of Novel Coronavirus Pneumonia in Wuhan

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