ARTICLES| VOLUME 20, ISSUE 4, P425-434, APRIL 01, 2020

Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

Heshui Shi, Xiaoyu Han, Nanchuan Jiang, et al

Lancet Infect Dis 2020; 20: 425-434

Summary 摘要

Background 背景

A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course.

中国武汉连续报告了一组新冠病毒感染导致的肺炎(COVID-19)患者。我们旨在描述病程中不同时间点CT影像学表现。

Methods 方法

Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups.

回顾性纳入武汉2家医院收治的接受系列胸部CT扫描的COVID-19肺炎患者（根据二代测序或RT-PCR确诊）。根据发病距首次CT扫描的时间间隔，将患者分组：1组（亚临床患者；发病前进行扫描），2组（扫描距发病1周内），3组（1-2周之间），4组（2-3周之间）。分析影像学特征及分布，并进行组间比较。

Findings 结果

81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4).

2019年12月20日至2020年1月23日间，共有81名患者入院治疗。其中男性42名(52%)，女性39名 (48%)，平均年龄 49·5 岁 (SD 11·0)。平均受累肺段数为 10·5 (SD 6·4)，1组 2·8 (3·3)，2组 11·1 (5·4)，3组 13·0 (5·7)，4组 12·1 (5·9)。观察到的影像学异常主要包括双侧 (64名 [79%] 患者)，外周 (44 [54%])，边界不清 (66 [81%])及磨玻璃影 (53 [65%])，主要累及右下叶 (849个受累肺段的225个 [27%])。1组 (n=15) 患者中，主要异常为单侧 (9 [60%]) 及多叶 (8 [53%]) 磨玻璃影 (14 [93%])。2组 (n=21) 患者病变迅速进展为双侧 (19 [90%])，弥漫性 (11 [52%])，磨玻璃病变 (17 [81%])。此后，磨玻璃影比例逐渐降低 (3组30名患者中17名 [57%]，4组15名患者中5名 [33%])，实变和混合表现逐渐增加 (3组中12名 [40%] 患者，4组中8名 [53%] 患者)。

Interpretation 结论

COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1–3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia.

COVID-19肺炎表现为胸部CT影像异常，即使在无症状患者也是如此，且在1-3周内从局灶性单侧磨玻璃影迅速进展为弥漫性双侧膜玻璃影，进而发展为或合并实变。临床和实验室检查联合影像学表现有助于早期诊断COVID-19肺炎。

Funding

None.