{"title":"Imaging diagnosis and prognosis of cerebral venous sinus thrombosis","authors":"Yan-yao Du, Ruomei Xu, Xiaochun Wang, Hui Zhang","doi":"10.3760/CMA.J.CN112149-20200102-00007","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200102-00007","url":null,"abstract":"脑静脉窦血栓形成（CVST）是少见的卒中样颅内静脉系统疾病，其诊断主要依靠影像学检查。本文从CVST的流行病学、病因学、临床与病理入手，重点介绍了CVST特征性CT、MRI及DSA表现，并根据其影像表现初步判断预后。CVST早期准确诊断，对指导临床精准治疗及预后评估具有重要意义。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48724873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The progress and application of artificial intelligence and radiomics on abdominal tumors","authors":"Tiansong Xie, Zhengrong Zhou","doi":"10.3760/CMA.J.CN112149-20190421-00098","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190421-00098","url":null,"abstract":"人工智能（AI）是影像学的发展方向之一，尤其是深度学习等AI在图像识别上取得了不俗的成果。其中，影像组学是AI在肿瘤影像领域的研究热点。AI技术及影像组学在结直肠肿瘤、肝脏肿瘤、肾脏肿瘤中均取得了进展。与此同时，AI与影像的融合仍处于起步阶段，还面临诸多挑战。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46700938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retrospective analysis of gadolinium imaging data of 13 patients (21 ears) with large vestibular aqueduct syndrome (LVAS group) and 23 patients (23 ears) with normal hearing (normal group) diagnosed clinically at the Affiliated Hospital of Jining Medical College from July 2013 to September 2018. First, 3D steady state interference (3D-CISS) and 3D liquid attenuation inversion recovery (3D-FLAIR) sequence MRI scans were performed. Diluted gadolinium contrast agent was injected into the tympanic cavity through the tympanic membrane, and 3D-FLAIR scans were performed after 1, 2, 3, and 6 days, respectively. Score the display of cochlear, vestibular, and semicircular lymphatic spaces between two groups, and compare the scoring results using Wilcoxon rank sum test. Measure the signal intensity of the lymphatic vessel (ED) and lymphatic sac (ES) in the LVAS group before and after injection of contrast agent, calculate the signal intensity ratio (SIR) with the same layer of brainstem, and compare the differences before and after injection using one-way analysis of variance. The results showed that the cochlea, vestibule, and semicircular canals of the LVAS group and the normal group showed low signal intensity on 3D-FLAIR before injection of contrast agent; After injection of contrast agent, the contrast agent was distributed in the cochlea of the inner ear, vestibule, and perilymphatic space of the semicircular canal. There was no statistically significant difference in display scores between the two groups (Z=-0.95, P=0.34). Both ED and ES were not displayed in the normal group, and there was no change in signal intensity after injection of contrast agent; The ED and ES regions of the LVAS group showed complete low signal in 2 ears on 3D-FLAIR, with clear boundaries between low and high signal in 19 ears. After injection of contrast agent, the signal intensity of the low signal area in the ED and ES areas on the affected side increased, and there was a statistically significant difference in SIR values before and after injection of contrast agent (F=111.93, P<0.01). The results of this study suggest that there is no significant lymphatic hydrops in the inner ear (cochlea, vestibule, and semicircular canal) of LVAS patients; The ED and ES of the affected ear may be connected to the anterior extramural lymphatic space; There may be gaps between ED and ES in some affected ears.
{"title":"Inner ear perilymphaticum gadolinium based MR imaging in large vestibular aqueduct: a pilot study","authors":"Lihong Zhang, Linsheng Wang, Xiaoyan Li, Xian Li, Xi-bin Hu, Yueqin Chen","doi":"10.3760/CMA.J.CN112149-20190523-00443","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190523-00443","url":null,"abstract":"回顾性分析2013年7月至2018年9月济宁医学院附属医院经临床诊断的13例（21耳）大前庭导水管综合征（LVAS）患者（LVAS组）和23例（23耳）听力正常者（正常组）外淋巴间隙钆成像资料。先行三维稳态构成干扰（3D-CISS）和三维液体衰减反转恢复（3D-FLAIR）序列MRI扫描，经鼓膜向鼓室内注入稀释的钆对比剂，1、2、3、6 d后分别行3D-FLAIR扫描。对两组耳蜗、前庭及半规管外淋巴间隙显示情况进行评分，评分结果比较采用Wilcoxon秩和检验。测量LVAS组内淋巴管（ED）和内淋巴囊（ES）区注射对比剂前后信号强度，计算与同层脑干的信号强度比（SIR），采用单因素方差分析比较注射前后的差异。结果显示注射对比剂前LVAS组和正常组耳蜗、前庭及半规管在3D-FLAIR上呈低信号；注射对比剂后，对比剂分布于内耳耳蜗、前庭、半规管外淋巴间隙，两组间显示情况评分差异无统计学意义（Z=-0.95，P=0.34）。正常组ED和ES均未显示，注射对比剂后亦无信号强度改变；LVAS组ED和ES区在3D-FLAIR上呈完全低信号2耳，呈分界清晰低、高信号19耳。注射对比剂后患侧ED和ES区低信号区信号强度增强，注射对比剂前后SIR值间比较差异有统计学意义（F=111.93，P <0.01）。本研究结果提示：LVAS患耳内耳（耳蜗、前庭和半规管）内淋巴积水不显著；患耳ED和ES可能与前庭外淋巴间隙相通；部分患耳的ED和ES内可能存在间隔。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47500150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20200205-00089
Nanchuan Jiang, C. Zheng, Yanqing Fan, Xiaoyu Han, Yan Chen, Qiguang Cheng, B. Liang, P. Han, Heshui Shi
Objective: To explore the characteristics and short-term changes of high resolution CT (HRCT) in subclinical stage of COVID-19. Methods: The HRCT images of 17 COVID-19 patients in subclinical stage were analyzed retrospectively in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Wuhan Jinyintan Hospital from January 15 to 31, 2020. There were 4 males and 13 females, age ranged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with other COVID-19 patients. The follow-up CT examination was performed within 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation and symptomatic therapy, while the other 11 patients were untreated. The subclinical CT findings and short-term follow-up were analyzed, and the CT changes of short-term follow-up were summarized. Results: The lesions of 17 COVID-19 patients were mainly located at the lower lobes of bilateral lungs (at the left lower lobe in 9 cases and at the right lower lobe in 10 cases in the subclinical stage, at the left lower lobe in 9 cases and at the right lower lobe in 11 cases in the short-term follow-up). The number of involved lung segments increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, the multiple lesions were found in 13 cases, while in the short-term follow-up, the number of cases with multiple lesions decreased by 7, however the cases with focal lesions increased by 6 and diffuse lesions by 4. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle(10 cases). In the short-term follow-up, the lesion in 1 case expanded from the subpleural area to neighbouring bronchovascular bundle. There were 3 main types of the lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, the ground glass opacities were seen in all the 17 cases. In the short-term follow-up, the number of cases with ground glass nodules decreased by 4 and crazy-paving pattern increased by 4. In 6 patients after treatment, the multiple ground glass nodules became single one in 3 cases, and in other 3 cases the multiple ground glass opacities were getting smaller. However, the scope of lesions in 11 patients without treatment enlarged. Conclusion: The HRCT features of the COVID-19 in subcilincal stage have some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural area or along the bronchovascular bundle, and the great changes can be seen in the short-term follow-up.
{"title":"CT appearances and short-term changes of COVID-19 in subclinical period/ 新型冠状病毒肺炎亚临床期CT影像特征及短期演变","authors":"Nanchuan Jiang, C. Zheng, Yanqing Fan, Xiaoyu Han, Yan Chen, Qiguang Cheng, B. Liang, P. Han, Heshui Shi","doi":"10.3760/CMA.J.CN112149-20200205-00089","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200205-00089","url":null,"abstract":"Objective: To explore the characteristics and short-term changes of high resolution CT (HRCT) in subclinical stage of COVID-19. Methods: The HRCT images of 17 COVID-19 patients in subclinical stage were analyzed retrospectively in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Wuhan Jinyintan Hospital from January 15 to 31, 2020. There were 4 males and 13 females, age ranged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with other COVID-19 patients. The follow-up CT examination was performed within 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation and symptomatic therapy, while the other 11 patients were untreated. The subclinical CT findings and short-term follow-up were analyzed, and the CT changes of short-term follow-up were summarized. Results: The lesions of 17 COVID-19 patients were mainly located at the lower lobes of bilateral lungs (at the left lower lobe in 9 cases and at the right lower lobe in 10 cases in the subclinical stage, at the left lower lobe in 9 cases and at the right lower lobe in 11 cases in the short-term follow-up). The number of involved lung segments increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, the multiple lesions were found in 13 cases, while in the short-term follow-up, the number of cases with multiple lesions decreased by 7, however the cases with focal lesions increased by 6 and diffuse lesions by 4. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle(10 cases). In the short-term follow-up, the lesion in 1 case expanded from the subpleural area to neighbouring bronchovascular bundle. There were 3 main types of the lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, the ground glass opacities were seen in all the 17 cases. In the short-term follow-up, the number of cases with ground glass nodules decreased by 4 and crazy-paving pattern increased by 4. In 6 patients after treatment, the multiple ground glass nodules became single one in 3 cases, and in other 3 cases the multiple ground glass opacities were getting smaller. However, the scope of lesions in 11 patients without treatment enlarged. Conclusion: The HRCT features of the COVID-19 in subcilincal stage have some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural area or along the bronchovascular bundle, and the great changes can be seen in the short-term follow-up.","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48501722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20200205-00087
Lu Huang, R. Han, Pengxin Yu, Shao-hua Wang, L. Xia
Objective: To investigate the CT and clinical features of COVID-19. Methods: Chest CT and clinical data of 103 patients who were confirmed as COVID-19 in January 2020 were collected retrospectively. According to diagnosis and treatment of COVID-19 (trial version 5), all the patients were classified into common(n=58), severe (n=36) and critical (n=9) types, and their clinical findings, laboratory examination and CT finding were analyzed. CT features included distribution, location, size, shape, edge, number and density of the lesion, percentage of pneumonia lesions of the whole lung and extra-pulmonary manifestations. The CT features among different clinical types were compared using χ 2test or Fisher's exact probability. Comparisons of age, duration from onset to CT examination, and percentage of pneumonic lesions to total lung volume among different types were performed by using analysis of variance (normal distribution) or Kruskal-Wallis rank sum test (non-normal distribution). Results: In terms of clinical manifestations, the patients with critical COVID-19 were more common in elderly men, with a median age of 65 years. Fever was the first symptom in 49 (84%) of 58 common patients, and also the first symptom in both severe and critical COVID-19 patients. The incidence of coughing in severe (25/36, 69%) and critical (6/9, 67%) COVID-19 patients was higher than that in common patients (20/58, 34%). All critical patients had dyspnea. CT showed the common COVID-19 was located in bilateral lung (40/58, 71%)with multiple (40/58, 69%), ground glass (31/58, 52%) or mixed (25/58, 43%)opacities (56/58, 97%), while all the severe and critical COVID-19 were located in bilateral lung(100%) with multiple (34/36, 96%), patchy (33 /36, 92%), or mixed opacities (26/36, 72%) in severe patients, and with mixed opacities more than 3 cm in critical patients. As for the percentage of pneumonia focus in the whole lung volume, the common type (12.5%±6.1%) was significantly lower than the severe type (25.9%± 10.7%) and the critical type (47.2%±19.2%), with statistically significant differences(P< 0.001 and 0.002 respectively), and the severe type COVID-19 was also significantly lower than the critical type (P= 0.032). Conclusions: CT and clinical features of different clinical types of COVID-19 pneumonia are different. Chest CT findings are characteristic, which can not only help the early diagnosis but also evaluate the clinical course and severity.
{"title":"A correlation study of CT and clinical features of different clinical types of COVID-19/ 新型冠状病毒肺炎不同临床分型间CT和临床表现的相关性研究","authors":"Lu Huang, R. Han, Pengxin Yu, Shao-hua Wang, L. Xia","doi":"10.3760/CMA.J.CN112149-20200205-00087","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200205-00087","url":null,"abstract":"Objective: To investigate the CT and clinical features of COVID-19. Methods: Chest CT and clinical data of 103 patients who were confirmed as COVID-19 in January 2020 were collected retrospectively. According to diagnosis and treatment of COVID-19 (trial version 5), all the patients were classified into common(n=58), severe (n=36) and critical (n=9) types, and their clinical findings, laboratory examination and CT finding were analyzed. CT features included distribution, location, size, shape, edge, number and density of the lesion, percentage of pneumonia lesions of the whole lung and extra-pulmonary manifestations. The CT features among different clinical types were compared using χ 2test or Fisher's exact probability. Comparisons of age, duration from onset to CT examination, and percentage of pneumonic lesions to total lung volume among different types were performed by using analysis of variance (normal distribution) or Kruskal-Wallis rank sum test (non-normal distribution). Results: In terms of clinical manifestations, the patients with critical COVID-19 were more common in elderly men, with a median age of 65 years. Fever was the first symptom in 49 (84%) of 58 common patients, and also the first symptom in both severe and critical COVID-19 patients. The incidence of coughing in severe (25/36, 69%) and critical (6/9, 67%) COVID-19 patients was higher than that in common patients (20/58, 34%). All critical patients had dyspnea. CT showed the common COVID-19 was located in bilateral lung (40/58, 71%)with multiple (40/58, 69%), ground glass (31/58, 52%) or mixed (25/58, 43%)opacities (56/58, 97%), while all the severe and critical COVID-19 were located in bilateral lung(100%) with multiple (34/36, 96%), patchy (33 /36, 92%), or mixed opacities (26/36, 72%) in severe patients, and with mixed opacities more than 3 cm in critical patients. As for the percentage of pneumonia focus in the whole lung volume, the common type (12.5%±6.1%) was significantly lower than the severe type (25.9%± 10.7%) and the critical type (47.2%±19.2%), with statistically significant differences(P< 0.001 and 0.002 respectively), and the severe type COVID-19 was also significantly lower than the critical type (P= 0.032). Conclusions: CT and clinical features of different clinical types of COVID-19 pneumonia are different. Chest CT findings are characteristic, which can not only help the early diagnosis but also evaluate the clinical course and severity.","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45499452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-31DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.0021
Zhaoping Cheng, Yan Li, Y. Duan, Hui Gu, Changhu Liang, Yumao Yan, B. Gao, Shaoxian Li, Lin-li Sun, Ximing Wang
Objective To explorethe evolution of continuous dynamic chest high resolution CT (HRCT) image in patients with mild COVID-19. Methods The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 ordinary patients and 1 light patient) were enrolled in the group, including 14 males and 11 females, with (42±12) years and hospital stay of (19±5) days. The basic image and dynamic image of HRCT were analyzed and compared by the radiologists. Results The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lack specificity. There was no significant abnormality in chest CT of one light patient. HRCT findings of the common type patients were as follows: (1) the distribution of the lesions: most of the multiple lesions in both lungs (19 cases), the average number of involved lobes (3±1), most of which were located in the extra pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); With the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5 (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days. Conclusions Continuous dynamic chest HRCT can monitor the basic evolution process of patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment. Key words: COVID-19; Tomography, X-ray computed
{"title":"A preliminary study on the dynamic image evolution of chest high resolution CT in patients with mild COVID-19","authors":"Zhaoping Cheng, Yan Li, Y. Duan, Hui Gu, Changhu Liang, Yumao Yan, B. Gao, Shaoxian Li, Lin-li Sun, Ximing Wang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.0021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.0021","url":null,"abstract":"Objective \u0000To explorethe evolution of continuous dynamic chest high resolution CT (HRCT) image in patients with mild COVID-19. \u0000 \u0000 \u0000Methods \u0000The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 ordinary patients and 1 light patient) were enrolled in the group, including 14 males and 11 females, with (42±12) years and hospital stay of (19±5) days. The basic image and dynamic image of HRCT were analyzed and compared by the radiologists. \u0000 \u0000 \u0000Results \u0000The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lack specificity. There was no significant abnormality in chest CT of one light patient. HRCT findings of the common type patients were as follows: (1) the distribution of the lesions: most of the multiple lesions in both lungs (19 cases), the average number of involved lobes (3±1), most of which were located in the extra pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); With the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5 (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days. \u0000 \u0000 \u0000Conclusions \u0000Continuous dynamic chest HRCT can monitor the basic evolution process of patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Tomography, X-ray computed","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42729457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the CT manifestations and clinical features of 8 cases of COVID-19 imported from abroad with clustering disease. Retrospective collection of clinical and CT imaging data of 8 patients with imported cluster disease confirmed on March 1 and 2, 2020 in Lishui City, Zhejiang Province. Eight patients were practitioners from the same restaurant in Italy, all returning from Milan, Italy. There were six males and two females, aged 30.0-40.0 (33.5 ± 3.3) years old. All patients underwent CT re examination 3-5 days after their first CT examination. All 8 patients had normal blood routine and no fever upon admission. Among them, 1 had dry cough and diarrhea, 1 had dry cough, and 6 had no obvious symptoms. The first CT scan showed multiple patchy, wedge-shaped ground glass or solid lesions in the pleura of both lungs in 3 cases, diffuse ground glass and solid lesions in 1 case, single lobar subpleural patchy ground glass lesions in 2 cases, and fibrous lesions in the middle and lower left lobes of the right lung in 1 case. The imaging appearance was normal in 1 case. After an interval of 3-5 days, CT scans showed significant absorption in 5 lesions, slight absorption in 1 case, and no change in 1 fibrous lesion. Non COVID-19 changes were considered. The COVID-19 patients with aggregation disease imported from overseas in this group did not have fever, and there was no decrease in white blood cell and lymphocyte counts. The CT imaging manifestations were diverse, but absorption was rapid, indicating that the clinical symptoms and CT manifestations of imported cases were more subtle and complex. It is necessary to be vigilant to avoid misdiagnosis.
{"title":"CT features and clinical characteristics of 8 cluster cases of imported COVID-19/ 八例境外输入聚集性发病的新型冠状病毒肺炎的CT表现及临床特征","authors":"Weibing Yang, Q. Weng, Yangrui Xiao, Jun Lin, Yiping Zhang, J. Ji","doi":"10.3760/CMA.J.CN112149-20200306-00333","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200306-00333","url":null,"abstract":"探讨境外输入聚集性发病的8例新型冠状病毒肺炎(COVID-19)的CT表现和临床特征。回顾性收集2020年3月1日和2日确诊的浙江省丽水市8例境外输入聚集性发病患者的临床及CT影像学资料。8例患者为意大利同一餐厅的从业者，均自意大利米兰出发回国，男6例，女2例，年龄30.0~40.0（33.5±3.3）岁，所有患者首次CT检查后3~5 d再次行CT复查。8例患者血常规均正常，且入院时均无发热，其中1例有干咳和腹泻，1例干咳，6例无明显症状。首次CT检查表现为两肺胸膜下多发斑片状、楔形磨玻璃或实性病灶3例，两肺弥漫分布磨玻璃及实性病灶1例，单一肺叶胸膜下斑片状磨玻璃病灶2例，右肺中叶及左肺下叶纤维灶1例，影像表现正常1例。间隔3~5 d后复查CT显示5例病灶明显吸收，1例稍有吸收，1例纤维灶无改变，考虑非COVID-19改变。本组境外输入聚集性发病的COVID-19患者均无发热，白细胞及淋巴细胞计数等无下降，CT影像表现形态多样，但吸收快速，提示境外输入性病例临床症状及CT表现更为隐蔽复杂，需提高警惕，避免误诊。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48365763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-13DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.0020
Zhibin Lyu, Chun-shuang Guan, Shuo Yan, Tao Cui, A. Zhou, R. Xie, Budong Chen
Objective To investigate the value of CT findings in predicting transformation of clinical types of COVID-19. Methods From January 24 to February 6, 2020, the clinical and chest CT data of patients with common covid-19 were analyzed retrospectively. A total of 64 patients were enrolled, 32 males and 32 females, ranging in age from 18 to 76 years, with an average age of (45 ± 15) years. Based on the fact whether patients’ conditions had deteriorated into severe type, all the cases were divided into common type group (51 cases) and deteriorated type group (13cases). Differences of CT findings in two groups of patients were analyzed, and visual semi-quantitative scores were introduced to evaluate the pneumonia. Results Compared with the common type group, the heavy type group was more likely to involve the left upper lobe, the right middle lobe and the part far away from the pleura. The difference between the two groups was statistically significant (χ2= 5.897, P = 0.027; χ2= 8.549, P= 0.005; χ2= 10.169,P= 0.002). There were 2 (1,5) medians of the involved lobes in the general type group and 5 (4,5) medians of the involved lobes in the heavy type group. The difference between the two groups was statistically significant (Z = -3.303, P = 0.001). Taking the involved lobes (n=4) as the boundary value, the sensitivity and specificity of the diagnosis of the general type to the heavy type patients were the highest, 76.9% and 74.5% respectively, and the area under the ROC curve was 0.787. Pneumonia score 10 (4,16) of the severe group was higher than that of the common group 4 (1,13), the difference was statistically significant (Z=-4.040, P<0.001); the sensitivity and specificity of the general severe group were the highest, 69.2% and 86.3% respectively, and the area under ROC curve was 0.863. Conclusions CT imaging has a profound value in early prediction of deterioration in clinical type. It can help evaluate the severity of pneumonia in early stage. Range of lesions might be an important indicator for prognosis of common type COVID-19. Key words: COVID-19; Tomography, X-ray computed
目的探讨CT表现对新型冠状病毒临床分型转变的预测价值。方法回顾性分析2020年1月24日至2月6日收治的常见covid-19患者的临床及胸部CT资料。共纳入64例患者，男32例，女32例，年龄18 ~ 76岁，平均年龄(45±15)岁。根据患者病情是否恶化为重症，将所有病例分为普通型组(51例)和恶化型组(13例)。分析两组患者CT表现的差异，采用视觉半定量评分法评价肺炎。结果重型组较普通型组更易累及左上肺叶、右中肺叶及远离胸膜部位。两组间差异有统计学意义(χ2= 5.897, P = 0.027;χ2= 8.549, p = 0.005;χ2= 10.169, p = 0.002)。一般型组受累叶中位数为2(1,5)个，重型组受累叶中位数为5(4,5)个。两组间差异有统计学意义(Z = -3.303, P = 0.001)。以受累肺叶(n=4)为边界值，一般型诊断对重型患者的敏感性和特异性最高，分别为76.9%和74.5%，ROC曲线下面积为0.787。重症组肺炎评分10分(4,16分)高于普通组4分(1,13分)，差异有统计学意义(Z=-4.040, P<0.001);一般重症组的敏感性和特异性最高，分别为69.2%和86.3%，ROC曲线下面积为0.863。结论CT对临床分型恶化的早期预测具有重要价值。它可以帮助在早期评估肺炎的严重程度。病变范围可能是判断普通型COVID-19预后的重要指标。关键词:COVID-19;x线计算机断层扫描
{"title":"Value of CT findings in predicting transformation of clinical types of COVID-19","authors":"Zhibin Lyu, Chun-shuang Guan, Shuo Yan, Tao Cui, A. Zhou, R. Xie, Budong Chen","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.0020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.0020","url":null,"abstract":"Objective \u0000To investigate the value of CT findings in predicting transformation of clinical types of COVID-19. \u0000 \u0000 \u0000Methods \u0000From January 24 to February 6, 2020, the clinical and chest CT data of patients with common covid-19 were analyzed retrospectively. A total of 64 patients were enrolled, 32 males and 32 females, ranging in age from 18 to 76 years, with an average age of (45 ± 15) years. Based on the fact whether patients’ conditions had deteriorated into severe type, all the cases were divided into common type group (51 cases) and deteriorated type group (13cases). Differences of CT findings in two groups of patients were analyzed, and visual semi-quantitative scores were introduced to evaluate the pneumonia. \u0000 \u0000 \u0000Results \u0000Compared with the common type group, the heavy type group was more likely to involve the left upper lobe, the right middle lobe and the part far away from the pleura. The difference between the two groups was statistically significant (χ2= 5.897, P = 0.027; χ2= 8.549, P= 0.005; χ2= 10.169,P= 0.002). There were 2 (1,5) medians of the involved lobes in the general type group and 5 (4,5) medians of the involved lobes in the heavy type group. The difference between the two groups was statistically significant (Z = -3.303, P = 0.001). Taking the involved lobes (n=4) as the boundary value, the sensitivity and specificity of the diagnosis of the general type to the heavy type patients were the highest, 76.9% and 74.5% respectively, and the area under the ROC curve was 0.787. Pneumonia score 10 (4,16) of the severe group was higher than that of the common group 4 (1,13), the difference was statistically significant (Z=-4.040, P<0.001); the sensitivity and specificity of the general severe group were the highest, 69.2% and 86.3% respectively, and the area under ROC curve was 0.863. \u0000 \u0000 \u0000Conclusions \u0000CT imaging has a profound value in early prediction of deterioration in clinical type. It can help evaluate the severity of pneumonia in early stage. Range of lesions might be an important indicator for prognosis of common type COVID-19. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Tomography, X-ray computed","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48290058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To explore the value of bedside chest radiograph in the diagnosis and follow-up of severe and critical COVID-19, and to improve the effect of bedside chest radiograph in the prevention and treatment of critical COVID-19. Methods Twenty-nine patients with COVID-19 were collected from January 23to February 23, 2020, fromfourCOVID-19 designated hospitals in Guangdong Province,which were clinically diagnosed as severe or critical COVID-19.Bedside radiography was taken in all the 29 patients, and thetotal number ranged from 1 to 16 times. Twenty-sevenpatients underwent follow-up, and the number of re-examination ranged 1 to 15 times, and the interval of review is 1 to 8 days.The imaging findings of bedside chest radiography and the imaging changes of follow-up were analyzed retrospectively. Results Twenty-nine patients were collected. The radiography showed the distribution of lesions was all more than 3 lung fields. Among them, 6 lung fields were found in 8 cases, 5 lung fields in 8 cases, 4 lung fields in 7 cases, 3 lung fields in 6 cases. The films showed consolidation shadow in 19 cases, multiple patches shadow in 23 cases, reticular pattern in 12 cases, strips shadow in 14 cases, interlobar fissure thickening in 18 cases, and "white lung" in 4 cases.The complications included pleural effusion in 4 cases, pneumothorax in 2 cases, mediastinal and subcutaneous emphysema in 1 case. The radiography showed the lesions increased in 15 cases, mainly showing the range of original lesions was enlarged, the density increasing in 6 cases, new lesionsfound in 5 cases, andboth of them found in 4 cases.Decreased in 9 cases, showing the range of lesions was reduced and the density was reduced. 8 cases showed patchy or consolidation shadow turned to strips shadow or articular pattern shadow.No significant change in 3 casesshowed large consolidation shadow. Conclusions Bedside chest radiography has a good value in the follow-up of severely and critically ill patients with COVID-19, and can provide great help for clinicians to evaluate their condition. Key words: COVID-19; Radiography
{"title":"The effect of bedside chest radiograph in the diagnosis and follow-up ofsevereand criticalCOVID-19","authors":"Huai Chen, Yujian Zou, Bowen Lan, Zheng-Jia Wu, Zhiwen Ni, Suidan Huang, Xiaoqing Liu, Y. Song, Q. Zeng","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.0018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.0018","url":null,"abstract":"Objective \u0000To explore the value of bedside chest radiograph in the diagnosis and follow-up of severe and critical COVID-19, and to improve the effect of bedside chest radiograph in the prevention and treatment of critical COVID-19. \u0000 \u0000 \u0000Methods \u0000Twenty-nine patients with COVID-19 were collected from January 23to February 23, 2020, fromfourCOVID-19 designated hospitals in Guangdong Province,which were clinically diagnosed as severe or critical COVID-19.Bedside radiography was taken in all the 29 patients, and thetotal number ranged from 1 to 16 times. Twenty-sevenpatients underwent follow-up, and the number of re-examination ranged 1 to 15 times, and the interval of review is 1 to 8 days.The imaging findings of bedside chest radiography and the imaging changes of follow-up were analyzed retrospectively. \u0000 \u0000 \u0000Results \u0000Twenty-nine patients were collected. The radiography showed the distribution of lesions was all more than 3 lung fields. Among them, 6 lung fields were found in 8 cases, 5 lung fields in 8 cases, 4 lung fields in 7 cases, 3 lung fields in 6 cases. The films showed consolidation shadow in 19 cases, multiple patches shadow in 23 cases, reticular pattern in 12 cases, strips shadow in 14 cases, interlobar fissure thickening in 18 cases, and \"white lung\" in 4 cases.The complications included pleural effusion in 4 cases, pneumothorax in 2 cases, mediastinal and subcutaneous emphysema in 1 case. The radiography showed the lesions increased in 15 cases, mainly showing the range of original lesions was enlarged, the density increasing in 6 cases, new lesionsfound in 5 cases, andboth of them found in 4 cases.Decreased in 9 cases, showing the range of lesions was reduced and the density was reduced. 8 cases showed patchy or consolidation shadow turned to strips shadow or articular pattern shadow.No significant change in 3 casesshowed large consolidation shadow. \u0000 \u0000 \u0000Conclusions \u0000Bedside chest radiography has a good value in the follow-up of severely and critically ill patients with COVID-19, and can provide great help for clinicians to evaluate their condition. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Radiography","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48127304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：