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Analysis of the initial chest high resolution CT manifestations of COVID-19/ 新型冠状病毒肺炎首次胸部高分辨率CT影像分析

Objective: To investigate the initial chest high resolution CT (HRCT) manifestations of the patients with COVID-19. Methods: A retrospective analysis of the first chest HRCT images of 106 patients with COVID-19 was performed who were confirmed in our hospital from January 3 to 25, 2020. Lesion distribution, morphology and surrounding involvement were analyzed. Results: The lesions were found on all initial HRCT images of 106 patients, with unilateral lung distribution in 11 cases (10.4%) and bilateral lung distribution in other 95 cases(89.6%), peripheral distribution of lung in 65 cases (61.3%) and peripheral and central distribution in other 41 cases (38.7%). HRCT showed 8 cases (7.5%) with 1 lesion, 5 cases (4.7%) with 2 lesions, and other 93 cases (87.8%) with multiple lesions. HRCT also showed the nodular lesions in 12 cases(11.3%), ground-glass opacities in 94 cases (88.7%), fibrous stripes in 7 cases (6.6%), and mixed lesions in 15 cases (14.2%). Only one lung lobe was involved in 10 cases (9.4%), while more than two lobes were involved in other 96 cases (90.6%). In addition, 24 cases (22.6%) with enlarged mediastinal lymph nodes (over 60 years old in 19 cases, accounting for 79.2%), 3 cases with pleural effusion (2.8 %), 1 case with pericardial effusion (0.9%), and 2 cases with pleural involvement/thickening (1.9%) were found. Patients over 60 years old mostly presented with multiple lesions, various appearances, peripheral and central distributions of lungs, involving multiple lobes, and enlarged mediastinal lymph nodes. Conclusions: Lung COVID-19 lesions can be shown by the initial chest HRCT, which is the preferred imaging method. Thoracic HRCT scans play an important role in the early diagnosis of COVID-19.