Dynamic diagnostic value of CT in differentiating 2019 novel coronavirus pneumonia from interstitial pneumonia caused by chemoradiotherapy

SHI Bin; DING Huaming; WANG Chuanbin; CAO Feng; GAO Fei; LIN Tingting; CHEN Dong; DONG Jiangning

doi:10.19732/j.cnki.2096-6210.2020.03.001

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Dynamic diagnostic value of CT in differentiating 2019 novel coronavirus pneumonia from interstitial pneumonia caused by chemoradiotherapy

更新时间：2025-12-15

- Dynamic diagnostic value of CT in differentiating 2019 novel coronavirus pneumonia from interstitial pneumonia caused by chemoradiotherapy
- Vol. 29, Issue 3, Pages: 201-208(2020)
- 作者机构：
  
  1. 中国科学技术大学附属第一医院（安徽省立医院），肿瘤医院院区影像科,安徽,合肥,230031
  2. 中国科学技术大学附属第一医院（安徽省立医院），感染病医院院区影像科,安徽,合肥,230000
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2020.03.001
  CLC：
- Published Online：28 June 2020，
  
  Published：28 June 2020
- 稿件说明：
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史彬,丁华明,王传彬,等. CT对新型冠状病毒肺炎与肿瘤放化疗所致间质性肺炎的鉴别价值[J]. 肿瘤影像学, 2020, 29(3): 201-208 https://doi.

org/10.19732/j.cnki.2096-6210.2020.03.001
史彬,丁华明,王传彬,等. CT对新型冠状病毒肺炎与肿瘤放化疗所致间质性肺炎的鉴别价值[J]. 肿瘤影像学, 2020, 29(3): 201-208 https://doi. DOI： 10.19732/j.cnki.2096-6210.2020.03.001.

org/10.19732/j.cnki.2096-6210.2020.03.001 DOI：

摘要

目的：

探讨胸部CT检查对新型冠状病毒（2019 novel coronavirus，COVID-19）肺炎与肿瘤放化疗所致间质性肺炎（interstitial pneumonia caused by chemoradiotherapy，IP-CRT）的不同时期进行鉴别诊断的价值。

方法：

收集中国科学技术大学附属第一医院感染病院区2020年13月确诊的73例COVID-19感染患者（COVID-19组）及肿瘤院区2019年12月2020年3月收治的44例IP-CRT（IP-CRT组）的动态胸部CT资料，评估内容包括：病灶分布、范围、形态、密度、主要征象及伴随征象。

结果：

① 初次阳性胸部CT检查分析显示，两组均以多发、双肺、多肺段受累、多形态共存及磨玻璃密度为主，且均可见条索影、细网格影、铺路石征、支气管改变及胸膜增厚（

＞0.05）；COVID-19肺炎病灶主要分布于胸膜下周边区域，可伴晕/反晕征及血管改变，空洞/空泡征、胸腔积液及淋巴结肿大在IP-CRT更常见（

＜0.05）。② 临床进展期COVID-19肺炎主要表现为小片状影融合成大片状、伴实变病灶、铺路石征；IP-CRT发生的部位和表现形式多样。③ 临床恢复期分析显示COVID-19肺炎可形成树上挂网征，随时间后延纤维化条索影可吸收；IP-CRT所致的纤维化条索影多永久存在，伴随胸腔积液量减少、淋巴结大小恢复（

＜0.05）。

结论：

胸部CT检查对COVID-19肺炎与IP-CRT的发生、发展及转归的鉴别诊断具有重要价值。

Abstract

Objective:

To dynamic differential diagnosis on 2019 novel coronavirus (COVID-19) pneumonia and interstitial pneumonia caused by chemoradiotherapy (IP-CRT) by using CT examination.

Methods:

A total of 73 patients with COVID-19 pneumonia from Jan. 2020 to Mar. 2020

and 44 patients with IP-CRT from Dec. 2019 to Mar. 2020 were enrolled in the First Affiliated Hospital of USTC. We evaluated the dynamic chest CT features of these lesions

including the distribution

extent

form

density

main and other features.

Results:

① Initial positive CT revealed that both the two groups manifested as multifocal

bilateral

multiple lobe lesions with multiple form of ground-glass opacities (

＞0.05). Linear opacities

fine grid shadow

crazy paving pattern

bronchial changes and pleural thickening existed in both the two groups (

＞0.05). Peripheral/subpleural distribution

halo/reversed halo sign and vascular changes could be seen more common in COVID-19 pneumonia (

＜0.05). Vacuole/cavity sign

pleural effusion and lymph node enlargement happened in IP-CRT more common (

＜0.05). ② In clinical progression

lesions of COVID-19 pneumonia showed that multiple patchy opacities merged into large opacities with consolidation pattern and crazy paving pattern. The location and manifestation of IP-CRT were various. ③ In clinical recovery phase

COVID-19 pneumonia could manifested as the sign of ground-glass nets hanged on the trees

and the fibrotic linear opacities could disappear over time; but the fibrotic linear opacities would exist for a long time in IP-CRT

with decreased pleural effusion and recovery lymph nodes (

＜0.05).

Conclusion:

CT features has good value in differential diagnosis for the occurrence

progression and recovery of COVID-19 pneumonia and IP-CRT.

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