看完别害怕！新冠CT影像

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                    <section data-role="paragraph" data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.png" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械媒体报道先锋</span></p><p><span>分享专业医疗器械知识</span></p></section><section><section><section><span>关注</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><p><br  /></p><p><p><img src="image/20201014/c4ba9ea5b5136d25e518adb4bf4a5ebd_2.gif" /></p></p><p><br  /></p><p><span>人体的呼吸道就像一个倒着长的大树，气管是树干，分成左右主支气管进入两肺，再越分越细，最终形成无数的终末细支气管，再发出呼吸性细支气管，其管壁多处半球状膨大，形成具有气体交换功能的、只有一层上皮细胞组成壁的肺泡。</span><span>肺泡周围环抱着大量的由肺动脉逐级细分下来的毛细血管网。</span><span>吸入肺泡内的空气中氧含量比血液中的高，而二氧化碳的含量比血液中的少，因此肺泡内的氧气弥散到血液里，与红细胞中的血红蛋白结合，血液中的二氧化碳弥散到肺泡里，这就是肺最重要的换气功能，以保障人体各器官的氧气供给。</span><br  /></p><p><span><br  /></span></p><p><p><img src="image/20201014/9009a7bc8c1fbc3ba8d8c6009e948dfb_3.jpg" /></p></p><p><br  /></p><p><span>新型冠状病毒特别喜欢富含血管紧张转换酶2受体的黏膜上皮细胞，比如口鼻、呼吸道、结膜等，新型冠状病毒与细胞表面的受体结合后，穿透细胞膜进入细胞内，不断复制产生大量的下一代病毒，再释放到细胞外，侵犯周边细胞或者通过痰液排出体外进行传播。</span><span>新型冠状病毒通过呼吸道进入肺后，在支气管、肺泡的上皮细胞中快速繁殖，造成组织充血、水肿，而机体则动员淋巴细胞、单核细胞来进行防卫，结果就是肺的间质增厚、肺泡腔内渗出增多形成透明膜样结构，严重者影响气体交换能力，因此，临床上表现为发热、咳嗽、喘息，重症者出现呼吸困难、休克、昏迷，多器官功能衰竭，危及生命。</span></p><p><br  /></p><p><span>正是因为感染病毒后身体发生了这样的病理变化，那么，胸部CT就会出现相应的影像表现。</span></p><p><span><br  /></span></p><p><span>下面看图，先看看第一例，<strong>轻症</strong>。</span></p><p><br  /></p><p><p><img src="image/20201014/a1c0ee62bdce654aa69dc5f3f0515ada_4.png" /></p></p><p><br  /></p><p><span>只在左下肺出现两小片阴影，呈淡淡的、局灶性、磨玻璃密度影，是不是有点“雾里看花”的感觉？</span></p><p><span><br  /></span></p><p><span>把病灶放大看看，内侧靠近胸主动脉病灶的密度高低不均哦，有的淡白，有的雪白，这是什么原因呢？</span></p><p><br  /></p><p><p><img src="image/20201014/326e2a4e7dc1a4012874defc12cbbc04_5.png" /></p></p><p><br  /></p><p><span>这是因为病毒引起的肺炎肺泡内渗出液相对较少，液体内的蛋白质、白细胞、上皮细胞少，呈相对透明的液膜，因此，密度较低，边界不清。</span><span>但是，随着疾病进展、合并细菌感染，渗出液内容物越来越多，这个密度就会逐渐增高，和血管的密度差就越来越小，表现为大片实变影。</span></p><p><br  /></p><p><span>如果<strong>病情加重</strong>，病变范围就会扩大，两肺都可能发病，但病灶主要还是位于中下肺的中外带，上肺较少，那就变成这样的。</span></p><p><span><br  /></span></p><p><span>来看第二例。</span></p><p><br  /></p><p><p><img src="image/20201014/3962cd92929c977e8e2e7496d5d89362_6.png" /></p></p><p><p><img src="image/20201014/d403b400236f3707204c7e7993ddce6b_7.png" /></p></p><p><p><img src="image/20201014/8068e8f35de31cfa2aae3e0e1de7f30f_8.png" /></p></p><p><p><img src="image/20201014/ab32edf79547e976f738592895083a92_9.png" /></p></p><p><br  /></p><p><span>再看第三例，很相似吧，只是病灶范围没那么广。</span></p><p><br  /></p><p><p><img src="image/20201014/34d3547a439071240d97def460f81343_10.png" /></p></p><p><p><img src="image/20201014/6de13c717120e4bfbdfc3418b990b3e1_11.png" /></p></p><p><br  /></p><p><span>再仔细看这两例，是不是在淡淡的、磨玻璃样的病灶里看到了一条条“枯枝”一样的支气管，专业名称叫做“空气支气管征”，只是支气管壁比正常的有些增厚。</span></p><p><br  /></p><p><p><img src="image/20201014/0d18e7a288008eb394d17bfcc0e1eee3_12.png" /></p></p><p><p><img src="image/20201014/1686df2a8b074465a5338850333597bb_13.png" /></p></p><p><br  /></p><p><span>病灶里的肺间质有些增厚，呈网格状，血管也有点增粗，看起来朦朦胧胧的一团乱麻。</span></p><p><br  /></p><p><p><img src="image/20201014/2d72dcc65c36d9786a800aa6aaaf46e3_14.png" /></p></p><p><br  /></p><p><strong><span>到了重症</span></strong><span>，CT图像上满肺都是病灶，肺的换气功能严重受损，透不过气来，血氧饱和度明显下降，临床上表现为发热、咳嗽咳痰、呼吸困难，多器官功能衰竭，出现休克、昏迷，救不过来就要去极乐世界了。</span></p><p><br  /></p><p><span>屏住呼吸，来看这一例。</span></p><p><br  /></p><p><p><img src="image/20201014/038df8cda3c8f20564e898cc956ddb31_15.png" /></p></p><p><p><img src="image/20201014/bfe6b115b8da8366fe16626461d734a7_16.png" /></p></p><p><p><img src="image/20201014/ea7ba69e9057214e7a7dcbc3dd9c3e4a_17.png" /></p><br  /></p><p><p><img src="image/20201014/c8bcf5f7452a82eecec615d788aad6b7_18.png" /></p></p><p><br  /></p><p><span>最后，来一个小视频，打开前请做好心理准备。<br  /></span></p><p><span><br  /></span></p><p><video width="100%" height="580" controls="controls"><source src="http://mpvideo.qpic.cn/0b78cmaaiaaabaabtmz4a5pfae6daqjqabaa.f10004.mp4?dis_k=aac8215cd766b1661e9cb1787b40707c&dis_t=1602651376" type="video/mp4"></source></video></p><p><br  /></p><section data-role="outer" label="Powered by gulangu"><section data-role="paragraph" data-color="#27939d"><p><a data-miniprogram-appid="wxdc7efe409d688f37" data-miniprogram-path="pages/index/index" data-miniprogram-nickname="智械采购" href="" data-miniprogram-type="image" data-miniprogram-servicetype="" href=""><p><img src="image/20201014/8edb31f87313bf5aa17544207dad3968_19.gif" 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