CORRELATION BETWEEN CHEST COMPUTED TOMOGRAPHY AND LUNG ULTRASONOGRAPHY IN PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19)
CORRELATION BETWEEN CHEST COMPUTED TOMOGRAPHY AND LUNG ULTRASONOGRAPHY IN PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19)
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DOI：
10.1016/j.ultrasmedbio.2020.07.003
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发表时间：
2020-11-01
影响因子：
2.9
通讯作者：
Llamas-Fuentes, Rafael
中科院分区：
文献类型：
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作者：
Tung-Chen, Yale;Marti de Gracia, Milagros;Llamas-Fuentes, Rafael
关于2019冠状病毒病（COVID-19）的胸部X光和计算机断层扫描（CT）结果的证据越来越多。目前，肺部超声检查（LUS）的作用还有待探讨。本研究的主要目的是评价确诊（逆转录聚合酶链反应[RT-PCR]阳性）或临床高度怀疑（呼吸困难、发热、肌无力、胃肠道症状、干咳、味觉丧失或嗅觉丧失）COVID-19患者的LUS结果与胸部CT之间的相关性。这项前瞻性研究在急诊科进行，招募了确诊或临床高度怀疑患有COVID-19的患者，并进行了胸部CT和同时LUS检查。一名经验丰富的急诊科医生在对临床病史和CT扫描结果不知情的情况下进行了LUS检查，由两名放射科医生一致审查与COVID-19相符的体征（外周分布的双侧毛玻璃样阴影）。兼容的LUS检查被认为是双侧B线模式、不规则胸膜线和胸膜下实变。2020年3月至4月期间，连续入组了51例患者。CT的适应症是阴性或不确定的RT-PCR检测（49.0%），其次是怀疑肺栓塞（41.2%）。37例患者存在与COVID-19相符的放射学体征CT扫描为72.5%，LUS检查结果的存在与提示COVID-19的阳性CT扫描相关（比值比：13.3，95%可信区间：4.5-39.6，p < 0.001），敏感性为100.0%，特异性为78.6%，阳性预测值为92.5%，阴性预测值为100.0%。在我们的队列中，与CT相比，LUS没有对COVID-19的漏诊。LUS评分与CT总严重程度评分之间的相关性良好（组内相关系数：0.803，95%置信区间：0.60-0.90，p < 0.001）。LUS在检测COVID-19患者肺部异常方面的准确性与胸部CT相似。（电子邮件：yale. tung@salud.madrid。org）（C）2020年世界医学和生物学超声联合会。All rights reserved.
There is growing evidence regarding chest X-ray and computed tomography (CT) findings for corona-virus disease 2019 (COVID-19). At present, the role of lung ultrasonography (LUS) has yet to be explored. The main purpose of this study was to evaluate the correlation between LUS findings and chest CT in patients confirmed to have (positive reverse transcription polymerase chain reaction [RT-PCR]) or clinically highly suspected of having (dyspnea, fever, myasthenia, gastrointestinal symptoms, dry cough, ageusia or anosmia) COVID-19. This prospective study was carried out in the emergency department, where patients confirmed of having or clinically highly suspected of having COVID-19 were recruited and underwent chest CT and concurrent LUS exam. An experienced emergency department physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). A compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations. Between March and April 2020, 51 patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism (41.2%). Radiologic signs compatible with COVID-19 were present in 37 patients (72.5%) on CT scan and 40 patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (odds ratio: 13.3, 95% confidence interval: 4.5-39.6, p < 0.001) with a sensitivity of 100.0%, specificity of 78.6%, positive predictive value of 92.5% and negative predictive value of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared with CT in our cohort. The correlation between LUS score and CT total severity score was good (intraclass correlation coefficient: 0.803, 95% confidence interval: 0.60-0.90, p < 0.001). LUS exhibited similar accuracy compared with chest CT in the detection of lung abnormalities in COVID-19 patients. (E-mail: yale.tung@salud.madrid. org) (C) 2020 World Federation for Ultrasound in Medicine & Biology. All rights reserved.