COVID-19 S: A new proposal for diagnosis and structured reporting of COVID-19 on computed tomography imaging
COVID-19 S: A new proposal for diagnosis and structured reporting of COVID-19 on computed tomography imaging
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DOI：
10.5152/dir.2020.20351
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发表时间：
2020-07-01
影响因子：
2.1
通讯作者：
Kilinc, Oguz
中科院分区：
文献类型：
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作者：
Gezer, Naciye Sinem;Ergan, Begum;Kilinc, Oguz
由于计算机断层扫描（CT）在COVID-19诊断中的广泛使用，单个、少数或单侧病变等不确定的表现相当多。我们的目标是开发一种新的分类和结构化的报告系统的CT成像（COVID-19 S），这将有助于诊断COVID-19在最准确的方式。METHODS我们的回顾性队列包括803例患者的胸部CT扫描后怀疑COVID-19。对患者的病史、体格检查、CT结果、RT-PCR和其他实验室检查结果进行了审查，并最终诊断为COVID-19或非COVID-19。根据COVID-19 S CT诊断标准对胸部CT扫描进行分类。采用Cohen’s kappa分析，98例患者（12%）的最终临床诊断为COVID-19。根据COVID-19 S CT诊断标准，正常、符合COVID-19、不确定和替代诊断组的患者数量分别为581例（72.3%）、97例（12.1%）、16例（2.0%）和109例（13.6%）。当不确定组与COVID-19相容组合并时，COVID-19 S的敏感性和特异性分别为99.0%和87.1%，阳性预测值（PPV）为85.8%，阴性预测值（NPV）为99.1%。当不确定组与替代诊断组合并时，COVID-19 S的敏感性和特异性分别为93.9%和96.0%，PPV和NPV分别为94.8%和95.2%。19例来自其他病因的肺炎，并通过使用结构化报告，帮助优化这一大流行病的患者管理和疾病控制。
PURPOSEBecause of the widespread use of computed tomography (CT) in the diagnosis of COVID-19, indeterminate presentations such as single, few or unilateral lesions amount to a considerable number. We aimed to develop a new classification and structured reporting system on CT imaging (COVID-19 S) that would facilitate the diagnosis of COVID-19 in the most accurate way.METHODSOur retrospective cohort included 803 patients with a chest CT scan upon suspicion of COVID-19. The patients' history, physical examination, CT findings, RT-PCR, and other laboratory test results were reviewed, and a final diagnosis was made as COVID-19 or non-COVID-19. Chest CT scans were classified according to the COVID-19 S CT diagnosis criteria. Cohen's kappa analysis was used.RESULTSFinal clinical diagnosis was COVID-19 in 98 patients (12%). According to the COVID-19 S CT diagnosis criteria, the number of patients in the normal, compatible with COVID-19, indeterminate and alternative diagnosis groups were 581 (72.3%), 97 (12.1%), 16 (2.0%) and 109 (13.6%). When the indeterminate group was combined with the group compatible with COVID-19, the sensitivity and specificity of COVID-19 S were 99.0% and 87.1%, with 85.8% positive predictive value (PPV) and 99.1% negative predictive value (NPV). When the indeterminate group was combined with the alternative diagnosis group, the sensitivity and specificity of COVID-19 S were 93.9% and 96.0%, with 94.8% PPV and 95.2% NPV.CONCLUSIONCOVID-19 S CT classification system may meet the needs of radiologists in distinguishing COVID-19 from pneumonia of other etiologies and help optimize patient management and disease control in this pandemic by the use of structured reporting.