Coronavirus Disease 2019: Initial Detection on Chest CT in a Retrospective Multicenter Study of 103 Chinese Patients
Coronavirus Disease 2019: Initial Detection on Chest CT in a Retrospective Multicenter Study of 103 Chinese Patients
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DOI：
10.1148/ryct.2020200092
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发表时间：
2020-04-01
期刊：
影响因子：
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通讯作者：
Wang, Daoqing
中科院分区：
文献类型：
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作者：
Wen, Zeying;Chi, Yonge;Wang, Daoqing
目的：评价疑似2019冠状病毒病（COVID-19）患者的胸部CT表现。材料和方法：根据世界卫生组织临时指南的纳入标准，回顾性收集2020年1月21日至2020年2月14日期间正在接受COVID-19调查的103例患者的数据。所有患者在医院就诊时均接受胸部CT扫描和逆转录聚合酶链反应（RT-PCR）检测。计算CT的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）（95%置信区间）来评价CT的性能。还根据这些病例在中国河南省的地理分布进行了亚组分析。结果：103例患者中有88例（85%）经RT-PCR检测确诊。总体敏感性、特异性、PPV和NPV分别为93%（85%、97%）、53%（27%、77%）、92%（83%、96%）和42%（18%、70%）。在两个地理区域都显示出类似的结果。信阳、驻马店地区（n = 56）胸部CT的敏感性、特异度、PPV、NPV分别为92%（80%、97%）、63%（26%、90%）、93%（81%、98%）、56%(23%、85%)，安阳地区（n = 47）的这些指标分别为95%（81%、99%）、43%（12%、80%）、90%（76%、97%）、60%（17% ~ 93%）。CT （P =.423）和RT-PCR （P =.931）的阳性检出率在两个地理亚组中无显著差异。结论：尽管在河南省两个地理区域的COVID-19调查患者入院时获得的初始胸部CT显示出高敏感性，但NPV仅为中等，表明CT作为筛查工具的价值较低。
Purpose: To evaluate the performance of chest CT regarding the initial presentation of patients suspected of having coronavirus disease 2019 (COVID-19).Materials and Methods: Data from 103 patients who were under investigation for COVID-19 based on inclusion criteria according to the World Health Organization Interim Guidance were retrospectively collected from January 21, 2020, to February 14, 2020. All patients underwent chest CT scanning and reverse-transcription polymerase chain reaction (RT-PCR) testing for COVID-19 at hospital presentation. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) (with 95% confidence intervals) were calculated to evaluate the performance of CT. Subgroup analyses were also performed based on the geographical distribution of these cases in the province of Henan, China.Results: There were 88/103 (85%) patients with COVID-19 confirmed by RT-PCR testing. The overall sensitivity, specificity, PPV, and NPV were 93% (85%, 97%), 53% (27%, 77%), 92% (83%, 96%), and 42% (18%, 70%), respectively. Similar results were shown in both geographic regions. The respective sensitivity, specificity, PPV, and NPV for chest CT in the districts of Xinyang and Zhumadian (n = 56) were 92% (80%, 97%), 63% (26%, 90%), 93% (81%, 98%), and 56% (23%, 85%), while these indicators in the district of Anyang (n = 47) were 95% (81%, 99%), 43% (12%, 80%), 90% (76%, 97%), and 60% (17%-93%). There were no significant differences in the prevalence of positive examinations in the two geographic subgroups for CT (P =.423) or RT-PCR (P =.931).Conclusion: Although initial chest CT obtained at hospital presentation showed high sensitivity in patients under investigation for COVID-19 in the two geographic regions in Henan Province, the NPV was only modest, suggesting a low value of CT as a screening tool.