Quantitative and semi-quantitative CT assessments of lung lesion burden in COVID-19 pneumonia.
Quantitative and semi-quantitative CT assessments of lung lesion burden in COVID-19 pneumonia.
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DOI：
10.1038/s41598-021-84561-7
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发表时间：
2021-03-04
影响因子：
4.6
通讯作者：
Xu X
中科院分区：
文献类型：
--
作者：
Guan X;Yao L;Tan Y;Shen Z;Zheng H;Zhou H;Gao Y;Li Y;Ji W;Zhang H;Wang J;Zhang M;Xu X
本研究旨在阐明和提供临床证据，使CT评估方法能更准确地反映新冠肺炎肺炎的肺损害负担。研究人员从当地三家医院招募了244名新冠肺炎患者。所有患者均分为轻度、普通型和重型。半定量评估方法，如基于肺叶、节段性的CT评分和阴影加权评分，以及定量评估方法，即病变体积量化，用于对肺部病变进行量化。所有四种评估方法都有很高的评分者间协议。在组水平上，在四种评估方法的应用中，重型患者的皮损负荷始终显著高于普通型患者(均p <； 0.001)。在个体水平上区分严重和普通患者时，基于肺叶、基于节段和不透明加权的评估结果有很高的真阳性，而定量病变体积有很高的真阴性。结论：半定量和定量方法在测量炎性病变方面均具有良好的重复性，并能很好地区分普通型和重型患者。基于脑叶的CT评分快速，临床上容易获得，并且在识别重症患者方面具有很高的敏感性。建议将其作为评估新冠肺炎患者肺部病变负担的优先方法。
This study aimed to clarify and provide clinical evidence for which computed tomography (CT) assessment method can more appropriately reflect lung lesion burden of the COVID-19 pneumonia. A total of 244 COVID-19 patients were recruited from three local hospitals. All the patients were assigned to mild, common and severe types. Semi-quantitative assessment methods, e.g., lobar-, segmental-based CT scores and opacity-weighted score, and quantitative assessment method, i.e., lesion volume quantification, were applied to quantify the lung lesions. All four assessment methods had high inter-rater agreements. At the group level, the lesion load in severe type patients was consistently observed to be significantly higher than that in common type in the applications of four assessment methods (all the p < 0.001). In discriminating severe from common patients at the individual level, results for lobe-based, segment-based and opacity-weighted assessments had high true positives while the quantitative lesion volume had high true negatives. In conclusion, both semi-quantitative and quantitative methods have excellent repeatability in measuring inflammatory lesions, and can well distinguish between common type and severe type patients. Lobe-based CT score is fast, readily clinically available, and has a high sensitivity in identifying severe type patients. It is suggested to be a prioritized method for assessing the burden of lung lesions in COVID-19 patients.
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