Clinical usefulness of tomographic standards for COVID-19 pneumonia diagnosis: Experience from a Brazilian reference center.
Clinical usefulness of tomographic standards for COVID-19 pneumonia diagnosis: Experience from a Brazilian reference center.
复制标题
DOI：
10.1016/j.bjid.2020.10.002
复制
发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Gazzana MB
中科院分区：
文献类型：
--
作者：
Grando RD;Brentano VB;Zanardo AP;Hertz FT;Júnior LCA;Prietto Dos Santos JF;Galvão GS;Zavascki AP;Gazzana MB
COVID-19 是一种新疾病，最常见的并发症是肺炎。北美放射学会 (RSNA) 提出了 COVID-19 肺炎影像学分类的专家共识。评估巴西 COVID-19 爆发初期胸部 CT 标准的敏感性、特异性、准确性和重现性。横断面研究于2020年3月1日至4月14日进行。纳入了接受RT-PCR检测和胸部计算机断层扫描（CT）的疑似COVID-19肺炎患者。两名胸部放射科医生对 RT-PCR 不知情，临床和实验室结果根据 RSNA 专家共识对每例患者扫描结果进行分类。第三位胸部放射科医生也对不一致的情况进行了评估，并在三位放射科医生之间达成了共识。典型的表现被认为是 COVID-19 肺炎胸部 CT 阳性。计算敏感性、特异性、阳性和阴性预测值。 Cohen 的 kappa 系数用于评估评估者内部和评估者之间的一致性。总共纳入 159 名患者（平均年龄 57.9±18.0 岁；88 名 [55.3%] 男性）：86 名 (54.1%) COVID-19 患者和 73 名 (45.9%) 非 COVID-19 患者。 80 名 (50.3%) 患者的 COVID-19 肺炎 CT 呈阳性。典型外观的敏感性和特异性分别为 88.3% (95% CI, 79.9–93.5) 和 94.5% (95% CI, 86.7–97.8)。评估评估者内部和评估者之间的一致性（分别为 Cohen’s kappa=0.924，P=0.06；Cohen’s kappa=0.772，P=0.05）。 COVID-19 结果的胸部 CT 分类具有可重复性，并且与 COVID-19 的临床和 RT-PCR 诊断高度一致。在 RT-PCR 稀缺情况或模棱两可的情况下，它可能有助于主治医生评估急诊科就诊的疑似 COVID-19 肺炎患者。
COVID-19 is a new disease and the most common complication is pneumonia. The Radiological Society of North America (RSNA) proposed an expert consensus for imaging classification for COVID-19 pneumonia. To evaluate sensitivity, specificity, accuracy, and reproducibility of chest CT standards in the beginning of the Brazilian COVID-19 outbreak. Cross-sectional study performed from March 1st to April 14th, 2020. Patients with suspected COVID-19 pneumonia submitted to RT-PCR test and chest computed tomography (CT) were included. Two thoracic radiologists blinded for RT-PCR and clinical and laboratory results classified every patient scan according to the RSNA expert consensus. A third thoracic radiologist also evaluated in case of discordance, and consensus was reached among the three radiologists. A typical appearance was considered a positive chest CT for COVID-19 pneumonia. Sensitivity, specificity, positive and negative predictive values were calculated. Cohen’s kappa coefficient was used to evaluate intra- and inter-rater agreements. A total of 159 patients were included (mean age 57.9 ± 18.0 years; 88 [55.3%] males): 86 (54.1%) COVID-19 and 73 (45.9%) non-COVID-19 patients. Eighty (50.3%) patients had a positive CT for COVID-19 pneumonia. Sensitivity and specificity of typical appearance were 88.3% (95%CI, 79.9–93.5) and 94.5% (95%CI, 86.7–97.8), respectively. Intra- and inter-rater agreement were assessed (Cohen’s kappa = 0.924, P = 0.06; Cohen’s kappa=0.772, P = 0.05, respectively). Chest CT categorical classification of COVID-19 findings is reproducible and demonstrates high level of agreement with clinical and RT-PCR diagnosis of COVID-19. In RT-PCR scarcity scenarios or in equivocal cases, it may be useful for attending physicians in the evaluation of suspected COVID-19 pneumonia patients attended at the emergency unit.
登录
查看更多内容
DOI：
10.1148/ryct.2020200213
发表时间：
2020-06-01
期刊：
RADIOLOGY-CARDIOTHORACIC IMAGING
影响因子：
--
作者：
de Jaegere, Tom M. H.;Krdzalic, Jasenko;Kwee, Robert M.
通讯作者：
Kwee, Robert M.
影响因子：
19.7
作者：
Caruso, Damiano;Zerunian, Marta;Laghi, Andrea
通讯作者：
Laghi, Andrea
影响因子：
5
作者：
Adams, Hugo J. A.;Kwee, Thomas C.;Kwee, Robert M.
通讯作者：
Kwee, Robert M.
影响因子：
5.5
作者：
Kligerman, Seth J.;Franks, Teri J.;Galvin, Jeffrey R.
通讯作者：
Galvin, Jeffrey R.
影响因子：
3.1
作者：
Luo, Lin;Luo, Zhendong;Shen, Xinping
通讯作者：
Shen, Xinping