Can Chest CT Features Distinguish Patients With Negative From Those With Positive Initial RT-PCR Results for Coronavirus Disease (COVID-19)?
Can Chest CT Features Distinguish Patients With Negative From Those With Positive Initial RT-PCR Results for Coronavirus Disease (COVID-19)?
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DOI：
10.2214/ajr.20.23012
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发表时间：
2021-01-01
影响因子：
5
通讯作者：
Wei, Xinhua
中科院分区：
文献类型：
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作者：
Chen, Dandan;Jiang, Xinqing;Wei, Xinhua
目标。本研究旨在探讨CT对冠状病毒病（COVID-19）肺炎的诊断价值，特别是对逆转录聚合酶链反应（RT-PCR）初步检测结果阴性的患者。材料和方法。纳入2020年1月19日至2020年2月20日的COVID-19肺炎患者。所有患者均在3天内进行胸部CT和拭子RT-PCR检测。将患者分为初始RT-PCR结果阴性（7例）和阳性（14例）两组。记录两组患者的影像学表现并进行比较。21例有症状的患者（9名男性，12名女性，年龄范围26-90岁）被评估。在我们的研究中，大多数COVID-19病变位于双肺（72%）的多叶（67%）。CT主要表现为磨玻璃影（95%）和实变（72%），胸膜下分布（100%）。除此之外，33%的患者在支气管血管束周围有其他病变。其他CT表现包括支气管充气征（57%）、血管扩张（67%）、小叶间隔增厚（62%）和胸腔积液（19%）。与初始RT-PCR结果阳性组相比，初始RT-PCR结果阴性组CT显示肺实变的可能性较低（p < 0.05）。CT上肺实变越少，初始RT-PCR阴性的可能性越大。胸部CT在筛查临床怀疑患病的患者，特别是那些初始RT-PCR结果阴性的患者中具有重要意义。
OBJECTIVE. The purpose of this study was to explore the value of CT in the diagnosis of coronavirus disease (COVID-19) pneumonia, especially for patients who have negative initial results of reverse transcription-polymerase chain reaction (RT-PCR) testing.MATERIALS AND METHODS. Patients with COVID-19 pneumonia from January 19, 2020, to February 20, 2020, were included. All patients underwent chest CT and swab RT-PCR tests within 3 days. Patients were divided into groups with negative (seven patients) and positive (14 patients) initial RT-PCR results. The imaging findings in both groups were recorded and compared.RESULTS. Twenty-one patients with symptoms (nine men, 12 women; age range, 26-90 years) were evaluated. Most of the COVID-19 lesions were located in multiple lobes (67%) in both lungs (72%) in our study. The main CT features were ground-glass opacity (95%) and consolidation (72%) with a subpleural distribution (100%). Otherwise, 33% of patients had other lesions around the bronchovascular bundle. The other CT features included air bronchogram (57%), vascular enlargement (67%), interlobular septal thickening (62%), and pleural effusions (19%). Compared with that in the group with positive initial RT-PCR results, CT of the group with negative initial RT-PCR results was less likely to show pulmonary consolidation (p < 0.05).CONCLUSION. The less pulmonary consolidation found at CT, the greater is the possibility of negative initial RT-PCR results. Chest CT is important in the screening of patients in whom disease is clinically suspected, especially those who have negative initial RT-PCR results.