Diagnostic performance of chest CT to differentiate COVID-19 pneumonia in non-high-epidemic area in Japan
Diagnostic performance of chest CT to differentiate COVID-19 pneumonia in non-high-epidemic area in Japan
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DOI：
10.1007/s11604-020-00958-w
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发表时间：
2020-03-30
影响因子：
2.1
通讯作者：
Umeoka, Shigeaki
中科院分区：
文献类型：
--
作者：
Himoto, Yuki;Sakata, Akihiko;Umeoka, Shigeaki
目的评价胸部CT对日本非高发区新冠肺炎肺炎的诊断价值。材料与方法对21例临床疑似新冠肺炎肺炎患者在发病3天以上行胸部CT检查，其中6例经实时荧光定量逆转录聚合酶链式反应(RT-PCR)确诊为新冠肺炎肺炎，15例未感染。两位放射科医生(R1/R2)使用Likert评分及其受试者操作特征曲线分析，评估了五种CT标准的诊断性能：(1)磨玻璃样阴影(GGO)为主的病变，(2)GGO和外周占优势的病变，(3)双侧GGO和外周占优势的病变，(4)双侧GGO和外周占优势的病变，(5)双侧GGO和外周占优势的病变，无结节、呼吸道异常、胸腔积液和纵隔淋巴结病。结果所有确诊为新冠肺炎肺炎的患者均以双侧GGO和外周病变为主，无呼吸道异常、纵隔淋巴结肿大和胸腔积液。5种CT诊断标准表现为中等至优秀，曲线下面积(AUC)分别为：R1 0.77~0.88，R2 0.78~0.92。标准(E)显示最高的AUC。结论胸部CT对新冠肺炎肺炎与其他临床表现相似的呼吸系统疾病的鉴别诊断有一定的辅助作用。
Purpose To evaluate the diagnostic performance of chest CT to differentiate coronavirus disease 2019 (COVID-19) pneumonia in non-high-epidemic area in Japan. Materials and methods This retrospective study included 21 patients clinically suspected COVID-19 pneumonia and underwent chest CT more than 3 days after the symptom onset: six patients confirmed COVID-19 pneumonia by real-time reverse-transcription polymerase chain reaction (RT-PCR) and 15 patients proved uninfected. Using a Likert scale and its receiver operating characteristic curve analysis, two radiologists (R1/R2) evaluated the diagnostic performance of the five CT criteria: (1) ground glass opacity (GGO)-predominant lesions, (2) GGO- and peripheral-predominant lesions, (3) bilateral GGO-predominant lesions; (4) bilateral GGO- and peripheral-predominant lesions, and (5) bilateral GGO- and peripheral-predominant lesions without nodules, airway abnormalities, pleural effusion, and mediastinal lymphadenopathy. Results All patients confirmed COVID-19 pneumonia had bilateral GGO- and peripheral-predominant lesions without airway abnormalities, mediastinal lymphadenopathy, and pleural effusion. The five CT criteria showed moderate to excellent diagnostic performance with area under the curves (AUCs) ranging 0.77-0.88 for R1 and 0.78-0.92 for R2. The criterion (e) showed the highest AUC. Conclusion Chest CT would play a supplemental role to differentiate COVID-19 pneumonia from other respiratory diseases presenting with similar symptoms in a clinical setting.