Department of Radiology, Perelman School of Medicine of the University of Pennsylvania, PA.
University of Texas Southwestern Medical Center, Dallas, TX.
J Thorac Imaging. 2020 Jul;35(4):219-227. doi: 10.1097/RTI.0000000000000524.
Routine screening CT for the identification of COVID-19 pneumonia is currently not recommended by most radiology societies. However, the number of CTs performed in persons under investigation (PUI) for COVID-19 has increased. We also anticipate that some patients will have incidentally detected findings that could be attributable to COVID-19 pneumonia, requiring radiologists to decide whether or not to mention COVID-19 specifically as a differential diagnostic possibility. We aim to provide guidance to radiologists in reporting CT findings potentially attributable to COVID-19 pneumonia, including standardized language to reduce reporting variability when addressing the possibility of COVID-19. When typical or indeterminate features of COVID-19 pneumonia are present in endemic areas as an incidental finding, we recommend contacting the referring providers to discuss the likelihood of viral infection. These incidental findings do not necessarily need to be reported as COVID-19 pneumonia. In this setting, using the term "viral pneumonia" can be a reasonable and inclusive alternative. However, if one opts to use the term "COVID-19" in the incidental setting, consider the provided standardized reporting language. In addition, practice patterns may vary, and this document is meant to serve as a guide. Consultation with clinical colleagues at each institution is suggested to establish a consensus reporting approach. The goal of this expert consensus is to help radiologists recognize findings of COVID-19 pneumonia and aid their communication with other healthcare providers, assisting management of patients during this pandemic.
目前,大多数放射学会不建议将常规筛查 CT 用于识别 COVID-19 肺炎。然而,对 COVID-19 疑似病例(PUI)进行的 CT 检查数量有所增加。我们还预计,一些患者会偶然发现可能归因于 COVID-19 肺炎的发现,这需要放射科医生决定是否具体提及 COVID-19 作为鉴别诊断的可能性。我们旨在为放射科医生报告可能归因于 COVID-19 肺炎的 CT 结果提供指导,包括标准化语言,以减少在提及 COVID-19 可能性时的报告变异性。当 COVID-19 肺炎的典型或不确定特征在流行地区作为偶然发现时,我们建议与转诊医生联系,讨论病毒感染的可能性。这些偶然发现不一定需要报告为 COVID-19 肺炎。在这种情况下,使用“病毒性肺炎”一词可以是合理且包容的替代方法。但是,如果选择在偶然情况下使用“COVID-19”一词,请考虑使用提供的标准化报告语言。此外,实践模式可能会有所不同,本文件旨在作为指南。建议与每个机构的临床同事进行咨询,以建立共识报告方法。本专家共识的目的是帮助放射科医生识别 COVID-19 肺炎的发现,并帮助他们与其他医疗保健提供者进行沟通,协助在大流行期间管理患者。