Department of Radiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 HDU, UK.
Department of Radiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 HDU, UK.
Clin Radiol. 2020 Aug;75(8):599-605. doi: 10.1016/j.crad.2020.06.006. Epub 2020 Jun 18.
To determine the incidence of possible COVID-19-related lung changes on preoperative screening computed tomography (CT) for COVID-19 and how their findings influenced decision-making. To also to determine whether the patients were managed as COVID-19 patients after their imaging findings, and the proportion who had SARS-CoV2 reverse transcriptionpolymerase chain reaction (RT-PCR) testing.
A retrospective study was undertaken of consecutive patients having imaging prior to urgent elective surgery (n=156) or acute abdominal imaging (n=283). Lung findings were categorised according to the British Society of Thoracic Imaging (BSTI) guidelines. RT-PCR testing, management, and outcomes were determined from the electronic patient records.
3% (13/439) of CT examinations demonstrated findings of classic/probable COVID-19 pneumonia, whilst 4% (19/439) had findings indeterminate for COVID-19. Of the total cohort, 1.6% (7/439) subsequently had confirmed RT-PCR-positive COVID-19. Importantly, all the patients with a normal chest or alternative diagnoses on CT who had PCR testing within the next 7 days, had a negative RT-PCR (92/407). There was a change in surgical outcome in 6% (10/156) of the elective surgical cohort with no change to surgical management was demonstrated in the acute abdominal emergency cohort requiring surgery (2/283).
There was a 7% (32/439) incidence of potential COVID-19-related lung changes in patients having preoperative CT. Although this altered surgical management in the elective surgical cohort, no change to surgical management was demonstrated in the acute abdominal emergency cohort requiring surgery.
确定 COVID-19 术前筛查计算机断层扫描（CT）中与 COVID-19 相关的肺部变化的发生率，以及这些发现如何影响决策。还确定了患者在影像学发现后是否被作为 COVID-19 患者进行管理，以及进行 SARS-CoV2 逆转录聚合酶链反应（RT-PCR）检测的比例。
对 156 例紧急择期手术前（n=156）或急性腹痛影像学检查（n=283）的连续患者进行回顾性研究。根据英国胸科影像学学会（BSTI）指南对肺部发现进行分类。从电子患者记录中确定 RT-PCR 检测、管理和结果。
3%（13/439）的 CT 检查显示出典型/可能的 COVID-19 肺炎的发现，而 4%（19/439）的检查结果对 COVID-19 不确定。在总队列中，1.6%（7/439）随后经 RT-PCR 检测证实 COVID-19 阳性。重要的是，所有在 CT 上有正常胸部或其他诊断且在接下来 7 天内进行 PCR 检测的患者，其 RT-PCR 均为阴性（92/407）。择期手术队列中有 6%（10/156）的手术结果发生了变化，而需要手术的急性腹痛急症队列中手术管理没有发生变化（2/283）。
术前 CT 检查中，有 7%（32/439）的患者存在潜在的 COVID-19 相关肺部变化。虽然这改变了择期手术队列中的手术管理，但需要手术的急性腹痛急症队列中并未显示手术管理发生变化。
