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意大利 2019 年冠状病毒病(COVID-19):使用结构化报告系统的胸部计算机断层扫描的特征。

Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system.

机构信息

Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy.

Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.

出版信息

Sci Rep. 2020 Oct 14;10(1):17236. doi: 10.1038/s41598-020-73788-5.

Abstract

To assess the use of a structured report in the Chest Computed Tomography (CT) reporting of patients with suspicious viral pneumonia by COVID-19 and the evaluation of the main CT patterns. This study included 134 patients (43 women and 91 men; 68.8 years of mean age, range 29-93 years) with suspicious COVID-19 viral infection evaluated by reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test. All patients underwent CT examinations at the time of admission. CT images were reviewed by two radiologists who identified COVID-19 CT patterns using a structured reports. Temporal difference mean value between RT-PCRs and CT scan was 0.18 days ± 2.0 days. CT findings were positive for viral pneumonia in 94.0% patients while COVID-19 was diagnosed at RT-PCR in 77.6% patients. Time mean value to complete the structured report by radiologist was 8.5 min ± 2.4 min. The disease on chest CT predominantly affected multiple lobes and the main CT feature was ground glass opacity (GGO) with or without consolidation (96.8%). GGO was predominantly bilateral (89.3%), peripheral (80.3%), multifocal/patching (70.5%). Consolidation disease was predominantly bilateral (83.9%) with prevalent peripheral (87.1%) and segmental (47.3%) distribution. Additional CT signs were the crazy-paving pattern in 75.4% of patients, the septal thickening in 37.3% of patients, the air bronchogram sign in 39.7% and the "reversed halo" sign in 23.8%. Less frequent characteristics at CT regard discrete pulmonary nodules, increased trunk diameter of the pulmonary artery, pleural effusion and pericardium effusion (7.9%, 6.3%, 14.3% and 16.7%, respectively). Barotrauma sign was absent in all the patients. High percentage (54.8%) of the patients had mediastinal lymphadenopathy. Using a Chest CT structured report, with a standardized language, we identified that the cardinal hallmarks of COVID-19 infection were bilateral, peripheral and multifocal/patching GGO and bilateral consolidation with peripheral and segmental distribution.

摘要

评估结构化报告在 COVID-19 疑似病毒性肺炎患者胸部 CT 报告中的应用,以及对主要 CT 模式的评估。本研究纳入了 134 名(43 名女性,91 名男性;平均年龄 68.8 岁,范围 29-93 岁)疑似 COVID-19 病毒感染的患者,所有患者均接受了反转录实时荧光聚合酶链反应(RT-PCR)检测。所有患者在入院时均进行 CT 检查。两位放射科医生使用结构化报告来识别 COVID-19 CT 模式。RT-PCR 和 CT 扫描之间的时间差值平均值为 0.18 天±2.0 天。94.0%的患者 CT 结果提示病毒性肺炎阳性,而 RT-PCR 诊断为 COVID-19 的患者为 77.6%。放射科医生完成结构化报告的平均时间为 8.5 分钟±2.4 分钟。胸部 CT 上的病变主要累及多个肺叶,主要 CT 特征是磨玻璃影(GGO)伴或不伴实变(96.8%)。GGO 主要为双侧(89.3%)、外周性(80.3%)、多灶性/补丁状(70.5%)。实变病变主要为双侧(83.9%),以外周性(87.1%)和节段性(47.3%)分布为主。其他 CT 征象包括铺路石征(75.4%)、间隔增厚(37.3%)、空气支气管征(39.7%)和“反晕征”(23.8%)。CT 上较少见的特征包括离散性肺结节、肺动脉干增粗、胸腔积液和心包积液(分别为 7.9%、6.3%、14.3%和 16.7%)。所有患者均无气压伤征象。纵隔淋巴结肿大的患者比例较高(54.8%)。使用胸部 CT 结构化报告,采用标准化语言,我们发现 COVID-19 感染的主要特征是双侧、外周性和多灶性/补丁状 GGO,以及双侧实变伴外周性和节段性分布。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8fb/7566610/a2e6acb9e94d/41598_2020_73788_Fig1_HTML.jpg

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