From the Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, the Netherlands (T.C.K.); and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard-Geleen, the Netherlands (R.M.K.).
Radiographics. 2020 Nov-Dec;40(7):1848-1865. doi: 10.1148/rg.2020200159. Epub 2020 Oct 23.
Chest CT has a potential role in the diagnosis, detection of complications, and prognostication of coronavirus disease 2019 (COVID-19). Implementation of appropriate precautionary safety measures, chest CT protocol optimization, and a standardized reporting system based on the pulmonary findings in this disease will enhance the clinical utility of chest CT. However, chest CT examinations may lead to both false-negative and false-positive results. Furthermore, the added value of chest CT in diagnostic decision making is dependent on several dynamic variables, most notably available resources (real-time reverse transcription-polymerase chain reaction [RT-PCR] tests, personal protective equipment, CT scanners, hospital and radiology personnel availability, and isolation room capacity) and the prevalence of both COVID-19 and other diseases with overlapping manifestations at chest CT. Chest CT is valuable to detect both alternative diagnoses and complications of COVID-19 (acute respiratory distress syndrome, pulmonary embolism, and heart failure), while its role for prognostication requires further investigation. The authors describe imaging and managing care of patients with COVID-19, with topics including chest CT protocol, chest CT findings of COVID-19 and its complications, the diagnostic accuracy of chest CT and its role in diagnostic decision making and prognostication, and reporting and communicating chest CT findings. The authors also review other specific topics, including the pathophysiology and clinical manifestations of COVID-19, the World Health Organization case definition, the value of performing RT-PCR tests, and the radiology department and personnel impact related to performing chest CT in COVID-19. RSNA, 2020.
胸部 CT 在 2019 冠状病毒病（COVID-19）的诊断、并发症的检测和预后判断方面具有一定的作用。实施适当的预防安全措施、优化胸部 CT 方案以及基于该疾病肺部表现的标准化报告系统，将提高胸部 CT 的临床应用价值。然而，胸部 CT 检查可能导致假阴性和假阳性结果。此外，胸部 CT 在诊断决策中的附加价值取决于多个动态变量，主要包括现有资源（实时逆转录-聚合酶链反应[RT-PCR]检测、个人防护设备、CT 扫描仪、医院和放射科人员的可用性以及隔离室的容量）以及 COVID-19 与胸部 CT 表现重叠的其他疾病的流行程度。胸部 CT 可用于发现 COVID-19 的其他诊断和并发症（急性呼吸窘迫综合征、肺栓塞和心力衰竭），而其预后判断的作用尚需进一步研究。作者描述了 COVID-19 患者的影像学诊断和管理，包括胸部 CT 方案、COVID-19 的胸部 CT 表现及其并发症、胸部 CT 的诊断准确性及其在诊断决策和预后判断中的作用以及胸部 CT 结果的报告和交流。作者还回顾了其他特定主题，包括 COVID-19 的病理生理学和临床表现、世界卫生组织的病例定义、进行 RT-PCR 检测的价值以及 COVID-19 中进行胸部 CT 检查对放射科和人员的影响。RSNA，2020 年。
