Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, 20900, Italy.
School of Medicine, University of Milano-Bicocca, Via Cadore 48, Monza, MB, 20900, Italy.
Eur Radiol. 2021 May;31(5):2726-2736. doi: 10.1007/s00330-020-07271-0. Epub 2020 Oct 30.
To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes.
All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated.
A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO (r = 0.176), HCO (r = 0.284), and PaO2/FiO2 (P/F) values (r = - 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = -0.225), CRP (r = 0.306), PaCO (r = 0.227), pH (r = 0.162), HCO (r = 0.394), and P/F (r = - 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05).
The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation.
• Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient's outcome, in particular concerning invasive ventilation.
评估一种半自动化分割和通气肺定量在胸部计算机断层扫描（CT）上评估 SARS-CoV-2 感染患者的肺部受累情况。结果与临床和功能参数及结果进行了比较。
所有图像均使用专用工作站进行定量分析，使用半自动化肺分割软件计算通气肺容积（VLV）、磨玻璃影（GGO）容积（GGO-V）和实变容积（CONS-V），以绝对值和占全肺容积（TLV）的百分比表示。分别计算 CONS-V/VLV 和 GGO-V/VLV（分别为 CONS-V/VLV 和 GGO-V/VLV）、TLV（CONS-V/TLV、GGO-V/TLV 和 GGO-V+CONS-V/TLV）以及 VLV/TLV 比值。
共纳入 108 例患者。GGO-V/TLV 与白细胞计数（WBC）（r=0.369）、中性粒细胞（r=0.446）、血小板（r=0.182）、C 反应蛋白（CRP）（r=0.190）、PaCO2（r=0.176）、HCO3-（r=0.284）和 PaO2/FiO2（P/F）值（r=-0.344）显著相关。CONS-V/TLV 与 WBC（r=0.294）、中性粒细胞（r=0.300）、淋巴细胞（r=-0.225）、CRP（r=0.306）、PaCO2（r=0.227）、pH 值（r=0.162）、HCO3-（r=0.394）和 P/F（r=-0.419）值显著相关。CONS-V、GGO-V、GGO-V/TLV、CONS-V/TLV、GGO-V/VLV、CONS-V/VLV、GGO-V+CONS-V/TLV、VLV/TLV、CT 评分和通过 ET 进行的有创通气之间存在统计学显著差异（均 p<0.05）。
使用定量半自动算法对肺部 CT 进行分析，可有效将 SARS-CoV-2 相关肺炎的严重程度与实验室参数和有创通气的需求联系起来。
磨玻璃影（GGO）和实变（CONS）容积可作为 SARS-CoV-2 相关肺炎的有用工具。
所有肺容积，包括绝对值和与 TLV 和 VLV 的比值，均与实验室数据相关，特别是 C 反应蛋白和白细胞计数。
所有肺容积均与患者的预后相关，特别是与有创通气相关。
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