Hu Xiaofei, Zeng Wenbing, Zhang Yuhan, Zhen Zhiming, Zheng Yalan, Cheng Lin, Wang Xianqi, Luo Haoran, Zhang Shu, Wu Zifeng, Sun Zeyu, Li Xiuli, Cao Yang, Xu Ming, Wang Jian, Chen Wei
Department of Radiology, First Affiliated Hospital of the Army Medical University (Southwest Hospital), Chongqing, China.
Department of Radiology, Chongqing University Three Gorges Hospital, Wanzhou, China.
J Thorac Dis. 2020 Oct;12(10):5336-5346. doi: 10.21037/jtd-20-1584.
The study is designed to explore the chest CT features of different clinical types of coronavirus disease 2019 (COVID-19) pneumonia based on a Chinese multicenter dataset using an artificial intelligence (AI) system.
A total of 164 patients confirmed COVID-19 were retrospectively enrolled from 6 hospitals. All patients were divided into the mild type (136 cases) and the severe type (28 cases) according to their clinical manifestations. The total CT severity score and quantitative CT features were calculated by AI pneumonia detection and evaluation system with correction by radiologists. The clinical and CT imaging features of different types were analyzed.
It was observed that patients in the severe type group were older than the mild type group. Round lesions, Fan-shaped lesions, crazy-paving pattern, fibrosis, "white lung", pleural thickening, pleural indentation, mediastinal lymphadenectasis were more common in the CT images of severe patients than in the mild ones. A higher total lung severity score and scores of each lobe were observed in the severe group, with higher scores in bilateral lower lobes of both groups. Further analysis showed that the volume and number of pneumonia lesions and consolidation lesions in overall lung were higher in the severe group, and showed a wider distribution in the lower lobes of bilateral lung in both groups.
Chest CT of patients with severe COVID-19 pneumonia showed more consolidative and progressive lesions. With the assistance of AI, CT could evaluate the clinical severity of COVID-19 pneumonia more precisely and help the early diagnosis and surveillance of the patients.
本研究旨在基于中国多中心数据集,利用人工智能(AI)系统探索2019冠状病毒病(COVID-19)肺炎不同临床类型的胸部CT特征。
回顾性纳入来自6家医院的164例确诊COVID-19患者。所有患者根据临床表现分为轻型(136例)和重型(28例)。通过AI肺炎检测与评估系统计算总CT严重程度评分和定量CT特征,并由放射科医生进行校正。分析不同类型的临床和CT影像特征。
观察到重型组患者年龄大于轻型组。圆形病灶、扇形病灶、铺路石征、纤维化、“白肺”、胸膜增厚、胸膜凹陷、纵隔淋巴结肿大在重型患者的CT图像中比轻型患者更常见。重型组的总肺严重程度评分及各肺叶评分更高,两组双侧下叶评分更高。进一步分析显示,重型组全肺肺炎病灶和实变病灶的体积及数量更多,且两组双侧肺下叶分布更广泛。
重型COVID-19肺炎患者的胸部CT显示出更多实变和进展性病灶。借助AI,CT能够更精确地评估COVID-19肺炎的临床严重程度,并有助于患者的早期诊断和监测。