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计算机断层扫描在新型冠状病毒肺炎诊断中的作用。

The role of computed tomography scan in the diagnosis of COVID-19 pneumonia.

作者信息

Axiaq Ariana, Almohtadi Ahmad, Massias Samuel A, Ngemoh Dorette, Harky Amer

机构信息

School of Medicine, Queen's University Belfast, Belfast.

Medical School, St George's University of London, London.

出版信息

Curr Opin Pulm Med. 2021 May 1;27(3):163-168. doi: 10.1097/MCP.0000000000000765.

Abstract

PURPOSE OF REVIEW

To summarize current literature evidence on the role of computed tomography (CT) scan in the diagnosis and assessment of coronavirus disease 2019 (COVID-19) pneumonia.

RECENT FINDINGS

Recent guidelines on the use of CT scans in COVID-19 vary between countries. However, the consensus is that it should not be used as the first line; a notion supported by the WHO. Currently, several investigations are being used including reverse transcription PCR testing, chest radiographs, and ultrasound scans, and CT scans. They are ideally performed later during the disease process as the sensitivity and specificity are highest by that time. Typical COVID-19 features on CT scans vary but include vascular enlargement, ground-glass opacities, and ground glass opacification together with consolidation.

SUMMARY

Since COVID-19 was declared as a global pandemic, there was a push towards identifying appropriate diagnostic tests that are both reliable and effective. There is a general agreement that CT scans have a high sensitivity but low specificity in diagnosing COVID-19. However, the quality of available studies is not optimal, so this must always be interpreted with the clinical context in mind. Clinicians must aim to weigh up the practicalities and drawbacks of CT scans when considering their use for a patient. The ease and speed of use of CT scans must be balanced with their high radiation doses, and infection control considerations.

摘要

综述目的

总结计算机断层扫描(CT)在2019冠状病毒病(COVID-19)肺炎诊断和评估中作用的当前文献证据。

最新发现

各国关于COVID-19中CT扫描使用的最新指南各不相同。然而,共识是它不应作为一线检查手段;这一观点得到了世界卫生组织的支持。目前,正在使用多种检查方法,包括逆转录聚合酶链反应检测、胸部X光片、超声扫描和CT扫描。它们最好在疾病进程后期进行,因为此时敏感性和特异性最高。CT扫描上典型的COVID-19特征各不相同,但包括血管增粗、磨玻璃影以及磨玻璃影合并实变。

总结

自COVID-19被宣布为全球大流行以来,人们一直在努力寻找既可靠又有效的合适诊断检测方法。普遍认为CT扫描在诊断COVID-19时具有高敏感性但特异性低。然而,现有研究的质量并不理想,因此在解读时必须始终结合临床背景。临床医生在考虑为患者使用CT扫描时,必须权衡其实际情况和缺点。CT扫描使用的便捷性和速度必须与其高辐射剂量以及感染控制方面进行权衡。

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