Department of Radiology, Damietta Hospital, Al-Azhar University, Damietta, Egypt.
Czech Rehabilitation Hospital, Royal Health Group, Al-Ain, UAE.
J Digit Imaging. 2021 Apr;34(2):273-283. doi: 10.1007/s10278-021-00426-5. Epub 2021 Feb 9.
To analyze diagnostic accuracy of chest computed tomography (CT) and RT-PCR (real-time polymerase chain reaction) for COVID-19 (coronavirus disease 19) pneumonia in early and progressive stages. To evaluate if combination of chest CT with RT-PCR can supplement the shortage of RT-PCR in diagnosis of COVID-19 pneumonia. We conducted a prospective study on 103 male patients. The study population were divided into two groups; early COVID-19 stage (number = 50 patients, with positive RT-PCR but mild symptoms) and progressive COVID-19 stage (number = 53, positive RT-PCR and sever symptoms including fever > 37.5 °C, cough, and shortness of breath). All patients underwent CT imaging. The early stage included typical category; 34% (17 out of 50 cases), 6% indeterminate category (3 cases), 10% atypical category (5 cases) and 50% (25 cases) were normal CT imaging. The progressive stage included typical category that was further divided to five subgroups; (i) peripheral bilateral lower lobe ground-glass opacity (GGO) in (37.7%), (ii) peripheral bilateral lower lobes GGO with peribronchovascular consolidation and bronchiolar dilatation in (18.8%), (iii) peripheral bilateral lower lobes GGO with crazy paving appearance in (15%), (iv) bilateral diffuse GGO in (18.8%), and (v) peripheral bilateral GGO with mediastinal lymph node enlargement (9.4%). Chest CT imaging could aid to supplement the shortages of PCR for clinically suspected patients of COVID-19 in the epidemic area as CT was positive in 50% of patients. Chest CT is very effective in detecting pulmonary parenchymal abnormalities in the progressive stage of COVID-19 patients in 100%.
分析胸部计算机断层扫描（CT）和实时聚合酶链反应（RT-PCR）在 COVID-19（冠状病毒病 19）肺炎早期和进展期的诊断准确性。评估胸部 CT 与 RT-PCR 联合应用是否可以弥补 RT-PCR 在 COVID-19 肺炎诊断中的不足。我们对 103 名男性患者进行了前瞻性研究。研究人群分为两组；早期 COVID-19 期（阳性 RT-PCR 但症状较轻，病例数=50 例）和进展期 COVID-19 期（阳性 RT-PCR 且症状严重，包括发热>37.5°C、咳嗽和呼吸急促，病例数=53 例）。所有患者均行 CT 成像。早期阶段包括典型类别；34%（50 例中的 17 例）、6%不确定类别（3 例）、10%非典型类别（5 例）和 50%（25 例）为正常 CT 成像。进展期包括进一步分为五个亚组的典型类别；（i）外周双侧下叶磨玻璃密度影（GGO）（37.7%），（ii）外周双侧下叶 GGO 伴支气管血管周围实变和细支气管扩张（18.8%），（iii）外周双侧下叶 GGO 伴铺路石样外观（15%），（iv）双侧弥漫性 GGO（18.8%）和（v）外周双侧 GGO 伴纵隔淋巴结肿大（9.4%）。在疫情地区，胸部 CT 成像可辅助补充 PCR 对临床疑似 COVID-19 患者的不足，因为 50%的患者 CT 呈阳性。胸部 CT 在 COVID-19 患者进展期检测肺实质异常非常有效，准确率为 100%。
