Department of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, University of Health Sciences, Elazığ Yolu 10. Km Üçkuyular Mevkii 21070, Kayapınar/Diyarbakır, Turkey.
Department of Radiology, Diyarbakır Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakır, Turkey.
Radiol Med. 2021 May;126(5):679-687. doi: 10.1007/s11547-021-01335-x. Epub 2021 Feb 12.
The increasing tendency of chest CT usage throughout the COVID-19 epidemic requires new tools and a systematic scheme for diagnosing and assessing the lung involvement in Coronavirus Disease 2019 (COVID-19). To investigate the use of the COVID-19 Reporting and Data System (CO-RADS) classification and chest CT Involvement Score (CT-IS) in COVID-19 pneumonia.
This retrospective study enrolled 280 hospitalized patients diagnosed with COVID-19 pneumonia in a tertiary hospital in Turkey. All patients underwent non-contrast CT chest imaging. Two radiologists interpreted all CT images according to CO-RADS classification without knowing the clinical features, laboratory findings. We used CT involvement score (CT-IS) for assessing chest CT images of COVID-19 patients. Also, we examined the relationship between CT-IS and clinical outcomes in COVID-19 patients.
Of the patients, 111(39.6%) had positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results. CO-RADS 5 group patients had statistically significant positive RT-PCR results than the other groups (P < 0.001). All of the CO-RADS 2 group patients (30) had negative RT-PCR results. The mean total CT-IS in CO-RADS 2 group was 3.4 ± 2.8. The mean total CT-IS in CO-RADS 5 group was 8.2 ± 4.7. Total CT-IS was statistically significantly different among CO-RADS groups (P < 0.001). The mean total CT-IS was statistically significantly different between survivors and patients died of COVID-19 pneumonia (P < 0.001).
CO-RADS is useful in detecting COVID-19 disease, even if RT-PCR testing is negative. CT-IS is also helpful as an imaging tool for evaluation of the severity and extent of COVID-19 pneumonia.
在整个 COVID-19 疫情期间，胸部 CT 使用呈上升趋势，这需要新的工具和系统方案来诊断和评估 2019 年冠状病毒病（COVID-19）肺部受累情况。探讨 COVID-19 报告和数据系统（CO-RADS）分类和胸部 CT 受累评分（CT-IS）在 COVID-19 肺炎中的应用。
本回顾性研究纳入了土耳其一家三级医院 280 例住院 COVID-19 肺炎患者。所有患者均行非对比 CT 胸部成像。两名放射科医生根据 CO-RADS 分类解读所有 CT 图像，而不了解临床特征、实验室结果。我们使用 CT 受累评分（CT-IS）评估 COVID-19 患者的胸部 CT 图像。此外，我们还检查了 COVID-19 患者 CT-IS 与临床结局之间的关系。
患者中，111 例（39.6%）实时逆转录聚合酶链反应（RT-PCR）检测结果阳性。CO-RADS 5 组患者的 RT-PCR 检测结果显著高于其他组（P<0.001）。CO-RADS 2 组所有患者（30 例）的 RT-PCR 检测结果均为阴性。CO-RADS 2 组的平均总 CT-IS 为 3.4±2.8。CO-RADS 5 组的平均总 CT-IS 为 8.2±4.7。CO-RADS 组间的总 CT-IS 差异有统计学意义（P<0.001）。幸存者与 COVID-19 肺炎死亡患者的总 CT-IS 差异有统计学意义（P<0.001）。
即使 RT-PCR 检测结果为阴性，CO-RADS 也有助于检测 COVID-19 疾病。CT-IS 也是评估 COVID-19 肺炎严重程度和范围的有用影像学工具。
