COVID-19 肺炎的胸部 CT 视觉和定量评估：与疾病严重程度和临床发现的关系。

Visual and Quantitative Assessment of COVID-19 Pneumonia on Chest CT: The Relationship with Disease Severity and Clinical Findings.

机构信息

Department of Radiology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.

Department of Infectious Disease, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.

出版信息

Curr Med Imaging. 2021;17(9):1142-1150. doi: 10.2174/1573405617666210215142528.

DOI:10.2174/1573405617666210215142528

PMID:33588737

Abstract

BACKGROUND

Lungs are the primary organ involved in COVID-19, and the severity of pneumonia in COVID-19 patients is an important cause of morbidity and mortality.

AIM

We aimed to evaluate the pneumonia severity through the visual and quantitative assessment on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) and compare the CT findings with clinical and laboratory findings.

METHODS

We retrospectively evaluated adult COVID-19 patients who underwent chest CT along with theirclinical scores, laboratory findings, and length of hospital stay. Two independent radiologists visually evaluated the pneumonia severity on chest CT (VSQS). Quantitative CT (QCT) assessment was performed using a free DICOM viewer, and the percentage of the well-aerated lung (%WAL), high-attenuation areas (%HAA) at different threshold values, and mean lung attenuation (MLA) values were calculated. The relationship between CT scores and the clinical, laboratory data, and the length of hospital stay were evaluated in this cross-sectional study. The student's t-test and chi-square test were used to analyze the differences between the variables. The Pearson correlation test analyzed the correlation between the variables. The diagnostic performance of the variables was assessed using the receiver operating characteristic (ROC) analysis.

RESULTS

The VSQS and QCT scores were significantly correlated with procalcitonin, d-dimer, ferritin, and C-reactive protein levels. Both VSQ and QCT scores were significantly correlated with the disease severity (p < 0.001). Among the QCT parameters, the %HAA-600 value showed the best correlation with the VSQS (r = 730, p < 0.001). VSQS and QCT scores had high sensitivity and specificity in distinguishing disease severity and predicting prolonged hospitalization.

CONCLUSION

The VSQS and QCT scores can help manage the COVID-19 and predict the duration of the hospitalization.

摘要

背景

肺部是 COVID-19 主要受累器官，COVID-19 患者肺炎严重程度是导致发病率和死亡率的重要原因。

目的

本研究旨在通过对新型冠状病毒肺炎（COVID-19）患者胸部 CT 进行视觉和定量评估，评估肺炎严重程度，并将 CT 结果与临床和实验室发现进行比较。

方法

我们回顾性分析了接受胸部 CT 检查的成年 COVID-19 患者的临床评分、实验室检查和住院时间。两位独立的放射科医生对胸部 CT （VSQS）的肺炎严重程度进行了视觉评估。使用免费的 DICOM 查看器进行定量 CT（QCT）评估，并计算了充气良好的肺百分比（%WAL）、不同阈值的高衰减区（%HAA）和平均肺衰减（MLA）值。在这项横断面研究中，评估了 CT 评分与临床、实验室数据和住院时间的关系。使用学生 t 检验和卡方检验分析变量之间的差异。使用 Pearson 相关检验分析变量之间的相关性。使用受试者工作特征（ROC）分析评估变量的诊断性能。

结果

VSQS 和 QCT 评分与降钙素原、D-二聚体、铁蛋白和 C 反应蛋白水平显著相关。VSQ 和 QCT 评分均与疾病严重程度显著相关（p < 0.001）。在 QCT 参数中，%HAA-600 值与 VSQS 相关性最好（r = 730，p < 0.001）。VSQS 和 QCT 评分在区分疾病严重程度和预测住院时间延长方面具有较高的灵敏度和特异性。