Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China.
Department of Lung Transplantation Center, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China.
Curr Med Imaging. 2021;17(11):1316-1323. doi: 10.2174/1573405617666210218092751.
Though imaging manifestations of COVID-19 and other types of viral pneumonia are similar, their clinical treatment methods differ. Accurate, non-invasive diagnostic methods using CT imaging can help develop an optimal therapeutic regimen for both conditions.
To compare the initial CT imaging features in COVID-19 with those in other types of viral pneumonia.
Clinical and imaging data of 51 patients with COVID-19 and 69 with other types of viral pneumonia were retrospectively studied. All significant imaging features (Youden index >0.3) were included for constituting the combined criteria for COVID-19 diagnosis, composed of two or more imaging features with a parallel model. McNemar's chi-square test or Fisher's exact test was used to compare the validity indices (sensitivity and specificity) among various criteria.
Ground glass opacities (GGO) dominated density, peripheral distribution, unilateral lung, clear margin of lesion, rounded morphology, long axis parallel to the pleura, vascular thickening, and crazy-paving pattern were more common in COVID-19 (p <0.05). Consolidation-dominated density, both central and peripheral distributions, bilateral lung, indistinct margin of lesion, tree-inbud pattern, mediastinal or hilar lymphadenectasis, pleural effusion, and pleural thickening were more common in other types of viral pneumonia (p < 0.05). GGO-dominated density or long axis parallel to the pleura (with the highest sensitivity), and GGO-dominated density or long axis parallel to the pleura or vascular thickening (with the highest specificity) are well combined criteria of COVID-19.
The initial CT imaging features are helpful for the differential diagnosis of COVID-19 and other types of viral pneumonia.
尽管 COVID-19 和其他类型病毒性肺炎的影像学表现相似，但它们的临床治疗方法却不同。使用 CT 成像的准确、非侵入性诊断方法可以帮助制定这两种疾病的最佳治疗方案。
比较 COVID-19 与其他类型病毒性肺炎的初始 CT 影像学特征。
回顾性研究了 51 例 COVID-19 患者和 69 例其他类型病毒性肺炎患者的临床和影像学资料。将所有具有显著影像特征（Youden 指数>0.3）的影像特征纳入 COVID-19 诊断的联合标准，这些特征由两个或更多的具有平行模型的影像特征组成。采用 McNemar 卡方检验或 Fisher 确切概率法比较各种标准的有效性指标（敏感性和特异性）。
磨玻璃密度影（GGO）为主的密度、周边分布、单侧肺、病变边界清晰、圆形形态、长轴与胸膜平行、血管增厚和铺路石征在 COVID-19 中更为常见（p<0.05）。实变为主的密度、中央和周边分布、双侧肺、病变边界模糊、树芽征、纵隔或肺门淋巴结肿大、胸腔积液和胸膜增厚在其他类型病毒性肺炎中更为常见（p<0.05）。以 GGO 为主的密度或长轴与胸膜平行（敏感性最高），或以 GGO 为主的密度或长轴与胸膜平行或血管增厚（特异性最高）的组合标准对 COVID-19 具有良好的诊断价值。
初始 CT 影像学特征有助于 COVID-19 和其他类型病毒性肺炎的鉴别诊断。
