胸部高分辨率 CT 与 RT-PCR 在 COVID-19 诊断中的比较。

Comparison of HRCT Chest and RT-PCR in Diagnosis of COVID-19.

机构信息

Department of Radiology, PGMI / AMC / Lahore General Hospital, Lahore, Pakistan.

Department of Central Research Lab, PGMI / AMC / Lahore General Hospital, Lahore, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2021 Jan;31(1):S1-S6. doi: 10.29271/jcpsp.2021.01.S1.

DOI:10.29271/jcpsp.2021.01.S1

PMID:33650414

Abstract

OBJECTIVE

To compare the diagnostic accuracies of HRCT chest and RT-PCR results in diagnosis of coronavirus disease (COVID-19) in a tertiary care hospital in Lahore.

STUDY DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

Department of Radiology and Central Research Lab, Lahore General Hospital, Lahore, from April to July, 2020.

METHODOLOGY

Patients aged 18 to 83 years, who had clinically suspected symptoms of COVID-19 (fever, cough/sore throat or shortness of breath) presenting in outpatient or emergency department, were included. These patients had their HRCT chest conducted from Radiology Department and RT-PCR performed at Central Research Lab. These data were retrieved from electronic system of PACS. Results were categorised into positive and negative findings for COVID-19. Diagnostic accuracies of HRCT chest and first RT-PCR along with 95% confidence interval were calculated.

RESULTS

A total of 94 patients, 55 (58.5%) males and 39 (41.5%) were females. Out of them, 83% patients had positive HRCT chest findings of COVID-19, 17% had negative HRCT chest findings; while 40.4% had positive and 59.6% had negative first PCR. Among the repeat second PCR, 19.6% had negative, 1.8% had positive PCR results; while 78.6% patients didn't undergo repeat PCR. The sensitivity, specificity, NPV, PPV and accuracy of HRCT chest was 92%, 23%, 81%, 45%, and 51%; while of first RT-PCR was 45%, 81%, 23%, 92% and 51%, respectively.

CONCLUSION

The sensitivity of HRCT chest is higher (92%) as compared to first RT-PCR (45%). Key Words: COVID-19, RT-PCR, HRCT chest, Sensitivity, Specificity.

摘要

目的

比较 HRCT 胸部和 RT-PCR 结果在拉合尔一家三级保健医院诊断冠状病毒病（COVID-19）的诊断准确性。

研究设计

描述性研究。

地点和研究时间

2020 年 4 月至 7 月，拉合尔总医院放射科和中央研究实验室。

方法

纳入年龄在 18 至 83 岁之间、具有 COVID-19 临床疑似症状（发热、咳嗽/咽痛或呼吸急促）的门诊或急诊科患者。这些患者在放射科进行 HRCT 胸部检查，在中央研究实验室进行 RT-PCR。这些数据从 PACS 的电子系统中检索。结果分为 COVID-19 的阳性和阴性发现。计算了 HRCT 胸部和第一次 RT-PCR 的诊断准确性及其 95%置信区间。

结果

共有 94 名患者，55 名（58.5%）男性和 39 名（41.5%）女性。其中，83%的患者 HRCT 胸部 COVID-19 检查结果阳性，17%的患者 HRCT 胸部检查结果阴性；而 40.4%的患者第一次 PCR 结果阳性，59.6%的患者第一次 PCR 结果阴性。在重复的第二次 PCR 中，19.6%的患者结果为阴性，1.8%的患者结果为阳性；而 78.6%的患者没有进行重复 PCR。HRCT 胸部的灵敏度、特异性、NPV、PPV 和准确性分别为 92%、23%、81%、45%和 51%；而第一次 RT-PCR 的灵敏度、特异性、NPV、PPV 和准确性分别为 45%、81%、23%、92%和 51%。