Yang Ran, Li Xiang, Liu Huan, Zhen Yanling, Zhang Xianxiang, Xiong Qiuxia, Luo Yong, Gao Cailiang, Zeng Wenbing
Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing 404000, China (R.Y., X.L., X.Z., Q.X., Y.L., C.G., W.Z.); Department of Radiology, Chongqing Three Gorges Central Hospital, Chongqing, China (R.Y., X.L., X.Z., Q.X., Y.L., C.G., W.Z.); GE Healthcare, Shanghai, China (H.L.); and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Sichuan, China (Y.Z.).
Radiol Cardiothorac Imaging. 2020 Mar 30;2(2):e200047. doi: 10.1148/ryct.2020200047. eCollection 2020 Apr.
To evaluate the value of chest CT severity score (CT-SS) in differentiating clinical forms of coronavirus disease 2019 (COVID-19).
A total of 102 patients with COVID-19 confirmed by a positive result from real-time reverse transcription polymerase chain reaction on throat swabs who underwent chest CT (53 men and 49 women, 15-79 years old, 84 cases with mild and 18 cases with severe disease) were included in the study. The CT-SS was defined by summing up individual scores from 20 lung regions; scores of 0, 1, and 2 were respectively assigned for each region if parenchymal opacification involved 0%, less than 50%, or equal to or more than 50% of each region (theoretic range of CT-SS from 0 to 40). The clinical and laboratory data were collected, and patients were clinically subdivided according to disease severity according to the Chinese National Health Commission guidelines.
The posterior segment of upper lobe (left, 68 of 102; right, 68 of 102), superior segment of lower lobe (left, 79 of 102; right, 79 of 102), lateral basal segment (left, 79 of 102; right, 70 of 102), and posterior basal segment of lower lobe (left, 81 of 102; right, 83 of 102) were the most frequently involved sites in COVID-19. Lung opacification mainly involved the lower lobes, in comparison with middle-upper lobes. No significant differences in distribution of the disease were seen between right and left lungs. The individual scores in each lung and the total CT-SS were higher in severe COVID-19 when compared with mild cases ( < .05). The optimal CT-SS threshold for identifying severe COVID-19 was 19.5 (area under curve = 0.892), with 83.3% sensitivity and 94% specificity.
The CT-SS could be used to evaluate the severity of pulmonary involvement quickly and objectively in patients with COVID-19.© RSNA, 2020.
评估胸部CT严重程度评分（CT-SS）在区分新型冠状病毒肺炎（COVID-19）临床类型中的价值。
本研究纳入了102例经咽拭子实时逆转录聚合酶链反应检测结果呈阳性确诊为COVID-19且接受了胸部CT检查的患者（53例男性和49例女性，年龄15 - 79岁，84例轻症患者和18例重症患者）。CT-SS通过对20个肺区的个体评分进行求和来定义；如果实质密度增高累及每个区域的0%、小于50%或等于或大于50%，则分别为每个区域赋予0、1和2分（CT-SS的理论范围为0至40）。收集临床和实验室数据，并根据中国国家卫生健康委员会的指南，按照疾病严重程度对患者进行临床细分。
COVID-19最常累及的部位是上叶后段（左侧，102例中有68例；右侧，102例中有68例）、下叶背段（左侧，102例中有79例；右侧，102例中有79例）、外侧基底段（左侧，102例中有79例；右侧，102例中有70例）和下叶后基底段（左侧，102例中有81例；右侧，102例中有83例）。与中上叶相比，肺部密度增高主要累及下叶。左右肺之间在疾病分布上未见显著差异。与轻症病例相比，重症COVID-19患者每个肺区的个体评分及总的CT-SS更高（P <.05）。鉴别重症COVID-19的最佳CT-SS阈值为19.5（曲线下面积 = 0.892），敏感性为83.3%，特异性为94%。
CT-SS可用于快速、客观地评估COVID-19患者肺部受累的严重程度。© RSNA，2020年
