2019冠状病毒病（COVID-19）肺炎胸部CT分级系统的比较
Comparison of Chest CT Grading Systems in Coronavirus Disease 2019 (COVID-19) Pneumonia.
作者信息
Inui Shohei, Kurokawa Ryo, Nakai Yudai, Watanabe Yusuke, Kurokawa Mariko, Sakurai Keita, Fujikawa Akira, Sugiura Hiroaki, Kawahara Takuya, Yoon Soon Ho, Uwabe Yasuhide, Uchida Yuto, Gonoi Wataru, Abe Osamu
机构信息
Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan (S.I., R.K., Y.N., Y.W., W.G., O.A,); Department of Radiology, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan (S.I., A.F.); Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan (M.K.); Department of Radiology, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan (K.S.); Department of Radiology, National Defense Medical College, 3-2, Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan (H.S.); Clinical Research Promotion Center, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan (T.K.); Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Chongno-gu, Seoul 03080, Republic of Korea (S.H.Y.); Department of Respiratory Medicine, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan (Y.U.); Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-ku, Nagoya, 467-8601, Japan (Y.U.).
出版信息
Radiol Cardiothorac Imaging. 2020 Nov 5;2(6):e200492. doi: 10.1148/ryct.2020200492. eCollection 2020 Dec.
PURPOSE
To compare the performance and interobserver agreement of the COVID-19 Reporting and Data System (CO-RADS), the COVID-19 imaging reporting and data system (COVID-RADS), the RSNA expert consensus statement, and the British Society of Thoracic Imaging (BSTI) guidance statement.
MATERIALS AND METHODS
In this case-control study, total of 100 symptomatic patients suspected of having COVID-19 were included: 50 patients with COVID-19 (59±17 years, 38 men) and 50 patients without COVID-19 (65±24 years, 30 men). Eight radiologists independently scored chest CT images of the cohort according to each reporting system. The area under the receiver operating characteristic curves (AUC) and interobserver agreements were calculated and statistically compared across the systems.
RESULTS
A total of 800 observations were made for each system. The level of suspicion of COVID-19 correlated with the RT-PCR positive rate except for the "negative for pneumonia" classifications in all the systems (Spearman's coefficient: ρ=1.0, =<.001 for all the systems). Average AUCs were as follows: CO-RADS, 0.84 (95% confidence interval, 0.83-0.85): COVID-RADS, 0.80 (0.78-0.81): the RSNA statement, 0.81 (0.79-0.82): and the BSTI statement, 0.84 (0.812-0.86). Average Cohen's kappa across observers was 0.62 (95% confidence interval, 0.58-0.66), 0.63 (0.58-0.68), 0.63 (0.57-0.69), and 0.61 (0.58-0.64) for CO-RADS, COVID-RADS, the RSNA statement and the BSTI statement, respectively. CO-RADS and the BSTI statement outperformed COVID-RADS and the RSNA statement in diagnostic performance (=.<.05 for all the comparison).
CONCLUSIONS
CO-RADS, COVID-RADS, the RSNA statement and the BSTI statement provided reasonable performances and interobserver agreements in reporting CT findings of COVID-19.
目的
比较新型冠状病毒肺炎报告与数据系统（CO-RADS）、新型冠状病毒肺炎影像报告和数据系统（COVID-RADS）、美国放射学会（RSNA）专家共识声明以及英国胸科影像学会（BSTI）指南声明的性能及观察者间的一致性。
材料与方法
在这项病例对照研究中，共纳入100例疑似新型冠状病毒肺炎的有症状患者：50例新型冠状病毒肺炎患者（59±17岁，38例男性）和50例非新型冠状病毒肺炎患者（65±24岁，30例男性）。8名放射科医生根据每个报告系统对该队列的胸部CT图像进行独立评分。计算各系统的受试者操作特征曲线下面积（AUC）和观察者间一致性，并进行统计学比较。
结果
每个系统共进行了800次观察。除所有系统中的“肺炎阴性”分类外，新型冠状病毒肺炎的怀疑程度与逆转录聚合酶链反应（RT-PCR）阳性率相关（斯皮尔曼系数：所有系统中ρ = 1.0，P <.001）。平均AUC如下：CO-RADS为0.84（95%置信区间，0.83 - 0.85）；COVID-RADS为0.80（0.78 - 0.81）；RSNA声明为0.81（0.79 - 0.82）；BSTI声明为0.84（0.812 - 0.86）。CO-RADS、COVID-RADS、RSNA声明和BSTI声明观察者间的平均科恩kappa系数分别为0.62（95%置信区间，0.58 - 0.66）、0.63（0.58 - 0.68）、0.63（0.57 - 0.69）和0.61（0.58 - 0.64）。在诊断性能方面，CO-RADS和BSTI声明优于COVID-RADS和RSNA声明（所有比较中P <.05）。
结论
CO-RADS、COVID-RADS、RSNA声明和BSTI声明在报告新型冠状病毒肺炎的CT表现时具有合理的性能和观察者间一致性。
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