Kwee Robert M, Adams Hugo J A, Kwee Thomas C
Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/Geleen, The Netherlands (R.M.K.); Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands. (H.J.A.A.); Department of Radiology, Nuclear Medicine and Molecular Imaging University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (T.C.K.).
Radiol Cardiothorac Imaging. 2021 Jan 14;3(1):e200510. doi: 10.1148/ryct.2021200510. eCollection 2021 Feb.
To determine the diagnostic performance of the COVID-19 Reporting and Data System (CO-RADS) and the Radiological Society of North America (RSNA) categorizations in patients with clinically suspected coronavirus disease 2019 (COVID-19) infection.
In this meta-analysis, studies from 2020, up to August 24, 2020 were assessed for inclusion criteria of studies that used CO-RADS or the RSNA categories for scoring chest CT in patients with suspected COVID-19. A total of 186 studies were identified. After review of abstracts and text, a total of nine studies were included in this study. Patient information ( age, sex), CO-RADS and RSNA scoring categories, and other study characteristics were extracted. Study quality was assessed with the QUADAS-2 tool. Meta-analysis was performed with a random effects model.
Nine studies (3283 patients) were included. Overall study quality was good, except for risk of non-performance of repeated reverse transcriptase polymerase chain reaction (RT-PCR) after negative initial RT-PCR and persistent clinical suspicion in four studies. Pooled COVID-19 frequencies in CO-RADS categories were: 1, 8.8%; 2, 11.1%; 3, 24.6%; 4, 61.9%; and 5, 89.6%. Pooled COVID-19 frequencies in RSNA classification categories were: negative 14.4%; atypical, 5.7%; indeterminate, 44.9%; and typical, 92.5%. Pooled pairs of sensitivity and specificity using CO-RADS thresholds were the following: at least 3, 92.5% (95% CI: 87.1, 95.7) and 69.2% (95%: CI: 60.8, 76.4); at least 4, 85.8% (95% CI: 78.7, 90.9) and 84.6% (95% CI: 79.5, 88.5); and 5, 70.4% (95% CI: 60.2, 78.9) and 93.1% (95% CI: 87.7, 96.2). Pooled pairs of sensitivity and specificity using RSNA classification thresholds for indeterminate were 90.2% (95% CI: 87.5, 92.3) and 75.1% (95% CI: 68.9, 80.4) and for typical were 65.2% (95% CI: 37.0, 85.7) and 94.9% (95% CI: 86.4, 98.2).
COVID-19 infection frequency was higher in patients categorized with higher CORADS and RSNA classification categories.
确定2019冠状病毒病（COVID-19）报告与数据系统（CO-RADS）及北美放射学会（RSNA）分类法对临床疑似COVID-19感染患者的诊断效能。
在这项荟萃分析中，评估了2020年至2020年8月24日的研究，纳入使用CO-RADS或RSNA分类法对疑似COVID-19患者胸部CT进行评分的研究纳入标准。共识别出186项研究。在审查摘要和正文后，本研究共纳入9项研究。提取了患者信息（年龄、性别）、CO-RADS和RSNA评分类别以及其他研究特征。使用QUADAS-2工具评估研究质量。采用随机效应模型进行荟萃分析。
纳入9项研究（3283例患者）。总体研究质量良好，但有4项研究存在初始逆转录酶聚合酶链反应（RT-PCR）阴性后未重复进行RT-PCR以及持续临床怀疑的风险。CO-RADS类别中COVID-19的合并频率分别为：1类，8.8%；2类，11.1%；3类，24.6%；4类，61.9%；5类，89.6%。RSNA分类类别中COVID-19的合并频率分别为：阴性，14.4%；非典型，5.7%；不确定，44.9%；典型，92.5%。使用CO-RADS阈值的合并敏感性和特异性对如下：至少3类，92.5%（95%CI：87.1，95.7）和69.2%（95%CI：60.8，76.4）；至少4类，85.8%（95%CI：78.7，90.9）和84.6%（95%CI：79.5，88.5）；5类，70.4%（95%CI：60.2，78.9）和93.1%（95%CI：87.7，96.2）。使用RSNA分类阈值对不确定类别的合并敏感性和特异性对为90.2%（95%CI：87.5，92.3）和75.1%（95%CI：68.9，80.4），对典型类别的为65.2%（95%CI：37.0，85.7）和94.9%（95%CI：86.4，98.2）。
CO-RADS和RSNA分类类别较高的患者中COVID-19感染频率更高。
