Sabatino Vittorio, Sergio Pietro, Muri Margherita, Zangrandi Ilaria, Voltini Giuseppe, Bosio Giancarlo, Betti Monia, Baglivo Francesca, Martinelli Enrico, Pan Angelo, Giorgi-Pierfranceschi Matteo Giorgi, Corvino Antonio, Romanini Laura
Radiology Department, Hospital of Cremona - Azienda Socio Sanitaria Territoriale di Cremona, Italy.
Pulmonology Department, Hospital of Cremona - Azienda Socio Sanitaria Territoriale di Cremona, Italy.
Pol J Radiol. 2021 Mar 22;86:e172-e176. doi: 10.5114/pjr.2021.104856. eCollection 2021.
In December 2019, a new coronavirus (SARS-CoV-2) was identified as being responsible for the pulmonary infection called COVID-19. On 21 February 2020, the first autochthonous case of COVID-19 was detected in Italy. Our goal is to report the most common chest computed tomography (CT) findings identified in 64 patients, in the initial phase of COVID-19.
Sixty-four chest high-resolution computed tomography (HRCT) examinations performed at the Radiology Unit of the Hospital of Cremona, from 22 to 29 February 2020, of 64 patients during first week of hospitalization for COVID-19 were retrospectively evaluated. All cases were confirmed by real-time RT-PCR for SARS-CoV-2. Image analysis was independently conducted by 2 radiologists with 10 years and 1 year of experience in chest imaging. The inter-observer agreement was obtained by applying a Cohen's κ test.
The average age of patients was 67.1 years (± 12.2); men 42 (66%). HRCT was performed on the 5 (± 1.5) day of hospitalization. More frequently, the initial CT changes of the lung show more or less extensive areas of ground-glass, as single pattern or with parenchymal consolidations. Coronavirus lung involvement appears very frequently multi-lobar, bilateral, and it concerns both subpleural and central regions. An excellent agreement (κ: 0.88-1, CI: 0.79-1.01, < 0.05) concerning CT findings between the 2 operators was reached.
Our data suggest that detection of the most frequent pulmonary CT-scan changes, in the early stages of COVID-19, can be performed, with excellent agreement, among readers with different experience, and consequently attribute their exact diagnostic value, in an appropriate clinical and environmental exposure setting.
2019年12月，一种新型冠状病毒（SARS-CoV-2）被确定为导致名为COVID-19的肺部感染的病原体。2020年2月21日，意大利检测到首例本土COVID-19病例。我们的目标是报告64例患者在COVID-19初始阶段最常见的胸部计算机断层扫描（CT）表现。
回顾性评估了2020年2月22日至29日在克雷莫纳医院放射科对64例因COVID-19住院第一周的患者进行的64次胸部高分辨率计算机断层扫描（HRCT）检查。所有病例均通过针对SARS-CoV-2的实时逆转录聚合酶链反应得到确诊。由两位分别具有10年和1年胸部影像诊断经验的放射科医生独立进行图像分析。通过应用科恩κ检验获得观察者间一致性。
患者的平均年龄为67.1岁（±12.2）；男性42例（66%）。HRCT在住院第5（±1.5）天进行。肺部的初始CT改变更常见的是或多或少的广泛磨玻璃样区域，可为单一表现或伴有实变。冠状病毒肺部受累非常常见为多叶、双侧性，且累及胸膜下和中央区域。两位操作者之间在CT表现方面达成了极好的一致性（κ：0.88 - 1，CI：0.79 - 1.01，P < 0.05）。
我们的数据表明，在COVID-19早期阶段，对于最常见的肺部CT扫描改变的检测，不同经验的阅片者之间能够达成极好的一致性，从而在适当临床和环境暴露背景下赋予其确切的诊断价值。
