Radiology Department, University Hospital Centre Poitiers, Poitiers, Vienne, France.
Dactim Mis, LMA, UMR CNRS 7348, Poitiers, Vienne, France.
Eur Radiol. 2021 Nov;31(11):8141-8146. doi: 10.1007/s00330-021-07863-4. Epub 2021 Apr 19.
Value of chest CT was mainly studied in area of high COVID-19 incidence. The aim of this study was therefore to evaluate chest CT performances to diagnose COVID-19 pneumonia with regard to RT-PCR as reference standard in a low incidence area.
A survey was sent to radiology department in 4 hospitals in an administrative French region of weak disease prevalence (3.4%). Study design was approved by the local institutional review board and recorded on the clinicaltrial.gov website (NCT04339686). Written informed consent was waived due to retrospective anonymized data collection. Patients who underwent a RT-PCR and a chest CT scan within 48 h for COVID-19 pneumonia suspicion were consecutively included. Diagnostic accuracy including the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of chest CT regarding RT-PCR as reference standard were calculated.
One hundred twenty-nine patients had abnormal chest CT findings compatible with a COVID-19 pneumonia (26%, 129/487). Among the 358 negative chest CT findings, 3% (10/358) were RT-PCR positive. Chest CT sensitivity, specificity, positive, and negative predictive value were respectively 87% (IC95: 85, 89; 69/79), 85% (IC95: 83, 87; 348/408), 53% (IC95: 50, 56; 69/129), and 97% (IC95: 95, 99; 348/358).
In a low prevalence area, chest CT scan is a good diagnostic tool to rule out COVID-19 infection among symptomatic suspected patients.
• In a low prevalence area (3.4% in the administrative area and 5.8% at mean in the study) chest CT sensitivity and specificity for diagnosing COVID-19 pneumonia were 87% and 85% respectively. • In patients with negative chest CT for COVID-19 pneumonia, the negative predictive value of COVID-19 infection was 97% (348/358 subjects). • Performance of CT was equivalent between the 4 centers participating to this study.
胸部 CT 的价值主要在新冠病毒高发病率地区进行了研究。因此，本研究的目的是评估胸部 CT 对新冠病毒肺炎的诊断性能，以 RT-PCR 作为参考标准，检测低发病率地区的新冠病毒肺炎。
向法国行政区域的 4 家医院放射科发送了一份调查。该研究设计获得了当地机构审查委员会的批准，并在 clinicaltrial.gov 网站上进行了记录（NCT04339686）。由于回顾性匿名数据收集，免除了书面知情同意。连续纳入在 48 小时内因怀疑新冠病毒肺炎而行 RT-PCR 和胸部 CT 扫描的患者。以 RT-PCR 作为参考标准，计算胸部 CT 的诊断准确性，包括敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。
129 例患者的胸部 CT 检查结果异常，与新冠病毒肺炎相符（26%，129/487）。358 例阴性胸部 CT 检查结果中，有 3%（10/358）为 RT-PCR 阳性。胸部 CT 的敏感度、特异度、阳性预测值和阴性预测值分别为 87%（95%可信区间：85，89；69/79）、85%（95%可信区间：83，87；348/408）、53%（95%可信区间：50，56；69/129）和 97%（95%可信区间：95，99；348/358）。
在低发病率地区，胸部 CT 扫描是一种很好的诊断工具，可以排除疑似新冠病毒感染的症状患者。
• 在低发病率地区（行政区域为 3.4%，研究中平均为 5.8%），胸部 CT 对诊断新冠病毒肺炎的敏感度和特异度分别为 87%和 85%。• 在新冠病毒肺炎阴性的胸部 CT 检查中，新冠病毒感染的阴性预测值为 97%（348/358 例）。• 4 家参与本研究的中心之间 CT 性能相当。
