Abdel-Tawab Mohamed, Basha Mohammad Abd Alkhalik, Mohamed Ibrahim A I, Ibrahim Hamdy M, Zaitoun Mohamed M A, Elsayed Saeed Bakry, Mahmoud Nader E M, El Sammak Ahmed A, Yousef Hala Y, Aly Sameh Abdelaziz, Khater Hamada M, Mosallam Walid, Abo Shanab Waleed S, Hendi Ali M, Hassan Sayed
Department of Diagnostic Radiology, Faculty of Human Medicine, Assiut University, Assiut, Egypt.
Department of Diagnostic Radiology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt.
Insights Imaging. 2021 Apr 28;12(1):55. doi: 10.1186/s13244-021-00998-4.
The Radiological Society of North America (RSNA) recently published a chest CT classification system and Dutch Association for Radiology has announced Coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) to provide guidelines to radiologists who interpret chest CT images of patients with suspected COVID-19 pneumonia. This study aimed to compare CO-RADS and RSNA classification with respect to their sensitivity and reliability for diagnosis of COVID-19 pneumonia.
A retrospective study assessed consecutive CT chest imaging of 359 COVID-19-positive patients. Three experienced radiologists who were aware of the final diagnosis of all patients, independently categorized each patient according to CO-RADS and RSNA classification. RT-PCR test performed within one week of chest CT scan was used as a reference standard for calculating sensitivity of each system. Kappa statistics and intraclass correlation coefficient were used to assess reliability of each system. The study group included 359 patients (180 men, 179 women; mean age, 45 ± 16.9 years). Considering combination of CO-RADS 3, 4 and 5 and combination of typical and indeterminate RSNA categories as positive predictors for COVID-19 diagnosis, the overall sensitivity was the same for both classification systems (72.7%). Applying both systems in moderate and severe/critically ill patients resulted in a significant increase in sensitivity (94.7% and 97.8%, respectively). The overall inter-reviewer agreement was excellent for CO-RADS (κ = 0.801), and good for RSNA classification (κ = 0.781).
CO-RADS and RSNA chest CT classification systems are comparable in diagnosis of COVID-19 pneumonia with similar sensitivity and reliability.
北美放射学会（RSNA）最近发布了一种胸部CT分类系统，荷兰放射学会也公布了2019冠状病毒病（COVID-19）报告和数据系统（CO-RADS），旨在为解读疑似COVID-19肺炎患者胸部CT图像的放射科医生提供指导。本研究旨在比较CO-RADS和RSNA分类在诊断COVID-19肺炎方面的敏感性和可靠性。
一项回顾性研究评估了359例COVID-19阳性患者的连续胸部CT成像。三位了解所有患者最终诊断结果的经验丰富的放射科医生，根据CO-RADS和RSNA分类对每位患者进行独立分类。在胸部CT扫描后一周内进行的RT-PCR检测被用作计算每个系统敏感性的参考标准。kappa统计量和组内相关系数用于评估每个系统的可靠性。研究组包括359例患者（180例男性，179例女性；平均年龄45±16.9岁）。将CO-RADS 3、4和5的组合以及典型和不确定的RSNA类别组合视为COVID-19诊断的阳性预测指标，两种分类系统的总体敏感性相同（72.7%）。在中度和重度/危重症患者中应用这两种系统，敏感性显著提高（分别为94.7%和97.8%）。CO-RADS的总体阅片者间一致性极佳（κ=0.801），RSNA分类的一致性良好（κ=0.781）。
CO-RADS和RSNA胸部CT分类系统在诊断COVID-19肺炎方面具有可比性，敏感性和可靠性相似。
