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新型冠状病毒肺炎患者管理面临的新挑战:基于多层螺旋CT的“肺炎自动分析程序”分析

New challenges for management of COVID-19 patients: Analysis of MDCT based "Automated pneumonia analysis program".

作者信息

Sezer Rahime, Esendagli Dorina, Erol Cigdem, Hekimoglu Koray

机构信息

Baskent University Faculty of Medicine, Department of Radiology, Turkey.

Baskent University Faculty of Medicine, Department of Chest Diseases, Turkey.

出版信息

Eur J Radiol Open. 2021;8:100370. doi: 10.1016/j.ejro.2021.100370. Epub 2021 Jul 20.

Abstract

PURPOSE

The aim of this study is to define the role of an "Automated Multi Detector Computed Tomography (MDCT) Pneumonia Analysis Program'' as an early outcome predictor for COVID-19 pneumonia in hospitalized patients.

MATERIALS AND METHODS

A total of 96 patients who had RT-PCR proven COVID-19 pneumonia diagnosed by non-contrast enhanced chest MDCT and hospitalized were enrolled in this retrospective study. An automated CT pneumonia analysis program was used for each patient to see the extent of disease. Patients were divided into two clinical subgroups upon their clinical status as good and bad clinical course. Total opacity scores (TOS), intensive care unit (ICU) entry, and mortality rates were measured for each clinical subgroups and also laboratory values were used to compare each subgroup.

RESULTS

Left lower lobe was the mostly effected side with a percentage of 78.12 % and followed up by right lower lobe with 73.95 %. TOS, ICU entry, and mortality rates were higher in bad clinical course subgroup. TOS values were also higher in patients older than 60 years and in patients with comorbidities including, Hypertension (HT), Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and malignancy.

CONCLUSION

Automated MDCT analysis programs for pneumonia are fast and an objective way to define the disease extent in COVID-19 pneumonia and it is highly correlated with the disease severity and clinical outcome thus providing physicians with valuable knowledge from the time of diagnosis.

摘要

目的

本研究旨在确定“自动多探测器计算机断层扫描(MDCT)肺炎分析程序”作为住院COVID-19肺炎患者早期预后预测指标的作用。

材料与方法

本回顾性研究纳入了96例经逆转录聚合酶链反应(RT-PCR)证实为COVID-19肺炎、通过非增强胸部MDCT诊断并住院的患者。使用自动CT肺炎分析程序观察每位患者的疾病范围。根据临床病程的好坏将患者分为两个临床亚组。测量每个临床亚组的总不透明度评分(TOS)、重症监护病房(ICU)入住率和死亡率,并使用实验室值比较每个亚组。

结果

左下叶是受影响最严重的部位,占比78.12%,其次是右下叶,占比73.95%。临床病程较差的亚组中,TOS、ICU入住率和死亡率更高。60岁以上患者以及患有高血压(HT)、糖尿病(DM)、慢性阻塞性肺疾病(COPD)、慢性心力衰竭(CHF)和恶性肿瘤等合并症的患者TOS值也更高。

结论

肺炎的自动MDCT分析程序是一种快速且客观的方法,可用于确定COVID-19肺炎的疾病范围,并且与疾病严重程度和临床结局高度相关,从而在诊断时为医生提供有价值的信息。

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