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放射科医生在 COVID-19 肺炎诊断中的表现如何变化:一项单中心回顾性研究。

How did radiologists' diagnostic performance has changed in COVID-19 pneumonia: A single-centre retrospective study.

机构信息

Department of Radiology, Izmir Bozyaka Education and Research Hospital, University of Health Sciences, Izmir, Turkey.

Department of Infectious Diseases, Izmir Bozyaka Education and Research Hospital, University of Health Sciences, Izmir, Turkey.

出版信息

Int J Clin Pract. 2021 Oct;75(10):e14693. doi: 10.1111/ijcp.14693. Epub 2021 Aug 9.

Abstract

AIMS

Delay and false positivity in PCR test results have necessitated accurate chest CT reporting for the management of patients with COVID-19-suspected symptoms. Pandemic related workload and level of experience on covid-dedicated chest CT scans might have affected the diagnostic performance of on-call radiologists. The aim of this study was to reveal the interpretation errors (IEs) in chest CT reports of COVID-19-suspected patients admitted to the Emergency Room (ER).

METHODS

Chest CT scans between March and June 2020 were re-evaluated and compared with the former reports and PCR test results. CT scan results were classified into four groups. Parenchymal involvement ratios, radiology departments' workload, COVID-19-related educational activities have been examined.

RESULTS

Out of 5721 Chest CT scans, 783 CTs belonging to 664 patients (340 female, 324 male) were included in this study. PCR test was positive in 398; negative in 385 cases. PCR positivity was found to be highest in "normal" and "typical for covid" groups whereas lowest in "atypical for covid" and "not covid" groups. 5%-25% parenchymal involvement ratio was found in 84.2% of the cases. Regarding the number of chest CT scans performed, radiologists' workload has found to be increased six-folds. With the re-evaluation, a total of 145 IEs (18.5%) have been found. IEs were mostly precipitated in the first two months (88.3%) and mostly in the "not covid" class (60%) regardless of PCR positivity. COVID-19 and radiology entitled educational activities along with the ER admission rates within the first two months of the pandemic have seemed to be related to the decline of IEs within time.

CONCLUSION

COVID-19 pandemic made a great impact on radiology departments with an inevitable burden of daily chest CT reporting. This workload and concomitant factors have effects on diagnostic challenges in COVID-19 pneumonia.

摘要

目的

聚合酶链反应(PCR)检测结果的延迟和假阳性使得对有 COVID-19 疑似症状的患者进行准确的胸部 CT 报告变得十分必要。大流行相关工作量和专门用于 COVID-19 胸部 CT 扫描的经验水平可能会影响值班放射科医生的诊断性能。本研究的目的是揭示急诊(ER)收治的 COVID-19 疑似患者胸部 CT 报告中的解释错误(IE)。

方法

重新评估 2020 年 3 月至 6 月之间的胸部 CT 扫描,并将其与之前的报告和 PCR 检测结果进行比较。将 CT 扫描结果分为四组。检查了实质受累比例、放射科工作量、与 COVID-19 相关的教育活动。

结果

在 5721 例胸部 CT 扫描中,纳入了 664 例患者(340 名女性,324 名男性)的 783 例 CT。PCR 检测阳性 398 例,阴性 385 例。在“正常”和“典型 COVID”组中,PCR 阳性率最高,而在“非典型 COVID”和“非 COVID”组中,PCR 阳性率最低。5%-25%的实质受累比例见于 84.2%的病例。关于胸部 CT 扫描的数量,放射科医生的工作量增加了六倍。通过重新评估,共发现 145 个 IE(18.5%)。IE 主要发生在前两个月(88.3%),主要发生在“非 COVID”类(60%),无论 PCR 阳性与否。COVID-19 和放射学相关的教育活动以及大流行前两个月的 ER 入院率似乎与 IE 随时间减少有关。

结论

COVID-19 大流行对放射科产生了巨大影响,日常胸部 CT 报告的负担不可避免。这种工作量和伴随因素对 COVID-19 肺炎的诊断挑战产生影响。

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Chest CT in COVID-19: What the Radiologist Needs to Know.COVID-19 的胸部 CT:放射科医生需要了解的知识。
Radiographics. 2020 Nov-Dec;40(7):1848-1865. doi: 10.1148/rg.2020200159. Epub 2020 Oct 23.

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