Adibi Atoosa, Kazemi Kimia, Hajiahmadi Somaye, Shayganfar Azin, Abdollahpour Ibrahim, Manteghinejad Amirreza, Vaseghi Golnaz, Javanmard Shaghayegh Haghjooye
Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2021 Nov 29;26:117. doi: 10.4103/jrms.JRMS_1187_20. eCollection 2021.
Novel coronavirus disease of 2019 (COVID-19) is the current pandemic causing massive morbidity and mortality worldwide. The gold standard diagnostic method in use is reverse transcription-polymerase chain reaction (RT-PCR) which cannot be solely relied upon. Computed tomography (CT) scan is a method currently used for diagnosis of lung disease and can play a substantial role if proved helpful in COVID-19 diagnosis. We conducted this study to evaluate the diagnostic value of CT scan compared to RT-PCR in the diagnosis of COVID-19.
We recruited 291 hospitalized patients suspicious of COVID-19 according to typical clinical findings during February-March 2020. The patients underwent CT-scan and RT-PCR procedures on the day of hospital admission. CT scans were reported by two radiologists as typical, indeterminate, negative, and atypical. Statistical indices were calculated twice: once considering "typical" and "indeterminate" categories as positive and the other time counting "typical" results as positive.
The CT reports were classified as typical (64.95%), indeterminate (10.31%), atypical (11%), and negative (13.75%). Considering "typical" and "intermediate" as positive, sensitivity and specificity were 85.3% and 38.8%, respectively, and using the second assumption, the mentioned indices were 75.9% and 50.4%, respectively.
According to our study, CT results do not create enough diagnostic benefit and could result in incorrect confidence if negative. Since widely available, CT integration in the clinical process may be helpful in screening of suspected patients in epidemics. Yet, suspected patients should be isolated till confirmed by (multiple) PCRs.
2019年新型冠状病毒病（COVID-19）是当前在全球范围内导致大量发病和死亡的大流行病。目前使用的金标准诊断方法是逆转录-聚合酶链反应（RT-PCR），但不能完全依赖于此。计算机断层扫描（CT）是目前用于诊断肺部疾病的一种方法，如果被证明对COVID-19诊断有帮助，则可发挥重要作用。我们进行这项研究以评估CT扫描与RT-PCR相比在COVID-19诊断中的诊断价值。
我们根据2020年2月至3月期间的典型临床表现招募了291名疑似COVID-19的住院患者。患者在入院当天接受了CT扫描和RT-PCR检测。两名放射科医生将CT扫描报告分为典型、不确定、阴性和非典型。统计指标计算了两次：一次将“典型”和“不确定”类别视为阳性，另一次将“典型”结果视为阳性。
CT报告分为典型（64.95%）、不确定（10.31%）、非典型（11%）和阴性（13.75%）。将“典型”和“中间型”视为阳性时，敏感性和特异性分别为85.3%和38.8%，使用第二种假设时，上述指标分别为75.9%和50.4%。
根据我们的研究，CT结果没有产生足够的诊断益处，如果为阴性可能会导致错误的信心。由于CT广泛可用，将其整合到临床过程中可能有助于在疫情中筛查疑似患者。然而，疑似患者应隔离，直到通过（多次）PCR确诊。
