Departments of Pediatric Radiology, Hacettepe University Faculty of Medicine Ankara, Turkey.
Departments of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine Ankara, Turkey.
Turk J Pediatr. 2022;64(1):19-31. doi: 10.24953/turkjped.2020.3708.
Chest computed tomography (CT) appears to be an important radiological modality for the diagnosis of COVID-19 in adults. Studies comparing the findings of such children with those of other viral infections have not been reported either. The aim of this study was to present comparative imaging findings of 75 pediatric COVID-19 patients and four patients with other viral upper respiratory tract infections. We also aimed to demonstrate the possible association between the radiological and laboratory findings in the COVID group.
From 11 March 2020 to 20 June 2020, 79 children (aged < 18 years) were enrolled. COVID-19 was detected by RT-PCR or antibody testing. A plain chest X-ray was obtained from all subjects. Non-contrast chest CT was performed for symptomatic patients.
Seventy-five patients had COVID-19 and 4 were infected with other pathogens i.e. adenovirus, rhinovirus, parainfluenza virus B, respiratory syncytial virus. The ages of the patients (36 M, 43 F) ranged from 7 months to 17 years old. The sensitivity of chest X-ray (as compared to RT-PCR) was 10.67% (95 CI%: 4.72 - 19.94%). From 23 chest CT`s five of them were normal and nine of them had only nodules ( < 5mm). The sensitivity of CT was 78.26% (95CI%: 54.30 - 92.54%), false-negative rate was 21.7%.
The sensitivity of chest CT was found to be low and any significant correlations could have not been depicted, between the radiological parameters and the presence of lymphopenia. Clinical follow-up combined with corresponding pathogen detection, and chest CT of the symptomatic COVID-19 patients might be a feasible/prompt protocol in children.
胸部计算机断层扫描（CT）似乎是诊断成人 COVID-19 的重要影像学手段。尚未有研究比较此类儿童与其他病毒感染的影像学表现。本研究旨在介绍 75 例儿科 COVID-19 患者和 4 例其他病毒上呼吸道感染患者的比较影像学表现。我们还旨在证明 COVID 组中影像学和实验室发现之间的可能关联。
从 2020 年 3 月 11 日至 6 月 20 日，共纳入 79 名（年龄<18 岁）儿童。通过 RT-PCR 或抗体检测检测 COVID-19。所有患者均行胸部 X 线平片检查。对有症状的患者进行非增强胸部 CT 检查。
75 例患者确诊为 COVID-19，4 例患者感染了其他病原体，即腺病毒、鼻病毒、副流感病毒 B、呼吸道合胞病毒。患者年龄（36 例男性，43 例女性）为 7 个月至 17 岁。胸部 X 射线（与 RT-PCR 相比）的灵敏度为 10.67%（95%置信区间：4.72-19.94%）。23 例胸部 CT 中，5 例正常，9 例仅有结节（<5mm）。CT 的灵敏度为 78.26%（95%置信区间：54.30-92.54%），假阴性率为 21.7%。
胸部 CT 的灵敏度较低，可能无法描绘出影像学参数与淋巴细胞减少症之间的任何显著相关性。对于有症状的 COVID-19 患者，临床随访结合相应的病原体检测和胸部 CT 可能是一种可行/及时的方案。
