University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
University Dusseldorf, Medical Faculty, Institute of Medical Microbiology and Hospital Hygiene, D-40225 Dusseldorf, Germany.
Rofo. 2022 Oct;194(10):1110-1118. doi: 10.1055/a-1779-9230. Epub 2022 May 11.
To assess whether it is possible to reliably detect patients with strong suspicion of COVID-19 despite initially negative quantitative polymerase-chain-reaction (qPCR) tests by means of computed tomography (CT).
437 patients with suspected COVID-19 but initially negative qPCR and subsequent chest CT between March 13 and November 30, 2020 were included in this retrospective study. CT findings were compared to results of successive qPCR tests (minimum of 3 qPCR tests if CT suggested infection) to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT for diagnosing COVID-19.
COVID-19 was diagnosed correctly with a sensitivity of 100 % [95 % confidence interval (CI): 65-100] and a specificity of 88 % [95 % CI: 84-90]. A PPV of 12 % [95 % CI: 6-22] and an NPV of 100 % [95 % CI: 99-100] were determined.
CT is able to detect COVID-19 before qPCR in initially negative patients in this special study setting. Similar CT findings in COVID-19 and other atypical pneumonias can lead to high numbers of false-positive patients, reducing the specificity of CT.
· Low-dose chest CT is able to diagnose COVID-19 in symptomatic patients even in cases of an initially negative quantitative PCR result and therefore is a fast support method to detect COVID-19, especially in early disease.. · Low-dose chest CT can reliably exclude COVID-19 in a pandemic setting.. · CT does not always ensure a reliable differentiation from other viral diseases..
· Valentin B, Steuwe A, Wienemann T, et al. CT Findings in Patients with COVID-19-Compatible Symptoms but Initially Negative qPCR Test. Fortschr Röntgenstr 2022; 194: 1110 - 1118.
通过计算机断层扫描（CT）评估在最初定量聚合酶链反应（qPCR）检测结果为阴性的情况下，是否可以可靠地检测出疑似 COVID-19 的患者。
本回顾性研究纳入了 2020 年 3 月 13 日至 11 月 30 日期间疑似 COVID-19 但最初 qPCR 检测结果为阴性且随后进行了胸部 CT 的 437 例患者。将 CT 结果与连续 qPCR 检测结果进行比较（如果 CT 提示感染，至少进行 3 次 qPCR 检测），以确定 CT 诊断 COVID-19 的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
COVID-19 的诊断敏感性为 100%[95%置信区间（CI）：65-100]，特异性为 88%[95%CI：84-90]。PPV 为 12%[95%CI：6-22]，NPV 为 100%[95%CI：99-100]。
在本特殊研究环境中，最初 qPCR 检测结果为阴性的患者中，CT 能够在 qPCR 之前检测到 COVID-19。COVID-19 与其他非典型性肺炎的 CT 表现相似，这可能导致大量假阳性患者，从而降低 CT 的特异性。
· 低剂量胸部 CT 即使在最初 qPCR 结果为阴性的情况下，也能够诊断有症状的 COVID-19 患者，因此是一种快速支持检测 COVID-19 的方法，尤其是在疾病早期。· 在大流行环境下，低剂量胸部 CT 能够可靠地排除 COVID-19。· CT 并不总是能够可靠地区分其他病毒性疾病。
