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年龄对计算机断层扫描结果的影响:2019冠状病毒病感染中的特异性和敏感性

Effect of age on computed tomography findings: Specificity and sensitivity in coronavirus disease 2019 infection.

作者信息

Karavas Erdal, Unver Edhem, Aydın Sonay, Yalcin Gonul Seven, Fatihoglu Erdem, Kuyrukluyildiz Ufuk, Arslan Yusuf Kemal, Yazici Mustafa

机构信息

Department of Radiology, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.

Department of Pulmonology, Erzincan Binali Yildirim University, Erzincan 24100, Turkey.

出版信息

World J Virol. 2022 Sep 25;11(5):331-340. doi: 10.5501/wjv.v11.i5.331.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a pandemic caused by the severe acute respiratory syndrome coronavirus in 2019. Although the real-time reverse tr-anscription PCR test for viral nucleic acids is the gold standard for COVID-19 diagnosis, computed tomography (CT) has grown in importance.

AIM

To evaluate the sensitivity and specificity of thoracic CT findings of COVID-19 pneumonia according to age groups.

METHODS

PCR and CT results from 411 patients were reviewed. The diagnosis of COVID-19 pneumonia was made by three radiologists. Lymphadenopathy, pericardial effusion, pleurisy, pleural thickening, pleural effusion, location features of the lesions, ground glass, consolidation, air bronchogram, vascular enlargement, bronchial dilatation, halo finding, inverted halo sign, nodularity, air bubble, subpleural band (curvilinear density), reticular density, crazy paving pattern, and fibrosis findings were recorded. The patients were divided into nine groups by decades while calculating the sensitivity, specificity, and diagnostic efficacy for CT positivity.

RESULTS

The mean age of the cases was 48.1 ± 22.7 years. The CT finding with the highest diagnostic power was ground glass. Vascular enlargement and bronchial dilatation followed ground glass. Peri-cardial effusion was the finding with the lowest diagnostic accuracy. The incidence of lymphadenopathy, pleurisy, pleural thickening, peripheral localization, bilateral, ground glass, vascular enlargement, bronchial dilatation, subpleural band, reticular density, crazy paving appearance, and fibrosis all increased increase significantly with age in patients with positive real-time reverse transcription PCR test.

CONCLUSION

There are few publications comparing sensitivity and specificity of thoracic CT findings according to age. In cases of COVID-19 pneumonia, there is an increase in the variety and frequency of CT findings with age, and parallel to this the sensitivity and specificity of the findings increase. COVID-19 cases in the pediatric age group have fewer lung findings than adults, and this situation decreases the diagnostic value of CT in pediatric patients.

摘要

背景

2019冠状病毒病(COVID-19)是由2019年严重急性呼吸综合征冠状病毒引起的大流行病。虽然病毒核酸的实时逆转录聚合酶链反应检测是COVID-19诊断的金标准,但计算机断层扫描(CT)的重要性日益凸显。

目的

根据年龄组评估COVID-19肺炎胸部CT表现的敏感性和特异性。

方法

回顾了411例患者的PCR和CT结果。由三名放射科医生做出COVID-19肺炎的诊断。记录淋巴结肿大、心包积液、胸膜炎、胸膜增厚、胸腔积液、病变的位置特征、磨玻璃影、实变、空气支气管征、血管增粗、支气管扩张、晕征、反晕征、结节、气泡、胸膜下带(曲线密度)、网状密度、铺路石样表现和纤维化表现。在计算CT阳性的敏感性、特异性和诊断效能时,将患者按年龄段分为九组。

结果

病例的平均年龄为48.1±22.7岁。诊断能力最高的CT表现是磨玻璃影。血管增粗和支气管扩张仅次于磨玻璃影。心包积液的诊断准确性最低。实时逆转录PCR检测呈阳性的患者中,淋巴结肿大、胸膜炎、胸膜增厚、外周定位、双侧、磨玻璃影、血管增粗、支气管扩张、胸膜下带、网状密度、铺路石样外观和纤维化的发生率均随年龄显著增加。

结论

很少有出版物根据年龄比较胸部CT表现的敏感性和特异性。在COVID-19肺炎病例中,CT表现的种类和频率随年龄增加,同时这些表现的敏感性和特异性也增加。儿童年龄组的COVID-19病例肺部表现比成人少,这种情况降低了CT在儿科患者中的诊断价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/371b/9523317/ee777cc5fdb9/WJV-11-331-g001.jpg

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