Zakariaee Seyed Salman, Salmanipour Hossein, Kaffashian Mohammad Reza
Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran.
Department of Radiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
J Med Signals Sens. 2023 May 29;13(2):129-135. doi: 10.4103/jmss.jmss_118_21. eCollection 2023 Apr-Jun.
A significant discrepancy between the results of previous studies is identified regarding the diagnostic efficacy of chest computed tomography (CT) for coronavirus disease 2019 (COVID-19). We aimed to evaluate the diagnostic efficacy of chest CT for COVID-19.
Suspected cases of COVID-19 with fever, cough, dyspnea, and evidence of pneumonia on chest CT scan were enrolled in the study. The accuracy, sensitivity, and specificity of chest CT were determined according to real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results as the gold standard method.
The study population comprised 356 suspected cases of COVID-19 (174 men and 182 women; age range 3-96 years; mean age ± standard deviation, 55.21 ± 18.38 years). COVID-19 patients were diagnosed using chest CT with 89.8% sensitivity, 78.1% accuracy, 21.3% specificity, 84.7% positive predictive value, and 30.23% negative predictive value. The odds ratio was 2.39 (95% confidence interval, 1.16-4.91). Typical CT manifestations of COVID-19 were observed in 48 (13.5%) patients with negative RT-PCR results and 30 (8.4%) patients with confirmed positive RT-PCR results had no radiological manifestations. Kappa coefficient of chest CT for diagnosis of COVID-19 was 0.78.
The results show that when RT-PCR results are negative, chest CT could be considered as a complementary diagnostic method for the diagnosis of COVID-19 patients. A more comprehensive diagnostic method could be established by combining the chest CT examination, clinical symptoms, and RT-PCR assay.
关于胸部计算机断层扫描（CT）对2019冠状病毒病（COVID-19）的诊断效能，以往研究结果存在显著差异。我们旨在评估胸部CT对COVID-19的诊断效能。
纳入有发热、咳嗽、呼吸困难且胸部CT扫描有肺炎证据的COVID-19疑似病例。以实时逆转录聚合酶链反应（RT-PCR）结果作为金标准方法，确定胸部CT的准确性、敏感性和特异性。
研究人群包括356例COVID-19疑似病例（男性174例，女性182例；年龄范围3 - 96岁；平均年龄±标准差，55.21±18.38岁）。使用胸部CT诊断COVID-19患者的敏感性为89.8%，准确性为78.1%，特异性为21.3%，阳性预测值为84.7%，阴性预测值为30.23%。优势比为2.39（95%置信区间，1.16 - 4.91）。48例（13.5%）RT-PCR结果阴性的患者出现了COVID-19的典型CT表现，30例（8.4%）RT-PCR确诊阳性的患者无放射学表现。胸部CT诊断COVID-19的Kappa系数为0.78。
结果表明，当RT-PCR结果为阴性时，胸部CT可被视为诊断COVID-19患者的一种补充诊断方法。结合胸部CT检查、临床症状和RT-PCR检测可建立更全面的诊断方法。
