Abstract:
Objective To investigate the value of high-resolution computed tomography (HRCT) findings and chest HRCT scoring in the clinical diagnosis and treatment of coronavirus disease 2019 (COVID-19).
Methods A total of 28 COVID-19 patients and 67 non-COVID-19 patients who underwent RT-PCR and chest CT simultaneously at Lianyungang were collected. The distribution, range, morphology, and density of lesions, mediastinal and hilar lymph nodes, and abnormalities in the thoracic cavity and pleura were observed and analyzed. According to the CT manifestations, chest HRCT was used to score COVID-19 and non-COVID-19 patients and divide them into grades 0 to 5, and the diagnostic value of each grade for COVID-19 was assessed.
Results Among the 28 cases of COVID-19, 20 presented subpleural or multicentric distribution of bilateral lung lesions as shown by chest HRCT, 11 had single or multiple patchy or segmental ground glass opacities (GGOs), 14 had GGOs accompanied by interlobular septal thickening, 8 had GGOs with consolidation, 5 had consolidation, 18 had bronchial wall thickening or dilatation, 5 had diffuse central ground glass nodules, 5 had mesh-or honeycomb-like fiber cords, and 1 had pleural thickening. Compared with non-COVID-19 patients, the incidence of bilateral subpleural or multicentre lesions (71% vs 12%, P＜0.001) and GGOs with septal thickening (50% vs 13%, P＜0.001) was significantly higher in COVID-19 patients, while other HRCT findings did not differ significantly between non-COVID-19 and COVID-19 patients. The sensitivities, specificities, accuracies, positive predictive values, negative predictive values, and Kappa values of HRCT grades 0-5 for the diagnosis of COVID-19 were 64.3%, 97.0%, 87.4%, 90.0%, 86.7%, 0.669, respectively.92.9%, 82.1%, 85.3%, 68.4%, 96.5%, and 0.679; 100.0%, 59.7%, 71.6%, 50.9%, 100.0%, and 0.466; 100.0%, 29.9%, 50.5%, 37.3%, 100.0%, and 0.201; and 100.0%, 7.5%, 29.5%, 31.1%, 100.0%, and 0.045, respectively.
Conclusion COVID-19 has characteristic chest HRCT manifestations. Chest HRCT scoring can provide an effective means for the control and early treatment of highly suspected COVID-19 patients, which is beneficial to medical institutions to control the epidemic situation and improve the cure rate.
Key words:
Coronavirus disease 2019,
Pneumonia,
High resolution,
Computed tomography
Lei Geng, Juan Zuo, Ge Lu, Yi Sun, Guofu Shi, Jinxin Wan, Junming Ding, Yan Zhao. Value of chest high-resolution computed tomography scoring in diagnosis of coronavirus disease 2019[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(12): 996-1001.