Clinical diagnostic value of computed tomography features of corona virus disease 2019 in 17 cases

中华传染病杂志 Pub Date : 2020-03-16 DOI:10.3760/CMA.J.CN311365-20200219-00088

Yu Wu, Ya-fang Dou, Songhua Zhan, Shuguang Chu, Ailan Cheng, Dongqin Zhang

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Abstract

Objective To investigate the specific chest computed tomography (CT) features of corona virus disease 2019(COVID-19) and to evaluate its clinical diagnostic value. Methods The clinical data of 35 cases with suspected novel coronavirus pneumonia diagnosed from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine and Oriental Hospital affiliated to Shanghai Tongji University School of Medicine from January 1, 2020 to February 14, 2020 were retrospectively analyzed. A total of 17 cases with positive results of two times of real time reverse-transcription–polymerase chain-reaction (RT-PCR) for 2019 novel coronavirus (2019-nCoV) were evaluated as the case group, and the remaining 18 cases with negative results of two times of RT-PCR for 2019-nCoV were evaluated as the control group. The features of chest CT images of 35 cases were obtained. The frequencies of four CT imaging indicators including ground-glass opacities (GGO), crazy-paving , heterogeneous consolidation and bilateral subpleural distribution were analyzed. The sensitivity, specificity, positive predictive values (PPV) and negative predictive value (NPV) for COVID-19 were calculated. Results In the case group, there were 11 cases (64.71%) with GGO, 7 cases (41.18%) with crazy-paving, 6 cases (35.29%) with heterogeneous consolidation, and 16 cases (94.12%) with bilateral subpleural distribution, while in the control group, there were 7 cases (27.28%) with GGO, 1 case (5.56%) with crazy-paving, 6 cases (33.33%) with heterogeneous consolidation, and 5 cases (29.41%) with bilateral subpleural distribution. When multiple subpleural lesions or any two of the CT indicators were used as the characteristic indicator, the diagnosis efficiencies were better, with the sensitivity, specificity, PPV, NPV and Youden index of 94.12%, 72.22%, 76.19%, 98.86% and 0.66, respectively, and 88.24%, 77.78%, 78.95%, 87.5% and 0.66, respectively. Conclusions Chest CT indictors are of high clinical diagnostic value for COVID-19. Any two of the four CT indicators (GGO, crazy-paving, heterogeneous consolidation and bilateral subpleural distribution) or the single characteristics (bilateral subpleural distribution) are of high diagnostic efficacy. Key words: COVID-19; Computed tomography

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17例2019冠状病毒病计算机断层扫描特征的临床诊断价值

目的探讨2019冠状病毒病（新冠肺炎）的胸部计算机断层扫描（CT）特征及其临床诊断价值。方法回顾性分析2020年1月1日至2月14日在上海中医药大学附属曙光医院和上海同济大学医学院附属东方医院确诊的35例疑似新型冠状病毒肺炎患者的临床资料。共17例2019年新型冠状病毒（2019-nCoV）两次实时逆转录聚合酶链反应（RT-PCR）阳性结果为病例组，其余18例2019-nCo病毒两次RT-PCR阴性结果为对照组。对35例患者的胸部CT图像进行了分析。分析了磨玻璃样混浊（GGO）、疯狂铺片、不均匀实变和双侧胸膜下分布四种CT影像学指标的频率。计算新冠肺炎的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。结果病例组GGO 11例（64.71%），疯狂铺贴7例（41.18%），不均匀固结6例（35.29%），双侧胸膜下分布16例（94.12%），对照组GGO 7例（27.28%），疯狂铺设1例（5.56%），双侧胸膜下分布5例（29.41%）。以胸膜下多发病变或任意两种CT指标作为特征指标，诊断效率较高，敏感性、特异性、PPV、NPV和Youden指数分别为94.12%、72.22%、76.19%、98.86%和0.66，88.24%、77.78%、78.95%、87.5%和0.66。结论胸部CT指标对新冠肺炎具有较高的临床诊断价值。四种CT指标中的任何两种（GGO、疯狂铺路、不均匀实变和双侧胸膜下分布）或单一特征（双侧胸膜下分配）都具有较高的诊断效率。关键词：新冠肺炎；计算机断层扫描

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中华传染病杂志

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