ISSN 1004-4140
CN 11-3017/P
方进智, 鄂林宁, 曾剑兵, 等. 基于胸部CT图像的新型冠状病毒感染严重程度评分系统对比分析[J]. CT理论与应用研究, 2023, 32(3): 395-401. DOI: 10.15953/j.ctta.2023.056.
引用本文: 方进智, 鄂林宁, 曾剑兵, 等. 基于胸部CT图像的新型冠状病毒感染严重程度评分系统对比分析[J]. CT理论与应用研究, 2023, 32(3): 395-401. DOI: 10.15953/j.ctta.2023.056.
FANG J Z, E L N, ZENG J B, et al. Comparison of Chest Computed Tomography-based Severity Scoring Systems for Detecting Lung Involvement in Patients with Coronavirus Disease 2019[J]. CT Theory and Applications, 2023, 32(3): 395-401. DOI: 10.15953/j.ctta.2023.056. (in Chinese).
Citation: FANG J Z, E L N, ZENG J B, et al. Comparison of Chest Computed Tomography-based Severity Scoring Systems for Detecting Lung Involvement in Patients with Coronavirus Disease 2019[J]. CT Theory and Applications, 2023, 32(3): 395-401. DOI: 10.15953/j.ctta.2023.056. (in Chinese).

基于胸部CT图像的新型冠状病毒感染严重程度评分系统对比分析

Comparison of Chest Computed Tomography-based Severity Scoring Systems for Detecting Lung Involvement in Patients with Coronavirus Disease 2019

  • 摘要: 目的:采用4种半定量测量方法评估新型冠状病毒感染患者的肺部病变负担,比较4种评估方法的诊断性能和观察者间的一致性,找出诊断时间最短、最精确的一种评估方法。方法:回顾性分析157例经鼻咽拭子标本进行实时逆转录聚合酶链反应确诊并住院治疗的新型冠状病毒感染患者,根据中国国家卫健委发布的《新型冠状病毒感染诊疗方案(试行第十版)》进行分型,中型87例,重症型66例,危重型4例。基于患者的胸部CT图像,两名放射科医生使用4种半定量评分系统独立评估肺部受累的严重程度,并记录每个评分系统所用的时间。采用组内相关系数(ICC)检验两名医生使用4种半定量评估方法的评估结果一致性。结果:重症组的D-二聚体、淋巴细胞百分比、淋巴细胞计数、乳酸脱氢酶和C反应蛋白与非重症组差异有统计学意义。4种半定量评估方法的评分结果显示,重症组的平均得分均高于非重症组。两名医师采用4种半定量评估方法的一致性均较差,4种方法的ICC均小于0.75,4种方法中T-SS法的平均用时最短。结论:基于视觉及主观经验的新型冠状病毒感染肺部病变严重程度半定量评估方法具有一定的局限性,未来开发基于人工智能且具有良好泛化性的定量评估模型具有重要临床应用价值。

     

    Abstract: Objective: This study aimed to evaluate the burden of lung involvement in patients with coronavirus disease 2019 (COVID-19) infection using four semi-quantitative measurement methods; compare the diagnostic performance of the four methods and consistency of results over time among observers; and find the fastest and most accurate evaluation method. Methods: Data of 157 patients with COVID-19 infection confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR) using nasopharyngeal swab samples and hospitalized were retrospectively analyzed. According to the "Diagnosis and Treatment Plan for COVID-19 Infection (Tenth Edition)" issued by the China's National Health Commission, 87 patients were classified as medium type, 66 as severe, and 4 as critical. Based on the patients' chest CT images, two radiologists independently evaluated the severity of lung involvement using four semi-quantitative scoring systems and recorded the time taken by each scoring system. The intra-group correlation coefficient (ICC) was used to test the evaluation results consistency between the two radiologists using four semi-quantitative evaluation methods. Result: There were statistically significant differences in D-dimer, lymphocyte percentage, lymphocyte count, lactate dehydrogenase, and C-reactive protein between the severe and non-severe groups. The scoring results of the four semi-quantitative evaluation methods showed that the average score in the severe group was higher than that in the non-severe one. The consistency of the four semi-quantitative evaluation methods used by the two radiologists was poor, of which the ICC of the four methods was less than 0.75. The total severity score (T-SS) method showed the shortest average time. Conclusion: The semi-quantitative assessment method for detecting severity of pulmonary lesions in patients infected with COVID-19 based on vision and subjective experience has some limitations. The development of a quantitative assessment model based on artificial intelligence with good generalization in the future has important clinical application value.

     

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