Main Article Content
Objective: The aim of this study was to explore the chest Computer Tomography (CT) features of COVID-19 patients and compare the diagnostic performance of chest CT with that of RT-PCR at our center.
Material and Methods: The study was conducted by retrospectively scanning the files of patients admitted to the Emergency Department of Karaman State Hospital under suspicion of COVID-19 between March 15 and May 18, 2020. The study included 218 patients (124 males, 94 females, 1-90 years of age, median 48.5) who met the inclusion criteria. Chest CT scan findings were recorded in detail by two radiologists with experience in chest radiology. Furthermore, the CT findings were categorized into four groups in the form of typical, indeterminate, atypical, and negative CT according to the structured reporting system.
Results: The RT-PCR results were positive in 41% of 139 cases with positive CT results, while the RT-PCR results were positive in 15.2% of the cases with negative CT results. Regarding the analysis between CT and RT-PCR, the sensitivity was 82.61%, the specificity was 44.97%, the PPV was 41.01%, the NPV was 84.81%. The positivity rate was 82.9% in those with typical imaging findings, 51.5% in those assessed as indeterminate. Those with a typical appearance had a higher rate of positivity than others.
Conclusion: The chest CT scan was found to have a high correlation with the RT-PCR in the patients with typical imaging findings in CT. The specificity was found to be low in the CT scan findings without subgroup analysis.
Adair II LB, Ledermann EJ. Chest CT Findings of Early and Progressive Phase COVID-19 Infection from a US Patient. Radiology Case Reports 2020
Kim H. Outbreak of novel coronavirus (COVID-19): What is the role of radiologists?: Springer, 2020.
Revel M-P, Parkar AP, Prosch H, et al. COVID-19 patients and the Radiology department–advice from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI). Eur. Radio. Accepted on April 2020;2:2020-04
Caruso D, Zerunian M, Polici M, et al. Chest CT features of COVID-19 in Rome, Italy. Radiology 2020:201237
Yang R, Li X, Liu H, et al. Chest ct severity score: An imaging tool for assessing severe covid-19. Radiology: Cardiothoracic Imaging 2020;2(2):e200047
Yang Y, Yang M, Shen C, et al. Laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. MedRxiv 2020
Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020:200642
D'Andrea A, Di Giannuario G, Marrazzo G, et al. The role of multimodality imaging in COVID-19 patients: from diagnosis to clinical monitoring and prognosis. Giornale Italiano di Cardiologia (2006) 2020;21(5):345-53
AKÇAY MŞ, ÖZLÜ T, YILMAZ A. Radiological approaches to COVID-19 pneumonia. Turkish Journal of Medical Sciences 2020;50(SI-1):604-10
Prokop M, van Everdingen W, van Rees Vellinga T, et al. CO-RADS–A categorical CT assessment scheme for patients with suspected COVID-19: definition and evaluation. Radiology 2020:201473
Fang Y, Zhang H, Xie J, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020:200432
Hope MD, Raptis CA, Shah A, Hammer MM, Henry TS. A role for CT in COVID-19? What data really tell us so far. The Lancet 2020;395(10231):1189-90
Simpson S, Kay FU, Abbara S, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiology: Cardiothoracic Imaging 2020;2(2):e200152
Plesner LL, Dyrberg E, Hansen IV, Abild A, Andersen MB. Billeddiagnostiske fund ved COVID-19. Ugeskr Læger 2020;182:V03200191
Ng M-Y, Lee EY, Yang J, et al. Imaging profile of the COVID-19 infection: radiologic findings and literature review. Radiology: Cardiothoracic Imaging 2020;2(1):e200034
Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology 2020:200463
Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020;295(1):202-07
Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. American Journal of Roentgenology 2020:1-7
Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology 2020:200343
Wen Z, Chi Y, Zhang L, et al. Coronavirus disease 2019: initial detection on chest CT in a retrospective multicenter study of 103 Chinese subjects. Radiology: Cardiothoracic Imaging 2020;2(2):e200092
Bai HX, Hsieh B, Xiong Z, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020:200823