高分辨CT定量分析评估新型冠状病毒肺炎临床分型及转归的价值

Evaluation of Novel Coronavirus Pneumonia Clinical Classification and Prognosis by High Resolution CT Quantitative Analysis

目的:探讨高分辨CT定量评分对新型冠状病毒肺炎(novel coronavirus pneumonia,NCP)临床分型及临床治愈转归评估的应用价值。资料与方法:回顾性分析符合该病临床诊断的30例NCP的胸部CT图像,对普通组、重型组、危重组、临床治愈转归组肺部渗出性病变进行CT定量范围、密度及两者综合评分,对各组间进行统计学差异性分析;同时对重型/危重型组、普通组,利用受试者工作特征曲线(ROC)分析,获取对重型/危重型组的预测阈值。结果:危重组、重型组、普通组及临床治愈转归组的范围评分、密度评分、综合评分分别为31.50±7.19、89.04±12.59、164.43±52.72,20.30±7.82、79.36±27.10、104.05±41.39,11.81±7.65、45.51±22.17、55.03±32.47,12.04±7.41、32.69±22.69、39.07±32.00。其中普通型与临床治愈转归组之间的炎症范围评分、密度评分及综合评分之间均不存显著性差异(P>0.05),炎症范围评分及综合评分在危重组、重型组及普通型之间均存在显著性差异(P<0.05),而炎症密度评分在危重型及重型之间不存在显著性差异(P>0.05)。对重型/危重型组患者预测的数据中,炎症范围、密度及综合评分对的预测阈值分别为:15.50、67.42、62.57,其以综合评分结果最准确(约登指数=0.68)。结论:通过CT定量评分方法,能提高临床对NCP疾病进展或恶化的预判能力,但尚不能对临床治愈转归作出有效评判,而炎症CT综合定量评分可对重型/危重型NCP作出准确评估。

Purpose:To explore the application value of CT quantitative score in clinical classification and prognosis evaluation of different novel coronavirus pneumonia(NCP).Methods:Retrospective analysis of 30 cases NCP chest CT images which accorded with clinical diagnosis of the disease.CT quantitative range,density and comprehensive score of the pulmonary leakage lesions in the normal group,severe group,critical group,and clinical cure group were analyzed.Statistical difference analysis was made among the groups.Meanwhile,the receiver operating characteristic curve(ROC)was used in the heavy/critical group and the general group.ROC analysis to obtain the prediction threshold of heavy/critical group.Results:The range score,density score and comprehensive score of the critical group,the severe group,the common group and the clinical cure group were respectively 31.50±7.19、89.04±12.59、164.43±52.72,20.30±7.82、79.36±27.10、104.05±41.39,11.81±7.65、45.51±22.17、55.03±32.47,12.04±7.41、32.69±22.69、39.07±32.00.there was no significant difference in inflammatory range score,density score and comprehensive score between the general type and the discharge type(P>0.05).There was significant difference in inflammatory range score and comprehensive score between the critical group,the severe group and the general type(P<0.05),but there was no significant difference in inflammatory density score between the critical group and the severe type(P>0.05).The prediction thresholds of inflammation range,density and comprehensive score were 15.50,67.42 and 62.57,respectively.The comprehensive score was the most accurate(yoden index=0.68).Conclusion:CT quantitative score can improve the predictive ability of clinical progress or deterioration of NCP,but it is not effective to evaluate the clinical outcome.The comprehensive CT score can be used to evaluate the heavy/critical NCP.