胸部低剂量CT辅助诊断新型冠状病毒肺炎

目的 探讨胸部低剂量CT（LDCT）辅助诊断新型冠状病毒肺炎（COVID-19）的临床应用价值。方法 收集50例咽拭子新型冠状病毒（2019-nCoV）核酸检测阳性的COVID-19患者。首次胸部CT采用常规剂量扫描（常规剂量组），随访胸部CT采用LDCT扫描方案（LD组），对2组图像质量进行评价。采用Kappa检验分析2名医师评价2组图像质量结果的一致性，比较2组图像质量及2种CT扫描方案X线有效辐射剂量（ED）。结果 2名医师图像质量评分一致性较高（Kappa=0.65，P<0.05）LD组与常规剂量组之间图像质量差异无统计学意义（Z=-0.93，P=0.35）。LD组ED[（2.43±0.66）mSv]较常规剂量组[（4.02±1.03）mSv]减少约39.55%（t=0.85，P<0.01）。结论 胸部LDCT可用于临床筛查和辅助诊断COVID-19，图像质量可满足临床诊断要求，且能降低辐射剂量，具有重要临床应用价值。

Chest low-dose CT in auxiliary diagnosis of corona virus disease 2019

Objective To observe the clinical application value of chest low-dose CT (LDCT) in auxiliary diagnosis of corona virus disease 2019 (COVID-19). Methods Totally 50 COVID-19 patients with positive 2019 novel coronavirus nucleic acid test of pharynx swabs were selected. All patients underwent routine dose chest CT examination on the first time (routine dose group), and followed chest LDCT for the review examination after treatment (LD group). The image quality of was evaluated by 2 imaging doctors. Kappa test was used to analyze the consistency of the image quality results of 2 groups evaluated by the two physicians. The X-ray radiation dose of the two CT scanning schemes were compared.Results The consistency of image quality scores of 2 groups evaluated by 2 physicians was relatively high (Kappa=0.65, P<0.05). There was no significant difference of image quality between LD group and routine dose group (Z=-0.93, P=0.35). The effective radiation dose (ED)in LD group ([2.43±0.66]mSv) reduced by 39.55% (t=0.85, P<0.01) compared with that of the routine dose group ([4.02±1.03]mSv).Conclusion Chest LDCT scan can be used for clinical screening and auxiliary diagnosis of COVID-19, which can ensure the image quality, meet clinical diagnosis requirements and reduce the dose of X-ray radiation.