Göðüs Hastanesi Dergisi. Baskýdaki Makaleler: IGHH-74946 | DOI: 10.14744/IGH.2022.74946

COVÝD-19 hastalýðýnda toraks BT bulgularýnýn “Radiological Society of North America” raporlama önerisine göre sýnýflandýrýlmasý; RT-PCR testi ile uyumu

Seher Susam¹, Berna Eren Kömürcüoðlu², Gülru Polat², Özgür Batum², Sena Ataman², Pelin Gülcü², Filiz Güldaval², Mine Gayaf², Fatma Demirci Üçsular², Emel Cireli Tellioðlu², Günseli Balcý^2
1SBÜ Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Radyoloji Bölümü
²SBÜ Dr Suat Seren Göðüs Hast. ve Cerr. Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Bölümü

Amaç: COVÝD-19 hastalýðýnda toraks BT bulgularýný Radiological Society of North America (RSNA) tarafýndan Mart 2020’de yayýnlanan konsensüs raporu kriterlerine göre sýnýflandýrmak ve RT-PCR test sonuçlarý ile karþýlaþtýrmaktýr.
Yöntem: Araþtýrma Mart 2020 ve Haziran 2020 tarihleri arasýnda tek merkezde retrospektif olarak yapýlmýþtýr. COVID-19 hastalýðý þüphesi ile baþvuran, en az bir kez RT-PCR testi, test ile en fazla 3 gün ara ile BT tetkiki yapýlan, klinik, radyolojik ve RT-PCR test sonucuna göre kesin taný alan 426 hasta çalýþmaya dahil edilmiþtir. BT görüntüleri toraks radyolojisi konusunda deneyimli 2 radyolog tarafýndan, RSNA kriterlerine göre “tipik”, “belirsiz”, “atipik” ve “negatif” olarak 4 gruba ayrýlmýþ, her grupta RT-PCR test sonuçlarý ile uyuma bakýlmýþtýr. Ýstatistik analiz için SPSS 26.0 (IBM Corporation) programý kullanýlmýþtýr.
Bulgular: BT bulgularý %44.4 tipik, %22.3 belirsiz, %11.7 atipik ve %21.6 negatif grupta yer almaktadýr. RT-PCR testi pozitif çýkma oraný sýrasý ile %63.5, %43.2, %42 ve %79.3’dür (p <0.001). Sýnýflama yapýlmadan bakýldýðýnda BT’nin duyarlýlýðý %71.8, özgüllük %10.5, PPD %54.5, NPD %20’dir (p<0.001). Tipik olan grup için duyarlýlýk %47.3, özgüllük %59.6, PPD %63.5, NPD %43’dür(p<0.001). 2 radyolog arasýnda uyumda kappa katsayýsý 0.956’dýr.
Sonuç: RSNA sýnýflamasýnda okuyucular arasýndaki uyum yüksektir. Tipik lezyonlar için %47.1 düzeyindeki duyarlýlýk literatüre göre düþüktür. BT görüntülemenin ilk 3 gün gibi erken bir dönemde yapýlmýþ olmasý ile iliþkili görünmektedir. RSNA sýnýflamasý, görüntüleme uygun zaman aralýðýnda yapýlýrsa, COVÝD-19 hastalýðýný rapor etmede güvenilir olarak düþünülmektedir.

Anahtar Kelimeler: COVID-19, bilgisayarlý tomografi, rapor, RSNA

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Classification of chest CT findings in COVÝD-19 disease according to the reporting recommendation of the Radiological Society of North America; compatibility with RT-PCR test

Seher Susam¹, Berna Eren Kömürcüoðlu², Gülru Polat², Özgür Batum², Sena Ataman², Pelin Gülcü², Filiz Güldaval², Mine Gayaf², Fatma Demirci Üçsular², Emel Cireli Tellioðlu², Günseli Balcý^2
1Department of Radiology, Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Health Sciences University,Ýzmir,Turkey
²Department of Chest Disease, Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Health Sciences University,Ýzmir,Turkey

Objective: The purpose of the study was to classify the thorax CT findings in COVID-19 according to the consensus report criteria that was published by the Radiological Society of North America (RSNA), and compare them with RT-PCR test results.

Method: The study was conducted in retrospective design in a single center between March 2020 and June 2020. A total of 426 patients with a definitive diagnosis, who applied with the suspicion of COVID-19, who had at least one RT-PCR test result, CT with a maximum of 3 days’ intervals, examination results, clinical, radiological and RT-PCR test results, were included in the study. The CT images were divided into 4 groups as “typical”, “indeterminate”, “atypical”, and “negative” according to RSNA criteria by 2 radiologists experienced in thoracic radiology, and compatibility with RT-PCR test results was checked in each group. The SPSS 26.0 (IBM Corporation) program was used for statistical analyses.

Results: CT findings were in the typical group with 44.4%, 22.3% were in the indeterminate group, 11.7% in atypical, and 21.6% were in the negative group. The RT-PCR test positivity rate was 63.5%, 43.2%, 42%, and 79.3%, respectively (p <0.001). Without any classification, the sensitivity of CT was 71.8%, the specificity was 10.5%, the PPV was 54.5%, and the NPV was 20% (p<0.001). The sensitivity was 47.3%, specificity 59.6%, PPV 63.5%, and NPV 43% in the typical group (p<0.001). The kappa coefficient of agreement between the two radiologists was 0.956.

Conclusion: The agreement among readers is high in the RSNA classification. The sensitivity of 47.1% for typical lesions is lower than in the literature. It seems to be related to the fact that CT imaging was performed as early as the first 3 days. RSNA classification is considered reliable in reporting COVID-19 if imaging is performed at the appropriate time interval.

Keywords: COVID-19, computed tomography, report, RSNA

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