Typical Imaging Patterns in COVID-19 Infections of the Lung on Plain Chest Radiographs to Aid Early Triage.
Rofo
; 193(10): 1189-1196, 2021 Oct.
Article
in English
| MEDLINE | ID: covidwho-1127196
ABSTRACT
PURPOSE:
To evaluate imaging patterns of a COVID-19 infection of the lungs on chest radiographs and their value in discriminating this infection from other viral pneumonias. MATERIALS ANDMETHODS:
All 321 patients who presented with respiratory impairment suspicious for COVID-19 infection between February 3 and May 8, 2020 and who received a chest radiograph were included in this analysis. Imaging findings were classified as typical for COVID-19 (bilateral, peripheral opacifications/consolidations), non-typical (findings consistent with lobar pneumonia), indeterminate (all other distribution patterns of opacifications/consolidations), or none (no opacifications/consolidations). The sensitivity, specificity, as well as positive and negative predictive value for the diagnostic value of the category "typical" were determined. Chi² test was used to compare the pattern distribution between the different types of pneumonia.RESULTS:
Imaging patterns defined as typical for COVID-19 infections were documented in 35/111 (31.5â%) patients with confirmed COVID-19 infection but only in 4/210 (2â%) patients with any other kind of pneumonia, resulting in a sensitivity of 31.5â%, a specificity of 98.1â%, and a positive and negative predictive value of 89.7â% or 73â%, respectively. The sensitivity could be increased to 45.9â% when defining also unilateral, peripheral opacifications/consolidations with no relevant pathology contralaterally as consistent with a COVID-19 infection, while the specificity decreases slightly to 93.3â%. The pattern distribution between COVID-19 patients and those with other types of pneumonia differed significantly (pâ<â0.0001).CONCLUSION:
Although the moderate sensitivity does not allow the meaningful use of chest radiographs as part of primary screening, the specific pattern of findings in a relevant proportion of those affected should be communicated quickly as additional information and trigger appropriate protective measures. KEY POINTS · COVID-19 infections show specific X-ray image patterns in 1/3 of patients.. · Bilateral, peripheral opacities and/or consolidations are typical imaging patterns.. · Unilateral, peripheral opacities and/or consolidations should also raise suspicion of COVID-19 infection.. CITATION FORMAT · Kasper J, Decker J, Wiesenreiter K etâal. Typical Imaging Patterns in COVID-19 Infections of the Lung on Plain Chest Radiographs to Aid Early Triage. Fortschr Röntgenstr 2021; 193 1189â-â1196.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Radiography, Thoracic
/
Tomography, X-Ray Computed
/
COVID-19
/
Lung
Type of study:
Diagnostic study
/
Experimental Studies
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Rofo
Year:
2021
Document Type:
Article
Affiliation country:
A-1388-8147
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