ABSTRACT
BackgroundThe stage of CT images was rarely studied and the relationship between the severity of Coronavirus Disease 2019 (COVID-19) and CT images has not been studied based on systematic quantitative analysis currently. PurposeTo investigate the staging duration and classification of CT images of patients with COVID-19 based on quantitative analysis. Materials and MethodsThis is an ambispective observational cohort study based on 125 patients with COVID-19 from Jan 23 to Feb 28, 2020. The stage of CT and pulmonary lesion size were quantitatively analyzed. The categorical regression analysis based on optimal scale (CATREG) was performed to evaluate the association of CT score, age, and gender with the clinical type. ResultsThe CT images of 125 patients with COVID-19 (50.13 {+/-} 16.91 years, 66 women) were analyzed in this study. Except for pre-early stage, the duration of early, progression-consolidation, and dissipation stage of CT images was 3.40 {+/-} 2.31, 10.07 {+/-} 4.91, and 20.60 {+/-} 7.64 days, respectively. The median CT score was 5.00 (2.00-8.50) during the first 30 days, which reached a peak on the 11th day. Significant differences were found between the median CT scores of different clinical types (P<0.05). Besides, the age was correlated with the clinical type (P<0.001), the CT scores of 0.00-11.50, 11.50-16.00, and 16.00-20.00 were separately correlated with the moderate, severe, and critical type with the output accuracy 69.60%. ConclusionThe four-stage staging method based on quantitative analysis is consistent with the change rules of staging features and COVID-19. Quantitative study by scoring pulmonary lesion sizes accurately revealed the evolvement of pulmonary lesions and differences between different clinical types. SummaryQuantitative study of the stage duration and classification of chest CT images can objectively reveal the relationship between Coronavirus Disease 2019 (COVID-19) and chest CT images. Key Results1. A four-stage staging method was proposed. Except for pre-early stage, the duration of early, progression-consolidation, and dissipation stage of CT images was 3.40 {+/-} 2.31, 10.07 {+/-} 4.91, and 20.60 {+/-} 7.64 days, respectively. 2. The severer the disease, the higher the median CT scores and their peak value. 3. The CT scores of 0.00-11.50, 11.50-16.00, and 16.00-20.00 were separately correlated with the moderate, severe, and critical type.
ABSTRACT
Objective To investigate the imaging features of the nigrosomes-1 region in the substantia nigra at 3.0 T with enhanced gradient echo T2 star weighted angiography(ESWAN), and to explore its clinical value in the evaluation of Parkinson disease (PD). Methods Fifty-four patients diagnosed with PD (PD group), and 51 non-PD volunteers (N-PD group) were scanned with 3.0 T ESWAN, who had selected randomly. The widths of the typical high signal correspondence with the nigrosomes-1 region (a), the width at the middle of the substantia nigra (b) and the width of the banded high signal of which the oval structure were not displayed (c) were measured and collected. The result of reclassification performed by 2 physicians were compared with clinical gold standard. Specificity and sensitivity were calculated; Eleven outpatients with clinically suspected PD but undiagnosed (UD group) were continusouly selected. They received the same scanning and were performed with imaging diagnosis according to the conclusions of previous studies, then compared the imaging diagnosis with the final clinical diagnosis. Results In non PD group, hyperintensity of nigrosomes-1 were shown in 49 cases (96.1%) in bilateral or unilateral of the SN, the hyperintensity were shaped as“drop”, wedge or oval and the average size (a/b) was (0.31 ± 0.07)mm approximately; PD group, all 54 cases (100.0%) of the oval rear the“drop”were completely disappeared. The sensitivity of the loss of the hyperintensity of nigrosomes-1 for the diagnosis of PD was about 100.0%(54/54)and the specificity of it was about 96.08%(49/51). In UD group, 7 cases with the“drop”completely missed and 1 case with smaller“c”were clinically proven to PD, 2 cases with the typical hyperintensity and 2 case with larger“c”were proven to Parkinson plus syndrome. Conclusions The nigrosomes-1 typical hyperintensity in PD patients' substantia nigra on the 3.0 T ESWAN are disappeared. There may be an effective method for PD and Parkinson's plus syndrome identification that by analyzing of the presence or absence of the typical hyperintensity and its size in the patients with symptoms of PD.
