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. 2020 Mar 28;45(3):229-235.
doi: 10.11817/j.issn.1672-7347.2020.200152.

Design, validation, and clinical practice of standardized imaging diagnostic report for COVID-19

[Article in English, Chinese]
Tianming Wang  1 , Zeng Xiong  2 , Hui Zhou  3 , Weijun Luo  3 , Haixiong Tang  3 , Jinkang Liu  3
Affiliations
Free article

Design, validation, and clinical practice of standardized imaging diagnostic report for COVID-19

[Article in English, Chinese]
Tianming Wang et al. Zhong Nan Da Xue Xue Bao Yi Xue Ban. .
Free article

Abstract
in English, Chinese

Objectives: To design a standardized imaging diagnostic reporting mode for screening coronavirus disease 2019 (COVID-19), and to prospectively verify its effectiveness in clinical practice.

Methods: A new classification and standardized imaging diagnosis report mode of viral pneumonia was established by studying and summarizing the imaging findings of various kinds of viral pneumonia, combining with lesion density, interstitial changes, pleural effusion, lymph nodes, and some special signs. After systematic training, the radiologist experienced clinical practice for screening CT features. COVID-19 cases were screened retrospectively in the single-center. The confirmed cases were verified, and the diagnostic efficacy of the standardized imaging reporting system in screening COVID-19 was tested.

Results: There were 912 patients in this stage receiving the screening imaging examination. Of them, 190 patients were screened in the report mode and 30 patients were diagnosed as COVID-19. The CT manifestation of COVID-19 was characterized by pure ground glass lesions or with a few solid components, predominant subpleural distribution, no lymph node enlargement and pleural effusion, and often with paving-way sign and air bronchus sign. In combination with the above signs, the diagnostic efficacy of COVID-19 was 0.942.

Conclusions: The standardized imaging diagnosis report mode based on COVID-19 chest image features is effective and practical, which should be popularized.

目的: 设计筛查2019冠状病毒病(coronavirus disease 2019，COVID-19)的规范化影像学诊断报告模式，并在临床实践中前瞻性验证其有效性。方法: 通过学习并总结多种病毒性肺炎的影像学表现，联合病灶密度、间质改变、胸腔积液、淋巴结等征象，建立新的病毒性肺炎的分级分类规范化影像学诊断报告模式，并对筛查阅片的医师进行系统性培训，通过阶段性的临床实践后，回顾性收集单中心行COVID-19筛查病例，利用确诊病例进行验证，并检测该规范化影像学报告模式在筛查COVID-19的诊断效能。结果: 阶段性筛查行影像学检查的患者912例，确诊COVID-19 30例，使用该报告模式190例。COVID-19的典型CT表现为纯磨玻璃影或伴少许实性成分、胸膜下分布为主、无淋巴结肿大及胸腔积液，常合并间质增厚、“铺路石”征和支气管充气征。联合上述征象对COVID-19进行分类，规范化分类、分级影像学报告诊断效能为0.942。结论: 基于COVID-19胸部影像学特征总结的规范化影像学诊断报告诊断效能较高，实用性强，应推广使用。.

Keywords: computer tomography; coronavirus disease 2019; coronavirus infection; structured report.

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