初回RT-PCR検査陰性の患者におけるCOVID-19の胸部CT。初回RT-PCR検査陽性患者との比較

Chest CT of COVID-19 in patients with a negative first RT-PCR test: Comparison with patients with a positive first RT-PCR test.

• Zu-Hua Chen
• Yun-Jiang Li
• Xiu-Juan Wang
• Yun-Feng Ye
• Bao-Liang Wu
• Yan Zhang
• Wei-Ling Xuan
• Jian-Feng Bao
• Xue-Ying Deng

抄録

逆転写ポリメラーゼ連鎖反応（RT-PCR）検査が初回陰性の患者と、RT-PCR検査が初回陽性の患者との間で、臨床的特徴と画像的特徴を比較することを目的とした。RT-PCR 陰性群の CT 追跡解析についても記述する。RT-PCR で SARS-CoV-2 感染が確認された患者 33 例、CT で 216 個の病変が確認された患者を対象とした。全群の平均年齢は46.9"Zs_200A"±"Zs_200A"11.1歳で、男性18名、女性15名であった。RT-PCR検査陽性群の患者は、RT-PCR検査陰性群の患者に比べて発熱の可能性が高かった(85.7%対50%、P"Zs_200A"<"Zs_200A".05)。また、陽性群の病変は、陰性群の病変よりも末梢部に位置する可能性が高かった（83.6％対68.2％、P"Zs_200A"<"Zs_200A".05）。216個の病変の出現については、陰性群では圧密を伴う硝子体混濁（43.2％）が最も多く、次いで純粋な硝子体混濁（31.8％）、陽性群では純粋な硝子体混濁（32％）と中隔肥厚を伴う硝子体混濁（32.8％）が最も多く、両者の間に差が明らかになった（P"Zs_200A"<"Zs_200A".05）。追跡解析では、病変の最大短軸は、より小さなマージンではあるが、追跡時に小さくなっていた（中央値サイズ13.6"Zs_200A"mm vs 14"Zs_200A"mm）。初回RT-PCR検査陰性の患者と初回RT-PCR検査陽性の患者におけるCOVID-19の発現はある程度異なっている。フォローアップ後に圧迫成分が増加する可能性がある。

To compare clinical and imaging features between patients with an initial negative reverse-transcription-polymerase chain-reaction (RT-PCR) test and patients with an initial positive RT-PCR test. CT follow-up analysis in the negative RT-PCR group is also described.Thirty-three patients with SARS-CoV-2 infection confirmed by RT-PCR, with 216 lesions upon CT, were included. Demographic information and chest CT imaging features were collected.The average age in the whole study group was 46.9 ± 11.1 years, with 18 males and 15 females. Patients in the positive RT-PCR test group were more likely to have a fever than patients in the negative RT-PCR test group (85.7% vs 50%, P < .05). Lesions in the positive group were more likely to be located in the peripheral area than lesions in the negative group (83.6% vs 68.2%, P < .05). Regarding the appearance of 216 lesions, ground-glass opacities (GGOs) with consolidation (43.2%) was the most common appearance in the negative group, followed by pure GGOs (31.8%), while in the positive group, pure GGOs (32%) and GGOs with interlobular septal thickening (32.8%) were both most frequent, and the difference between them was evident (P < .05). For the follow-up analysis, the largest short-axis of a lesion was smaller upon follow-up (median size 13.6 mm vs 14 mm), albeit by a smaller margin. Pure GGOs decreased in frequency, from 31.3% to 21.3%, while consolidation increased in frequency, from 7.5% to 12.5%.The manifestations of COVID-19 in patients with a first negative RT-PCR test and patients with a positive first RT-PCR test are different to some extent. The consolidation component may increase after follow-up.