This study examined the value of volume rendering （VR） interpretation in assessing the growth of pulmonary nodular ground-glass opacity （nGGO）. A total of 47 nGGOs （average size, 9.5 mm; range, 5.7-20.6 mm） were...This study examined the value of volume rendering （VR） interpretation in assessing the growth of pulmonary nodular ground-glass opacity （nGGO）. A total of 47 nGGOs （average size, 9.5 mm; range, 5.7-20.6 mm） were observed by CT scanning at different time under identical parameter settings. The growth of nGGO was analyzed by three radiologists by comparing the thin slice （TS） CT images of initial and repeat scans with side-by-side cine mode. One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth. The nodule growth was rated on a 5-degree scale： notable growth, slight growth, dubious growth, stagnant growth, shrinkage. Growth standard was defined as： Density increase 〉 30 HU and （or） diameter increase （by 20% in nodules 〉_10 mm, 30% in nodules of 5-9 mm）. Receiver operating characteristic （ROC） was performed. The results showed that 32 nGGOs met the growth criteria （29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density）. Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation （P〈0.01, P〈0.05 and P〈0.05 for observers A, B and C respectively）. Consistency between different observers was excellent with both VR interpretation （κ=0.89 for observers A＆C A＆B, B＆C） and TS interpretation （κ=0.71 for A＆B, κ=0.68 for A＆C, κ=0.74 for B＆C）, but time spending was less with VR interpretation than with TS interpretation （P〈0.0001, P〈0.0001 and P〈0.05 for observers A, B and C, respectively）. It was concluded that VR is a useful technique for evaluating the growth of nGGO.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is a major public health emergency with obvious characteristics of human-to-human transmission,and there are infective asymptomatic carriers.Early identification and proper...BACKGROUND Coronavirus disease 2019(COVID-19)is a major public health emergency with obvious characteristics of human-to-human transmission,and there are infective asymptomatic carriers.Early identification and proper management of patients with COVID-19 are important.Features in chest computed tomography(CT)can facilitate identifying newly infected individuals.However,CT findings of some lung contusions are similar to those of COVID-19,as shown in the present case.CASE SUMMARY A 46-year-old woman was admitted to hospital for backache and foot pain caused by a fall injury 1 d before hospitalization.She was suspected of having COVID-19,since there was a confirmed COVID-19 case near her residence.But she had no fever,cough,chest tightness,difficult breathing,nausea,vomiting,or diarrhea,etc.On physical examination,the lower posterior chest of both sides showed dullness on percussion and moist rales at the end of inspiration on auscultation.The white blood cell count and lymphocyte count were 10.88×109/L and 1.04×109/L,respectively.CT performed on February 7,2020 revealed that both lungs were scattered with patchy ground-glass opacity.The patient was diagnosed with pulmonary contusion with thoracic spinal fracture(T12),calcaneal fracture,and pelvic fracture.On day 9 after conservative treatment,her condition was alleviated.On review of the chest CT,the previous shadows were significantly reduced.CONCLUSION Differential diagnosis of lung contusion and COVID-19 must be emphasized.Both conditions require effective prompt actions,especially COVID-19.展开更多
基金supported by a grant from the Science and Technology Program of Guangdong Province of China(No.2009B030801120)
文摘This study examined the value of volume rendering （VR） interpretation in assessing the growth of pulmonary nodular ground-glass opacity （nGGO）. A total of 47 nGGOs （average size, 9.5 mm; range, 5.7-20.6 mm） were observed by CT scanning at different time under identical parameter settings. The growth of nGGO was analyzed by three radiologists by comparing the thin slice （TS） CT images of initial and repeat scans with side-by-side cine mode. One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth. The nodule growth was rated on a 5-degree scale： notable growth, slight growth, dubious growth, stagnant growth, shrinkage. Growth standard was defined as： Density increase 〉 30 HU and （or） diameter increase （by 20% in nodules 〉_10 mm, 30% in nodules of 5-9 mm）. Receiver operating characteristic （ROC） was performed. The results showed that 32 nGGOs met the growth criteria （29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density）. Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation （P〈0.01, P〈0.05 and P〈0.05 for observers A, B and C respectively）. Consistency between different observers was excellent with both VR interpretation （κ=0.89 for observers A＆C A＆B, B＆C） and TS interpretation （κ=0.71 for A＆B, κ=0.68 for A＆C, κ=0.74 for B＆C）, but time spending was less with VR interpretation than with TS interpretation （P〈0.0001, P〈0.0001 and P〈0.05 for observers A, B and C, respectively）. It was concluded that VR is a useful technique for evaluating the growth of nGGO.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is a major public health emergency with obvious characteristics of human-to-human transmission,and there are infective asymptomatic carriers.Early identification and proper management of patients with COVID-19 are important.Features in chest computed tomography(CT)can facilitate identifying newly infected individuals.However,CT findings of some lung contusions are similar to those of COVID-19,as shown in the present case.CASE SUMMARY A 46-year-old woman was admitted to hospital for backache and foot pain caused by a fall injury 1 d before hospitalization.She was suspected of having COVID-19,since there was a confirmed COVID-19 case near her residence.But she had no fever,cough,chest tightness,difficult breathing,nausea,vomiting,or diarrhea,etc.On physical examination,the lower posterior chest of both sides showed dullness on percussion and moist rales at the end of inspiration on auscultation.The white blood cell count and lymphocyte count were 10.88×109/L and 1.04×109/L,respectively.CT performed on February 7,2020 revealed that both lungs were scattered with patchy ground-glass opacity.The patient was diagnosed with pulmonary contusion with thoracic spinal fracture(T12),calcaneal fracture,and pelvic fracture.On day 9 after conservative treatment,her condition was alleviated.On review of the chest CT,the previous shadows were significantly reduced.CONCLUSION Differential diagnosis of lung contusion and COVID-19 must be emphasized.Both conditions require effective prompt actions,especially COVID-19.
