Correlation between Chest Computed Tomography and Lung Ultrasonography in
Patients with Coronavirus Disease 2019 (COVID-19)
#MMPMID32771222
Tung-Chen Y
; Martí de Gracia M
; Díez-Tascón A
; Alonso-González R
; Agudo-Fernández S
; Parra-Gordo ML
; Ossaba-Vélez S
; Rodríguez-Fuertes P
; Llamas-Fuentes R
Ultrasound Med Biol
2020[Nov]; 46
(11
): 2918-2926
PMID32771222
show ga
There is growing evidence regarding chest X-ray and computed tomography (CT)
findings for coronavirus disease 2019 (COVID-19). At present, the role of lung
ultrasonography (LUS) has yet to be explored. The main purpose of this study was
to evaluate the correlation between LUS findings and chest CT in patients
confirmed to have (positive reverse transcription polymerase chain reaction
[RT-PCR]) or clinically highly suspected of having (dyspnea, fever, myasthenia,
gastrointestinal symptoms, dry cough, ageusia or anosmia) COVID-19. This
prospective study was carried out in the emergency department, where patients
confirmed of having or clinically highly suspected of having COVID-19 were
recruited and underwent chest CT and concurrent LUS exam. An experienced
emergency department physician performed the LUS exam blind to the clinical
history and results of the CT scan, which were reviewed by two radiologists in
consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in
peripheral distribution). A compatible LUS exam was considered a bilateral
pattern of B-lines, irregular pleural line and subpleural consolidations. Between
March and April 2020, 51 patients were consecutively enrolled. The indication for
CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of
pulmonary embolism (41.2%). Radiologic signs compatible with COVID-19 were
present in 37 patients (72.5%) on CT scan and 40 patients (78.4%) on LUS exam.
The presence of LUS findings was correlated with a positive CT scan suggestive of
COVID-19 (odds ratio: 13.3, 95% confidence interval: 4.5-39.6, p < 0.001) with a
sensitivity of 100.0%, specificity of 78.6%, positive predictive value of 92.5%
and negative predictive value of 100.0%. There was no missed diagnosis of
COVID-19 with LUS compared with CT in our cohort. The correlation between LUS
score and CT total severity score was good (intraclass correlation coefficient:
0.803, 95% confidence interval: 0.60-0.90, p < 0.001). LUS exhibited similar
accuracy compared with chest CT in the detection of lung abnormalities in
COVID-19 patients.
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