tetano
Editor, Senior Moderator
Cureus
. 2024 Sep 11;16(9):e69161.
doi: 10.7759/cureus.69161. eCollection 2024 Sep. Evaluating the Accuracy of Chest CT in Detecting COVID-19 Through Tracheobronchial Wall Thickness: Insights From Emergency Department Patients in Mid-2023
Akiyuki Kotoku[SUP] 1 [/SUP], Hiroki Horinouchi[SUP] 1 [/SUP], Tatsuya Nishii[SUP] 1 [/SUP], Midori Fukuyama[SUP] 1 [/SUP], Yasutoshi Ohta[SUP] 1 [/SUP], Tetsuya Fukuda[SUP] 1 [/SUP]
Affiliations
Background The post-pandemic phase of the coronavirus infectious disease that emerged in 2019 (COVID-19) has necessitated updates in radiology, with emerging evidence suggesting tracheobronchial wall thickness as a potential new diagnostic marker. Purpose To evaluate the accuracy of chest computed tomography (CT) scans in identifying COVID-19 by assessing tracheobronchial wall thickness in mid-2023. Material and methods A retrospective review was conducted on 60 patients who underwent thoracoabdominal CT and the severe acute respiratory syndrome coronavirus (SARS-CoV-2) antigen tests during emergency visits between June and August 2023. Tracheobronchial wall thickness was measured using a 4-point scale (1=no thickening, 2=mild, 3=moderate, 4=significant). Lung assessment employed the COVID-19 Reporting and Data System (CO-RADS). Patients were classified based on antigen test results. The Mann-Whitney U test and Fisher's exact test compared characteristics and CT findings. Diagnostic performance was evaluated using the area under the receiver operating characteristic curves (AUC). Results The SARS-CoV-2-positive group showed significantly thicker tracheobronchial walls (median 1.5 mm vs. 1.2 mm, P < 0.001), especially in the trachea's membranous wall (median 1.2 mm vs. 0.9 mm, P < 0.001) and higher scores (median 3 vs. 2, P < 0.001). CO-RADS scores showed no significant difference. Quantitative and qualitative wall thickness assessments demonstrated high diagnostic value, with AUCs of 0.90 and 0.94, and accuracies of 85% and 87%, respectively. Conclusion Tracheobronchial wall thickness on chest CT exhibited high diagnostic accuracy, establishing it as a reliable marker for COVID-19 detection in mid-2023.
Keywords: covid-19; diagnostic imaging; sars-cov-2; tomography; trachea; x-ray computed.
. 2024 Sep 11;16(9):e69161.
doi: 10.7759/cureus.69161. eCollection 2024 Sep. Evaluating the Accuracy of Chest CT in Detecting COVID-19 Through Tracheobronchial Wall Thickness: Insights From Emergency Department Patients in Mid-2023
Akiyuki Kotoku[SUP] 1 [/SUP], Hiroki Horinouchi[SUP] 1 [/SUP], Tatsuya Nishii[SUP] 1 [/SUP], Midori Fukuyama[SUP] 1 [/SUP], Yasutoshi Ohta[SUP] 1 [/SUP], Tetsuya Fukuda[SUP] 1 [/SUP]
Affiliations
- PMID: 39398816
- PMCID: PMC11467821
- DOI: 10.7759/cureus.69161
Background The post-pandemic phase of the coronavirus infectious disease that emerged in 2019 (COVID-19) has necessitated updates in radiology, with emerging evidence suggesting tracheobronchial wall thickness as a potential new diagnostic marker. Purpose To evaluate the accuracy of chest computed tomography (CT) scans in identifying COVID-19 by assessing tracheobronchial wall thickness in mid-2023. Material and methods A retrospective review was conducted on 60 patients who underwent thoracoabdominal CT and the severe acute respiratory syndrome coronavirus (SARS-CoV-2) antigen tests during emergency visits between June and August 2023. Tracheobronchial wall thickness was measured using a 4-point scale (1=no thickening, 2=mild, 3=moderate, 4=significant). Lung assessment employed the COVID-19 Reporting and Data System (CO-RADS). Patients were classified based on antigen test results. The Mann-Whitney U test and Fisher's exact test compared characteristics and CT findings. Diagnostic performance was evaluated using the area under the receiver operating characteristic curves (AUC). Results The SARS-CoV-2-positive group showed significantly thicker tracheobronchial walls (median 1.5 mm vs. 1.2 mm, P < 0.001), especially in the trachea's membranous wall (median 1.2 mm vs. 0.9 mm, P < 0.001) and higher scores (median 3 vs. 2, P < 0.001). CO-RADS scores showed no significant difference. Quantitative and qualitative wall thickness assessments demonstrated high diagnostic value, with AUCs of 0.90 and 0.94, and accuracies of 85% and 87%, respectively. Conclusion Tracheobronchial wall thickness on chest CT exhibited high diagnostic accuracy, establishing it as a reliable marker for COVID-19 detection in mid-2023.
Keywords: covid-19; diagnostic imaging; sars-cov-2; tomography; trachea; x-ray computed.