Ankara Med J. 2021; 21(1): 134-149 | DOI: 10.5505/amj.2021.04207

Pediatrik COVID-19 hastalarýnda toraks BT bulgularý ve RT-PCR test sonuçlarý ile korelasyonu

Gülþah Bayram Ilýkan, Þükriye Yýlmaz
Ankara Þehir Hastanesi, Radyoloji Bölümü, Ankara

GÝRÝÞ ve AMAÇ: COVID-19 ön tanýsý olan çocuk hastalarda revers transkriptaz-polimeraz zincir reaksiyon (RT-PCR) testi sonuçlarý ile toraks bilgisayarlý tomografi (BT) bulgularýný karþýlaþtýrmak.
YÖNTEM ve GEREÇLER: Retrospektif olarak, 177 çocuk hastada toraks BT bulgularý ve RT-PCR test sonuçlarý deðerlendirildi. Test sonuçlarýna göre hastalar ‘COVID-19 pozitif’ ve ‘COVID-19 negatif’ olmak üzere iki gruba ayrýldý.
BULGULAR: COVID-19 pozitif grupta hastalarýn %65,71’inin ailesinde COVID-19 tanýsý bulunmaktaydý (p<0.01). Ayný grupta BT bulgularý normal olan hastalarýn %50’si 16 yaþýndan küçüktü (p<0,01) ve en sýk tek lob tutulumu izlenmekteydi (%54,54, p<0.01). Her iki grupta en sýk izlenen BT bulgusu konsolidasyon ile birlikte buzlu cam dansitesi (BCD) idi. Fibrotik bantlar (% 51,46; p<0,01), retiküler patern (% 34,95; p<0,01), atelektazi (% 9,71, p<0.01), mozaik perfüzyon (% 26,21, p<0.01), ve plevral effüzyon (% 19,42, p<0.01) COVID-19 negatif grupta daha sýk izlendi. Altta yatan hastalýðý bulunanlarda BT’nin sensitivitesi 0,441, RT-PCR testin ise 0,863 olarak hesaplandý.
TARTIÞMA ve SONUÇ: Ailesinde COVID-19 hastalýðý olan çocuklarda en sýk BT bulgusu konsolidasyonun eþlik ettiði ya da etmediði fokal BCD’dir. BT bulgularý yaygýn ve þiddetli ise hasta yüksek olasýlýkla COVID-19 deðildir. Altta yatan kronik hastalýðý olan çocuklarda RT-PCR testi, taný koymada BT’den daha duyarlýdýr.

Anahtar Kelimeler: Bilgisayarlý tomografi, COVID-19 pnömonisi, pediatrik, revers transkripsiyon polimeraz zincir reaksiyon testi.

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Chest CT findings and their correlation with RT-PCR testing in pediatric COVID-19 patients

Gülþah Bayram Ilýkan, Þükriye Yýlmaz
Department Of Radiology, Ankara City Hospital, Ankara, Turkey

INTRODUCTION: To compare the reverse transcription-polymerase chain reaction (RT-PCR) test results and chest computerized tomography (CT) findings in pediatric patients with a pre-diagnosis of COVID-19.
METHODS: The thorax CT examinations and RT-PCR test results were retrospectively evaluated in 177 children. According to the test results, the patients were divided into two groups as ‘COVID-19-positive’ and ‘COVID-19-negative’.
RESULTS: In the COVID-19-positive group, 65.71% of the patients with a family history of COVID-19 (p<0.01). In the same group, 50.00% of patients with normal CT findings were older than 16 years (p<0.01), and single-lobe involvement was more common (54.54%, p<0.01). The most observed CT finding was consolidation with ground-glass opacities (GGO) in both groups. Fibrotic bands (51.46%, p<0.01), reticular pattern (34.95%, p<0.01), atelectasis (9.71%, p<0.01), mosaic perfusion (26.21%, p<0.01), and pleural effusion (19.42%, p<0.01) were mostly seen in the COVID-19-negative group. In patients with underlying diseases, the sensitivity values were calculated as 0.441 for CT and 0.863 for the RT-PCR test.
DISCUSSION AND CONCLUSION: In patients with a family history of COVID-19, the chest CT showed focal GGO with or without consolidation as the most common finding. If CT findings diffuse and severe, the patient most likely does not have COVID-19. The RT-PCR test results are more reliable than CT in children with underlying diseases.

Keywords: Computerized tomography, COVID-19 pneumonia, pediatrics, reverse transcription-polymerase chain reaction test.

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