ROLE OF CHEST CT IN DIAGNOSTIC DECISION MAKING
Chest CT(Computed Tomography) is performed to detect any abnormalities in the lung or respiratory tract. Generally, COVID-19 symptomatic patients go for rapid or RT PCR tests to confirm COVID-19 infection, but many doctors refer to Chest CT for more accurate results. It is because of the accuracy and helps for a better diagnosis of the condition.
In the CT report, you are given a CORDS number, CT severity score, CT findings, etc. People are not aware of the severity of their respective scores. Everyone needs to know about scores and their severity level.
During a CT scan, you are sent into a tunnel-like machine, while the inside of the machine rotates and takes a series of x-rays from different angles. These pictures are then sent to a computer, where they are combined to create images of slices of the part taken.
A radiologist studies the scan report assesses the percentage of infection in each lung lobe, and gives a total CT severity score.
LOBES OF LUNG
Lobes are five distinct anatomical compartments.
The right lung has three lobes-Superior, Middle, Inferior
Whereas the left lung has two lobes-Superior and inferior.
LOBAR SCORING
According to the lobar scoring system, score calculation is done based on the involvement of each lobe.
If less than 5% of the lobe is involved -1 point
If 5-25% of the lobe is involved -2 points
If 25-50% of the lobe is involved -3 points
If 50-60% of the lobe is involved, -4 points
If more than 70% of the lobe is involved -5 points
In this way, all five lobes are given a total score out of 25. This is the CT severity score.
INTERPRETATION
If the total CT severity score is below 8/25 - it suggests MILD COVID
9/25-15/25- suggests MODERATE COVID
more than 15/25- suggests SEVERE COVID
CORADS CLASSIFICATION
CORAD score is a CT-based system that is used to assess the suspicion of pulmonary involvement in COVID-19. The following table provides information about the CORDS scores given by the doctor in the scan report.
CO-RADS 0 inadequate scans technically insufficient for assigning a score
CO-RADS 1 Very low normal lung is present, no lung involvement in infections
CO-RADS 2 Low Abnormalities consistent with infections other than COVID-19
CO-RADS 3 Intermediate Unclear whether COVID is present or not
CO-RADS 4 High Abnormalities suspicious for COVID
CO-RADS 5 Very high Typical COVID-19 features
CO-RADS 6 Proven RT PCR positive for SARS CoV-2
CT severity score is only given for CO-RADS 5 and 6.
In this way, you can assess the severity of COVID-19 and interpret the values given in your CT scan report. CT Thorax has greater sensitivity (86%-98%) and lowers the false-negative rate.
The 25 point CT severity score correlates well with COVID-19 disease clinical severity. It is high time; everyone should have a minimum basic knowledge about the tests performed and how they are assessed. Awareness about vaccines, precautions, tests performed, medicines, etc., is necessary. Immediate action should be taken when you suspect COVID-19 symptoms. Consult a doctor and get treated.
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