Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Korean Clinical Imaging Guidelines for Justification of Diagnostic Imaging Study for COVID-19

한국형 COVID-19 흉부영상 진단 시행 가이드라인

  • Kwang Nam Jin (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Kyung-Hyun Do (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Bo Da Nam (Department of Radiology, Soonchunhyang University Hospital) ;
  • Sung Ho Hwang (Department of Radiology, Korea University Anam Hospital) ;
  • Miyoung Choi (Division for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency) ;
  • Hwan Seok Yong (Department of Radiology, Korea University Guro Hospital)
  • 진광남 (서울특별시보라매병원 영상의학과) ;
  • 도경현 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 남보다 (순천향대학교 서울병원 영상의학과) ;
  • 황성호 (고려대학교 안암병원 영상의학과) ;
  • 최미영 (한국보건의료연구원 보건의료근거연구본부) ;
  • 용환석 (고려대학교 구로병원 영상의학과)
  • Received : 2021.06.22
  • Accepted : 2021.09.17
  • Published : 2022.03.01
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Abstract

To develop Korean coronavirus disease (COVID-19) chest imaging justification guidelines, eight key questions were selected and the following recommendations were made with the evidence-based clinical imaging guideline adaptation methodology. It is appropriate not to use chest imaging tests (chest radiograph or CT) for the diagnosis of COVID-19 in asymptomatic patients. If reverse transcription-polymerase chain reaction testing is not available or if results are delayed or are initially negative in the presence of symptoms suggestive of COVID-19, chest imaging tests may be considered. In addition to clinical evaluations and laboratory tests, chest imaging may be contemplated to determine hospital admission for asymptomatic or mildly symptomatic un-hospitalized patients with confirmed COVID-19. In hospitalized patients with confirmed COVID-19, chest imaging may be advised to determine or modify treatment alternatives. CT angiography may be considered if hemoptysis or pulmonary embolism is clinically suspected in a patient with confirmed COVID-19. For COVID-19 patients with improved symptoms, chest imaging is not recommended to make decisions regarding hospital discharge. For patients with functional impairment after recovery from COVID-19, chest imaging may be considered to distinguish a potentially treatable disease.

흉부영상의 적절한 활용을 위해 한국형 코로나바이러스 감염증(이하 COVID-19) 흉부영상진단 시행 가이드라인을 개발하였다. 8가지 문장형 핵심 질문을 선정하고, 근거기반 임상영상 가이드라인 수용개작 방법론에 의거하여 권고안을 작성하였다. 권고 내용은 다음과 같다. COVID-19 확진자와 접촉한 증상이 없는 사람에 대하여 COVID-19의 진단을 위하여 흉부영상검사(흉부X선검사 또는 CT)를 사용하지 않는 것이 적절하다. COVID-19가 의심되는 증상이 있으나 reverse transcription polymerase chain reaction 검사를 이용할 수 없는 경우 흉부영상검사 사용을 고려할 수 있다. COVID-19가 확인된 환자에게 병원 입원을 결정하기 위하여 임상 평가 및 검사실 검사와 함께 흉부영상검사를 고려할 수 있다. COVID-19 입원환자의 증상 경중 및 위험요인의 유무에 따라 흉부영상검사를 고려할 수 있으며, 치료 방법을 결정하거나 수정하는데 이용할 수 있다. COVID-19 환자에서 객혈 또는 폐색전증이 의심되는 경우 CT 혈관조영술을 시행할 수 있다. 증상이 호전된 COVID-19 환자의 퇴원 결정을 하는데 흉부영상검사를 사용하지 않는 것이 적절하다. COVID-19에서 회복된 환자를 추적검사할 때 폐 기능 장애가 있는 환자에서 치료 가능한 폐질환과 구별하기 위해 흉부영상검사를 고려할 수 있다.

Keywords

Acknowledgement

This work was supported by the Korean Society of Radiology (KSR) grant funded by the Korean Government.

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