Ichikado CT scoring of acute respiratory distress syndrome
CT scoring systems have been proposed in patients with acute respiratory distress syndrome (ARDS) to predict clinical outcomes. This scoring system was established by Ichikado et al. in 2006 2 and at the time of writing (July 2016), this is the most widely used CT scoring system.
CT findings in patients with ARDS were graded on a scale of 1–6 2,3:
- normal attenuation (one point)
- ground-glass attenuation (two points)
- airspace consolidation (three points)
- ground-glass attenuation associated with traction bronchiolectasis or bronchiectasis (four points)
- airspace consolidation associated with traction bronchiolectasis or bronchiectasis (five points)
- honeycombing (six points)
To calculate the overall "CT score", each lung zone (upper, middle, lower) are interrogated, and the extent of each CT finding (see above) is estimated to the nearest 10%. Then that percentage of CT finding (should be 100% in each zone) is multiplied by the CT findings point scale and this results summed for each zone. There should be one of the scores for each zone, which are then summed to calculate a final "CT score" 3.
Overall CT scores of survivors were significantly lower than those of nonsurvivors (P = 0.0003). Also, the CT score was independently associated with mortality.
- 1. Ichikado K, Suga M, Müller NL, et al. Acute interstitial pneumonia: comparison of high-resolution computed tomography findings between survivors and nonsurvivors. Am J Respir Crit Care Med 2002;165(11):1551–1556.
- 2. Ichikado K, Suga M, Muranaka H et-al. Prediction of prognosis for acute respiratory distress syndrome with thin-section CT: validation in 44 cases. Radiology. 2006;238 (1): 321-9. doi:10.1148/radiol.2373041515 - Pubmed citation
- 3. Ichikado K, Muranaka H, Gushima Y et-al. Fibroproliferative changes on high-resolution CT in the acute respiratory distress syndrome predict mortality and ventilator dependency: a prospective observational cohort study. BMJ Open. 2012;2 (2): e000545. doi:10.1136/bmjopen-2011-000545 - Free text at pubmed - Pubmed citation