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  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 :

  • 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" .

Overall CT scores of survivors were significantly lower than those of nonsurvivors (P = 0.0003). Also, the CT score was independently associated with mortality.