Montgomery J L
Department of Radiology, Scott & White Clinic and Hospital, Temple, TX 76508.
Postgrad Med. 1991 Oct;90(5):58-66, 69-73. doi: 10.1080/00325481.1991.11701071.
The chest radiograph can detect pneumonia, but laboratory evaluation is needed to determine the specific causative organism. However, before these results become available, a presumptive diagnosis can be made with the help of chest radiography. A lobar pattern on radiography is usually produced by pneumococcal and Klebsiella infections. A lobular (bronchopneumonia) pattern may be produced by Staphylococcus, gram-negative organisms, and anaerobes. An interstitial pattern results from viral, Mycoplasma, and Pneumocystis carinii infections. Mixed patterns may also occur. There is great variation in the presentation of each infection. However, pertinent clinical information, epidemiologic factors, and associated radiographic findings (eg, adenopathy, pleural effusion, cavitation) are helpful in further limiting diagnostic possibilities.
胸部X光片可检测出肺炎，但需要实验室评估来确定具体的致病微生物。然而，在这些结果出来之前，借助胸部X光片可以做出初步诊断。X光片上的大叶性表现通常由肺炎球菌和克雷伯菌感染引起。小叶性（支气管肺炎）表现可能由葡萄球菌、革兰氏阴性菌和厌氧菌引起。间质性表现由病毒、支原体和卡氏肺孢子虫感染导致。也可能出现混合性表现。每种感染的表现差异很大。然而，相关的临床信息、流行病学因素以及相关的X光表现（如淋巴结肿大、胸腔积液、空洞形成）有助于进一步缩小诊断范围。
