Department of Medical Education, Providence Portland Medical Center, Oregon Health and Science Center, Portland, OR 97213, USA.
Chest. 2010 Feb;137(2):467-79. doi: 10.1378/chest.08-3002.
Timely diagnosis of pleural space infections and rapid initiation of effective pleural drainage for those patients with complicated parapneumonic effusions or empyema represent keystone principles for managing patients with pneumonia. Advances in chest imaging provide opportunities to detect parapneumonic effusions with high sensitivity in patients hospitalized for pneumonia and to guide interventional therapy. Standard radiographs retain their primary role for screening patients with pneumonia for the presence of an effusion to determine the need for thoracentesis. Ultrasonography and CT scanning, however, have greater sensitivity for fluid detection and provide additional information for determining the extent and nature of pleural infection. MRI and PET scan can image pleural disease, but their role in managing parapneumonic effusions is not yet clearly defined. Effective application of chest images for patients at risk for pleural infection, however, requires a comprehensive understanding of the unique features of each modality and relative value. This review presents the diagnostic usefulness and clinical application of chest imaging studies for evaluating and managing pleural space infections in patients hospitalized for pneumonia.
及时诊断胸腔感染，并为患有复杂性类肺炎性胸腔积液或脓胸的患者迅速进行有效的胸腔引流，是管理肺炎患者的关键原则。胸部影像学的进步为因肺炎住院的患者提供了高灵敏度检测类肺炎性胸腔积液的机会，并为介入治疗提供了指导。标准 X 线摄影仍在为肺炎患者筛查胸腔积液的存在并确定是否需要进行胸腔穿刺方面发挥主要作用。然而，超声和 CT 扫描在检测积液方面具有更高的灵敏度，并提供了更多有关胸膜感染程度和性质的信息。MRI 和 PET 扫描可用于胸膜疾病成像，但它们在管理类肺炎性胸腔积液中的作用尚未明确。然而，为有发生胸腔感染风险的患者有效应用胸部影像，需要全面了解每种影像学检查的独特特征及其相对价值。本文综述了胸部影像学检查在评估和管理因肺炎住院患者胸腔感染方面的诊断价值和临床应用。
