Haroon Attiya, Higa Futoshi, Fujita Jiro, Watanabe Akira, Aoki Nobuki, Niki Yoshihito, Kadota Jun-ichi, Yanagihara Katsunori, Kaku Mitsuo, Hori Seiji, Cash Haley L, Kohno Shigeru
Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Japan.
Intern Med. 2012;51(24):3343-9. doi: 10.2169/internalmedicine.51.7326. Epub 2012 Dec 15.
The main objective of our study was to describe the pulmonary distribution of consolidation and ground-glass opacity (GGO) in chest computed tomography (CT) scans of Streptococcus pneumoniae pneumonia. In addition, the percentage of other pulmonary abnormalities was also reported.
We retrospectively evaluated chest CT examinations performed between November 2008 and January 2010 in 39 patients with S. pneumoniae pneumonia. Eight patients with Haemophilus influenzae pneumonia were also included for comparison.
There were 19 women and 28 men with clinical symptoms of fever and productive cough and laboratory findings of leukocytosis with markedly high C-reactive protein levels. Chest X-ray scores before and after treatment were calculated. The average score before treatment was 4. The average score after treatment was 0. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusions. The distribution of parenchymal disease was also analyzed.
The chest CT findings in the patients with S. pneumoniae pneumonia consisted primarily of consolidation (56.4%), ground-glass opacity (71.7%), interlobular reticular opacity (69.2%), centrilobular nodules (53.8%), interlobular septal thickening (46.6%), bronchial wall thickening (46.6%), lymph node enlargement (10.2%) and pleural effusion (10.2%). Segmental distribution (65.7%) was seen more frequently than non-segmental distribution (35.9%). Abnormal findings were noticed bilaterally in 14 patients and unilaterally in 25 patients. On both the right and left sides, predominant zonal distributions were seen in the lower lobes. In contrast, among the eight patients with H. influenzae pneumonia, one patient had both segmental and non-segmental distributions and the remaining seven patients had only segmental distributions.
In conclusion, segmental distributions of parenchymal abnormalities are more common than non-segmental distributions on chest CT scans of patients with S. pneumoniae pneumonia.
我们研究的主要目的是描述肺炎链球菌肺炎胸部计算机断层扫描（CT）中实变和磨玻璃影（GGO）的肺部分布情况。此外，还报告了其他肺部异常的百分比。
我们回顾性评估了2008年11月至2010年1月期间39例肺炎链球菌肺炎患者的胸部CT检查。还纳入了8例流感嗜血杆菌肺炎患者进行比较。
有19名女性和28名男性，有发热和咳痰的临床症状，实验室检查发现白细胞增多且C反应蛋白水平明显升高。计算治疗前后的胸部X线评分。治疗前平均评分为4分。治疗后平均评分为0分。评估实质异常情况以及肿大淋巴结和胸腔积液的存在情况。还分析了实质疾病的分布情况。
肺炎链球菌肺炎患者的胸部CT表现主要包括实变（56.4%）、磨玻璃影（71.7%）、小叶间隔网状影（69.2%）、小叶中心结节（53.8%）、小叶间隔增厚（46.6%）、支气管壁增厚（46.6%）、淋巴结肿大（10.2%）和胸腔积液（10.2%）。节段性分布（65.7%）比非节段性分布（35.9%）更常见。14例患者双侧出现异常表现，25例患者单侧出现异常表现。在左右两侧，下叶均为主要的区域分布。相比之下，8例流感嗜血杆菌肺炎患者中，1例既有节段性分布也有非节段性分布，其余7例仅有节段性分布。
总之，在肺炎链球菌肺炎患者的胸部CT扫描中实质异常的节段性分布比非节段性分布更常见。
