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季节性流感病毒肺炎与肺炎链球菌肺炎的薄层CT表现对比研究

A comparative study of thin-section CT findings between seasonal influenza virus pneumonia and Streptococcus pneumoniae pneumonia.

作者信息

Ono A, Okada F, Takata S, Hiramatsu K, Ando Y, Nakayama T, Maeda T, Mori H

机构信息

Department of Radiology, Oita University Faculty of Medicine, Oita, Japan.

出版信息

Br J Radiol. 2014 Jul;87(1039):20140051. doi: 10.1259/bjr.20140051. Epub 2014 May 16.

Abstract

OBJECTIVE

To compare the pulmonary thin-section CT findings in patients with seasonal influenza virus pneumonia with Streptococcus pneumoniae pneumonia.

METHODS

The study group included 30 patients (20 males and 10 females; age range, 20-91 years; mean age, 55.9 years) with seasonal influenza virus pneumonia and 71 patients (47 males and 24 females; age range, 27-92 years; mean age, 67.5 years) with S. pneumoniae pneumonia.

RESULTS

The proportion of community-acquired infection was significantly higher in patients with influenza virus pneumonia than with S. pneumoniae pneumonia (p = 0.001). CT findings of ground-glass attenuation (GGA) (p = 0.012) and crazy-paving appearance (p = 0.03) were significantly more frequent in patients with influenza virus pneumonia than with S. pneumoniae pneumonia. Conversely, consolidation (p < 0.001), mucoid impaction (p < 0.001), centrilobular nodules (p = 0.04) and pleural effusion (p = 0.003) were significantly more frequent in patients with S. pneumoniae pneumonia than in those with influenza virus pneumonia.

CONCLUSION

Pulmonary thin-section CT findings, such as consolidation and mucoid impaction may be useful in distinguishing between seasonal influenza virus pneumonia and S. pneumoniae pneumonia.

ADVANCES IN KNOWLEDGE

(1) Distinguishing seasonal influenza virus pneumonia with S. pneumoniae pneumonia is important. (2) The CT findings of GGA and crazy-paving appearance were more frequently found in patients with influenza virus pneumonia than in patients with S. pneumoniae pneumonia, whereas consolidation, mucoid impaction, centrilobular nodules and pleural effusion were more frequently found in patients with S. pneumoniae pneumonia.

摘要

目的

比较季节性流感病毒肺炎患者与肺炎链球菌肺炎患者的肺部薄层CT表现。

方法

研究组包括30例季节性流感病毒肺炎患者(男20例,女10例;年龄范围20 - 91岁;平均年龄55.9岁)和71例肺炎链球菌肺炎患者(男47例,女24例;年龄范围27 - 92岁;平均年龄67.5岁)。

结果

流感病毒肺炎患者社区获得性感染的比例显著高于肺炎链球菌肺炎患者(p = 0.001)。流感病毒肺炎患者磨玻璃影(GGA)(p = 0.012)和铺路石样表现(p = 0.03)的CT表现显著多于肺炎链球菌肺炎患者。相反,肺炎链球菌肺炎患者实变(p < 0.001)、黏液嵌塞(p < 0.001)、小叶中心结节(p = 0.04)和胸腔积液(p = 0.003)的发生率显著高于流感病毒肺炎患者。

结论

肺部薄层CT表现,如实变和黏液嵌塞,可能有助于鉴别季节性流感病毒肺炎和肺炎链球菌肺炎。

知识进展

(1)区分季节性流感病毒肺炎和肺炎链球菌肺炎很重要。(2)流感病毒肺炎患者比肺炎链球菌肺炎患者更常出现GGA和铺路石样的CT表现,而肺炎链球菌肺炎患者更常出现实变、黏液嵌塞、小叶中心结节和胸腔积液。

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