Solyanik O, Gaass T, Hellbach K, Dinkel J
Institut für klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistraße 15, 81377, München, Deutschland.
Comprehensive Pneumology Center Munich (CPC‑M), Max-Lebsche-Platz 31, 81377, München, Deutschland.
Radiologe. 2017 Jan;57(1):22-28. doi: 10.1007/s00117-016-0197-4.
CLINICAL/METHODICAL ISSUE: Pulmonary infections are a common complication in immunosuppressed patients with a frequently fatal prognosis despite modern prophylactic therapy. An early and correct diagnosis is important for initiation of the appropriate therapy.
Chest radiography is the preferred initial imaging examination but is not accurate enough for the detection of pulmonary infections in immunosuppressed patients.
Pneumonia is caused by a broad spectrum of pathogens in immunocompromised patients. In addition to imaging, the clinical history and epidemiology also play an important role in the diagnostics.
Using epidemiological and anamnestic information, computed tomography (CT) shows a significantly better sensitivity and specificity particularly for the diagnosis of atypical forms of pneumonia. Due to the exact imaging of the different infiltration patterns CT provides an increased sensitivity with respect to the etiological classification of pulmonary infections.
This article reviews in particular the radiological findings of commonly occurring pulmonary infections in immunosuppressed patients.
临床/方法学问题：肺部感染是免疫抑制患者常见的并发症，尽管有现代预防性治疗，但其预后往往是致命的。早期正确诊断对于启动适当治疗很重要。
胸部X线摄影是首选的初始影像学检查，但对于检测免疫抑制患者的肺部感染不够准确。
免疫功能低下患者的肺炎由多种病原体引起。除影像学外，临床病史和流行病学在诊断中也起着重要作用。
利用流行病学和既往史信息，计算机断层扫描（CT）显示出显著更高的敏感性和特异性，特别是对于非典型肺炎的诊断。由于CT能准确显示不同的浸润模式，因此在肺部感染的病因分类方面具有更高的敏感性。
本文特别回顾了免疫抑制患者常见肺部感染的放射学表现。
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