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免疫功能正常的成年患者肺部感染的影像学检查

Imaging in pulmonary infections of immunocompetent adult patients.

作者信息

Pochepnia Svitlana, Grabczak Elzbieta Magdalena, Johnson Emma, Eyuboglu Fusun Oner, Akkerman Onno, Prosch Helmut

机构信息

Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.

Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.

出版信息

Breathe (Sheff). 2024 Mar;20(1):230186. doi: 10.1183/20734735.0186-2023. Epub 2024 Apr 9.


DOI:10.1183/20734735.0186-2023
PMID:38595938
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11003523/
Abstract

Pneumonia is a clinical syndrome characterised by fever, cough and alveolar infiltration of purulent fluid, caused by infection with a microbial pathogen. It can be caused by infections with bacteria, viruses or fungi, but a causative organism is identified in less than half of cases. The most common type of pneumonia is community-acquired pneumonia, which is caused by infections acquired outside the hospital. Current guidelines for pneumonia diagnosis require imaging to confirm the clinical suspicion of pneumonia. Thus, imaging plays an important role in both the diagnosis and management of pneumonia, with each modality having specific advantages and limitations. Chest radiographs are commonly used but have limitations in terms of sensitivity and specificity. Lung ultrasound shows high sensitivity and specificity. Computed tomography scans offer higher diagnostic accuracy but involve higher radiation doses. Radiological patterns, including lobar, lobular and interstitial pneumonia, provide valuable insights into causative pathogens and treatment decisions. Understanding these radiological patterns is crucial for accurate diagnosis. In this review, we will summarise the most important aspects pertaining to the role of imaging in pneumonia and will highlight the imaging characteristics of the most common causative organisms.

摘要

肺炎是一种临床综合征,其特征为发热、咳嗽以及肺泡内有脓性液体浸润,由微生物病原体感染引起。它可由细菌、病毒或真菌感染所致,但不到半数的病例能确定致病微生物。最常见的肺炎类型是社区获得性肺炎,由在医院外获得的感染引起。当前肺炎诊断指南要求进行影像学检查以证实临床对肺炎的怀疑。因此,影像学在肺炎的诊断和管理中都起着重要作用,每种检查方式都有其特定的优缺点。胸部X线片常用,但在敏感性和特异性方面存在局限性。肺部超声显示出高敏感性和特异性。计算机断层扫描提供更高的诊断准确性,但辐射剂量更高。包括大叶性、小叶性和间质性肺炎在内的放射学表现,为致病病原体和治疗决策提供了有价值的见解。了解这些放射学表现对于准确诊断至关重要。在本综述中,我们将总结影像学在肺炎中的作用的最重要方面,并突出最常见致病微生物的影像学特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/f42040bdfb51/EDU-0186-2023.05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/0326e130808d/EDU-0186-2023.01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/81955ca74f39/EDU-0186-2023.02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/2ed98612a4b4/EDU-0186-2023.03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/44f9ee7bb8c8/EDU-0186-2023.04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/f42040bdfb51/EDU-0186-2023.05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/0326e130808d/EDU-0186-2023.01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/81955ca74f39/EDU-0186-2023.02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/2ed98612a4b4/EDU-0186-2023.03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/44f9ee7bb8c8/EDU-0186-2023.04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/11003523/f42040bdfb51/EDU-0186-2023.05.jpg

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[2]
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[3]
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本文引用的文献

[1]
Protocol of a multicenter, single-blind, randomized, parallel controlled trial evaluating the effect of microbiological rapid on-site evaluation (M-ROSE) guiding anti-infection treatment in patients with severe hospital-acquired pneumonia.

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[2]
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