Tanaka N, Matsumoto T, Kuramitsu T, Nakaki H, Ito K, Uchisako H, Miura G, Matsunaga N, Yamakawa K
Department of Radiology, School of Medicine, Yamaguchi University, Japan.
J Comput Assist Tomogr. 1996 Jul-Aug;20(4):600-8. doi: 10.1097/00004728-199607000-00019.
Our goal was to clarify the high resolution CT (HRCT) findings of community-acquired pneumonia based on pathologic findings and to make a differential diagnosis between bacterial and atypical pneumonias.
This study evaluated 32 cases with community-acquired pneumonia, including 18 cases with bacterial pneumonia and 14 cases with atypical pneumonia [mycoplasma pneumonia (n = 12), chlamydia pneumonia (n = 1), and influenza viral pneumonia (n = 1)]. HRCT images in these cases were space consolidation, ground-glass attenuation, thickening of the bronchovascular bundle, and distribution of abnormal attenuation.
Bacterial pneumonia frequently showed air space consolidation with segmental distribution (72.2%) that tended to locate at the middle and outer zones of the lung. Atypical pneumonia frequently showed centrilobular shadow (64.3%), acinar shadow (71.4%), air space consolidation and ground-glass attenuation with lobular distribution (57.1 and 85.7%, respectively), and tendency of the lesions to distribute at the inner layer of the lung in addition to the middle and outer layers (85.7%).
Characteristic HRCT findings of both bacterial and atypical pneumonia were demonstrated. These HRCT features seemed to reflect pathologic findings and the manner of lesional progression. This information may support the appropriate antibiotic therapy in medical practice.
我们的目标是根据病理结果阐明社区获得性肺炎的高分辨率CT(HRCT)表现,并对细菌性肺炎和非典型肺炎进行鉴别诊断。
本研究评估了32例社区获得性肺炎患者,其中包括18例细菌性肺炎和14例非典型肺炎[支原体肺炎(n = 12)、衣原体肺炎(n = 1)和流感病毒性肺炎(n = 1)]。这些病例的HRCT图像表现为实变、磨玻璃影、支气管血管束增厚以及异常密度影的分布。
细菌性肺炎常表现为肺段性分布的实变(72.2%),且倾向于位于肺的中外带。非典型肺炎常表现为小叶中心阴影(64.3%)、腺泡阴影(71.4%)、小叶性分布的实变和磨玻璃影(分别为57.1%和85.7%),并且病变除了分布在肺的中外层外,还倾向于分布在肺的内层(85.7%)。
展示了细菌性肺炎和非典型肺炎的特征性HRCT表现。这些HRCT特征似乎反映了病理结果和病变进展方式。这些信息可能有助于在医疗实践中选择合适的抗生素治疗。