Boiselle P M, Tocino I, Hooley R J, Pumerantz A S, Selwyn P A, Neklesa V P, Lange R C
Department of Diagnostic Imaging, Yale University School of Medicine, New Haven, Connecticut, USA.
J Thorac Imaging. 1997 Jan;12(1):47-53. doi: 10.1097/00005382-199701000-00007.
The purpose of this study was to assess the accuracy of chest x-ray (CXR) interpretation in the diagnosis of pneumocystis carinii pneumonia (PCP), bacterial pneumonia (BP), and pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV)-positive patients and to identify the frequency with which these infections mimic one another radiographically. The admitting CXRs of 153 HIV-positive patients with laboratory proven BP (n = 71), PCP (n = 73), and TB (n = 9) and those of 10 HIV-positive patients with no active disease were reviewed retrospectively and independently by three radiologists who were blinded to clinical and laboratory data. Median percent accuracies were as follows: TB, 84%; PCP, 75%; BP, 64%; and no active disease, 100%. Fifteen of 153 cases (9.8%) were shown to mimic other infections radiographically. A confident and accurate diagnosis can be made radiographically in the majority of cases of PCP, BP, and TB in HIV-positive patients at the time of hospitalization. In approximately 10% of cases, these infections may mimic one another radiographically.
本研究的目的是评估胸部X线（CXR）解读在诊断人类免疫缺陷病毒（HIV）阳性患者的卡氏肺孢子虫肺炎（PCP）、细菌性肺炎（BP）和肺结核（TB）中的准确性，并确定这些感染在影像学上相互模仿的频率。对153例经实验室证实患有BP（n = 71）、PCP（n = 73）和TB（n = 9）的HIV阳性患者以及10例无活动性疾病的HIV阳性患者的入院CXR进行回顾性审查，由三位对临床和实验室数据不知情的放射科医生独立进行。中位准确率如下：TB为84%；PCP为75%；BP为64%；无活动性疾病为100%。153例病例中有15例（9.8%）在影像学上表现为模仿其他感染。在HIV阳性患者住院时，大多数PCP、BP和TB病例在影像学上可以做出可靠且准确的诊断。在大约10%的病例中，这些感染在影像学上可能相互模仿。
