Pneumonia: high-resolution CT findings in 114 patients.
The objective of the present study was to assess the high-resolution CT appearances of different types of pneumonia. The high-resolution CT scans obtained in 114 patients (58 immunocompetent, 59 immunocompromised) with bacterial, Mycoplasma pneumoniae, viral, fungal, and Pneumocystis carinii pneumonias were analyzed retrospectively by two independent observers for presence, pattern, and distribution of abnormalities. Areas of air-space consolidation were not detected in patients with viral pneumonia and were less frequently seen in patients with Pneumocystis carinii pneumonia (2 of 22 patients, 9%) than in bacterial (30 of 35, 85%), Mycoplasma pneumoniae (22 of 28, 79%), and fungal pneumonias (15 of 20, 75%; p<0.01). There was no significant difference in the prevalence or distribution of consolidation between bacterial, Mycoplasma pneumoniae, and fungal pneumonias. Extensive symmetric bilateral areas of ground-glass attenuation were present in 21 of 22 (95%) patients with Pneumocystis carinii pneumonia and were not seen in other pneumonias except in association with areas of consolidation and nodules. Centrilobular nodules were present less commonly in bacterial pneumonia (6 of 35 patients, 17%) than in Mycoplasma pneumoniae (24 of 28, 96%), viral (7 of 9, 78%), or fungal (12 of 20, 92%) pneumonia ( p<0.01). Except for Pneumocystis carinii pneumonia and Mycoplasma pneumoniae pneumonia, which often have a characteristic appearance, high-resolution CT is of limited value in the differential diagnosis of the various types of infective pneumonia.
Reittner
Pia
P
Department of Radiology, Vancouver Hospital and Health Sciences Center, 855 W. 12th Ave. Vancouver, BC, Canada V5Z 1M9. pia-reittner@kfunigraz.ac.at
Ward
Suzanne
S
Heyneman
Laura
L
Johkoh
Takeshi
T
Müller
Nestor L
NL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000276:immunology; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging; D011336:Probability; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*