当前位置： SCI文献检索 > EUROPEAN JOURNAL OF RADIOLOGY期刊下所有文献 > Differentiation of bacterial and non-bacterial community-acquired pneumonia by thin-section computed tomography.

Differentiation of bacterial and non-bacterial community-acquired pneumonia by thin-section computed tomography.

Abstract：

BACKGROUND AND OBJECTIVE:The management of community-acquired pneumonia (CAP) depends, in part, on the identification of the causative agents. The objective of this study was to determine the potential of thin-section computed tomography (CT) in differentiating bacterial and non-bacterial pneumonia. PATIENTS AND METHODS:Thin-section CT studies were prospectively examined in hospitalized CAP patients within 2 days of admission, followed by retrospective assessment by two pulmonary radiologists. Thin-section CT findings on the pneumonias caused by each pathogen were examined, and two types of pneumonias were compared. Using multivariate logistic regression analyses, receiver operating characteristic (ROC) curves were produced. RESULTS:Among 183 CAP episodes (181 patients, 125 men and 56 women, mean age+/-S.D.: 61.1+/-19.7) examined by thin-section CT, the etiologies of 125 were confirmed (94 bacterial pneumonia and 31 non-bacterial pneumonia). Centrilobular nodules were specific for non-bacterial pneumonia and airspace nodules were specific for bacterial pneumonia (specificities of 89% and 94%, respectively) when located in the outer lung areas. When centrilobular nodules were the principal finding, they were specific but lacked sensitivity for non-bacterial pneumonia (specificity 98% and sensitivity 23%). To distinguish the two types of pneumonias, centrilobular nodules, airspace nodules and lobular shadows were found to be important by multivariate analyses. ROC curve analysis discriminated bacterial pneumonia from non-bacterial pneumonia among patients without underlying lung diseases, yielding an optimal point with sensitivity and specificity of 86% and 79%, respectively, but was less effective when all patients were analyzed together (70% and 84%, respectively). CONCLUSION:Thin-section CT examination was applied for the differentiation of bacterial and non-bacterial pneumonias. Though showing some potential, this examination at the present time would not be applicable for patients with underlying lung diseases, severe conditions of pneumonia, or immunocompromised conditions.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Ito I,Ishida T,Togashi K,Niimi A,Koyama H,Ishimori T,Kobayashi H,Mishima M

doi

10.1016/j.ejrad.2008.08.004

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

388-95

issue

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(08)00461-0

journal_volume

pub_type

杂志文章

在线工具

Differentiation of bacterial and non-bacterial community-acquired pneumonia by thin-section computed tomography.