Pneumonia CT: Difference between revisions

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==Overview==
==Overview==
A chest CT scan is not routinely done in patients with pneumonia, but is a diagnostic test that may be useful when a chest X-ray is not conclusive. CT findings may include lobar consolidation, ground-glass oppacities, pleural effusion, lymphadenopathy, and tree-in-bud appereance.
A chest [[Computed tomography|CT scan]] is not routinely done in patients with pneumonia, but is a [[diagnostic test]] that may be useful when a [[Chest X-ray|chest x-ray]] is not conclusive. [[Computed tomography|CT]] findings may include lobar [[Consolidation (medicine)|consolidation]], ground-glass opacities, [[pleural effusion]], [[lymphadenopathy]], and tree-in-bud appereance.


==CT==
==CT==
*A chest CT could be useful when a chest X-ray has inconclusive signs of pneumonia but the clinical manifestation suggest pneumonia.
*A chest [[Computed tomography|CT]] could be useful when a [[Chest X-ray|chest x-ray]] has inconclusive signs of pneumonia but the clinical manifestation suggest pneumonia.
*CT findings in pneumonia include:<ref name="Ichikado2014">{{cite journal|last1=Ichikado|first1=Kazuya|title=High-Resolution Computed Tomography Findings of Acute Respiratory Distress Syndrome, Acute Interstitial Pneumonia, and Acute Exacerbation of Idiopathic Pulmonary Fibrosis|journal=Seminars in Ultrasound, CT and MRI|volume=35|issue=1|year=2014|pages=39–46|issn=08872171|doi=10.1053/j.sult.2013.10.007}}</ref>
*[[Computed tomography|CT]] findings in pneumonia include:<ref name="Ichikado2014">{{cite journal|last1=Ichikado|first1=Kazuya|title=High-Resolution Computed Tomography Findings of Acute Respiratory Distress Syndrome, Acute Interstitial Pneumonia, and Acute Exacerbation of Idiopathic Pulmonary Fibrosis|journal=Seminars in Ultrasound, CT and MRI|volume=35|issue=1|year=2014|pages=39–46|issn=08872171|doi=10.1053/j.sult.2013.10.007}}</ref>
**Airspace [[Consolidation (medicine)|consolidation]]
**Ground-glass opacities
**[[Pleural effusion]]
**Hilar and/or mediastinal [[lymphadenopathy]]
**[[Bronchiectasis]]
**Tree-in-bud appereance


:*Airspace consolidation
*A chest [[Computed tomography|CT]] can also help to assess reasons for therapy failure and complications, such as [[lung]] [[abscess]], and [[Pleural effusion|pleural effusions]].
:*Ground-glass oppacities
:*[[Pleural effusion]]
:*Hiliar and/or mediastinal [[lymphadenopathy]]
:*[[Bronchiectasis]]
:*Tree-in-bud appereance
 
*A chest CT can also help to assess reasons for therapy failure and complications, such as lung abscess and pleural effusions.
{|
{|
|[[Image:Pneumonia CT.jpg|thumb|350px|Right lower lobe pneumonia.<br>{{radiopaedia|name=RMH Key Conditions|link=http://radiopaedia.org/cases/right-lower-lobe-pneumonia-2}}]]
|[[Image:Pneumonia CT.jpg|thumb|350px|Right lower lobe pneumonia.<br>{{radiopaedia|name=RMH Key Conditions|link=http://radiopaedia.org/cases/right-lower-lobe-pneumonia-2}}]]
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====Comparison Between CT Findings in Viral and Bacterial Pneumonia====
====Comparison Between CT Findings in Viral and Bacterial Pneumonia====
{| style="border: 0px; font-size: 85%; margin: 3px; width:400px;" align=center
{| style="border: 0px; font-size: 85%; margin: 3px; width:400px;" align="center"
|valign=top|
| valign="top" |
|+
|+
! style="background: #4479BA; color:#FFF;  width: 200px;" | CT Finding  
! style="background: #4479BA; color:#FFF;  width: 200px;" | CT Finding  
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| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 33%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 33%
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Focal Consolidation  
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Focal [[Consolidation (medicine)|Consolidation]]
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 9%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 9%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 6%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 6%
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Pleural Effusion
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Pleural effusion|Pleural Effusion]]
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 41%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 41%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 22%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 22%
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| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 31%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" | 31%
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Multifocal Consolidation
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Multifocal [[Consolidation (medicine)|Consolidation]]
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" |  36%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" |  36%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" |  27%
| style="padding: 5px 5px; background: #F5F5F5;text-align:center" |  27%
|-
|-
| style="padding: 0px 5px; background: #F5F5F5;" colspan=3 |<small>Adapted from American Journal of Roentgenology. 2011;197: 1088-1095<ref name="MillerMickus2011">{{cite journal|last1=Miller|first1=Wallace T.|last2=Mickus|first2=Timothy J.|last3=Barbosa|first3=Eduardo|last4=Mullin|first4=Christopher|last5=Van Deerlin|first5=Vivanna M.|last6=Shiley|first6=Kevin T.|title=CT of Viral Lower Respiratory Tract Infections in Adults: Comparison Among Viral Organisms and Between Viral and Bacterial Infections|journal=American Journal of Roentgenology|volume=197|issue=5|year=2011|pages=1088–1095|issn=0361-803X|doi=10.2214/AJR.11.6501}}</ref></small>
| colspan="3" style="padding: 0px 5px; background: #F5F5F5;" |<small>Adapted from American Journal of Roentgenology. 2011;197: 1088-1095<ref name="MillerMickus2011">{{cite journal|last1=Miller|first1=Wallace T.|last2=Mickus|first2=Timothy J.|last3=Barbosa|first3=Eduardo|last4=Mullin|first4=Christopher|last5=Van Deerlin|first5=Vivanna M.|last6=Shiley|first6=Kevin T.|title=CT of Viral Lower Respiratory Tract Infections in Adults: Comparison Among Viral Organisms and Between Viral and Bacterial Infections|journal=American Journal of Roentgenology|volume=197|issue=5|year=2011|pages=1088–1095|issn=0361-803X|doi=10.2214/AJR.11.6501}}</ref></small>
|}
|}


Revision as of 22:34, 5 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Alejandro Lemor, M.D. [3]

Overview

A chest CT scan is not routinely done in patients with pneumonia, but is a diagnostic test that may be useful when a chest x-ray is not conclusive. CT findings may include lobar consolidation, ground-glass opacities, pleural effusion, lymphadenopathy, and tree-in-bud appereance.

CT

Right lower lobe pneumonia.
Image courtesy of RMH Key Conditions, Radiopedia. (original file here). Creative Commons BY-SA-NC
Right lower lobe pneumonia.
Image courtesy of RMH Key Conditions, Radiopedia. (original file here). Creative Commons BY-SA-NC

Comparison Between CT Findings in Viral and Bacterial Pneumonia
CT Finding Bacterial Viral
No findings 9% 33%
Focal Consolidation 9% 6%
Pleural Effusion 41% 22%
Ground-glass Opacity 45% 22%
Tree-in-bud Appereance 14% 31%
Bronchial Wall Thickening 27% 31%
Multifocal Consolidation 36% 27%
Adapted from American Journal of Roentgenology. 2011;197: 1088-1095[2]

References

  1. ↑ Ichikado, Kazuya (2014). "High-Resolution Computed Tomography Findings of Acute Respiratory Distress Syndrome, Acute Interstitial Pneumonia, and Acute Exacerbation of Idiopathic Pulmonary Fibrosis". Seminars in Ultrasound, CT and MRI. 35 (1): 39–46. doi:10.1053/j.sult.2013.10.007. ISSN 0887-2171.
  2. ↑ Miller, Wallace T.; Mickus, Timothy J.; Barbosa, Eduardo; Mullin, Christopher; Van Deerlin, Vivanna M.; Shiley, Kevin T. (2011). "CT of Viral Lower Respiratory Tract Infections in Adults: Comparison Among Viral Organisms and Between Viral and Bacterial Infections". American Journal of Roentgenology. 197 (5): 1088–1095. doi:10.2214/AJR.11.6501. ISSN 0361-803X.

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