High‐Resolution Computed Tomography for the Diagnosis of Community‐Acquired Pneumonia

Abstract

We compared high-resolution computed tomography (HRCT) with chest radiography (CR) to determine if there is any advantage to using HRCT in the diagnosis of community-acquired pneumonia (CAP). Simultaneously obtained chest radiographs were compared with HRCT scans for 47 patients with clinical symptoms and signs suspicious for CAP, HRCT identified all 18 CAP cases (38.3%) apparent on radiographs as well as eight additional cases (i.e., 55.3%); P = .004. The corresponding figures for bilateral involvement were six by CR (33.3%) and 16 by HRCT (61.5%), P = .001. CR did not show changes particularly affecting the upper and lower lung lobes and the lingula. Bronchopneumonia was visualized by CR in 11 cases (61.1%) and by HRCT in 22 cases (84.6%). The corresponding figures for airspace pneumonia were four (22.2%) and one (3.8%), respectively. The use of HRCT seems to increase the number of CAP cases confirmed by imaging and to improve the accuracy of diagnosing and typing of CAP.

Increased Emergency Department Computed Tomography Use for Common Chest Symptoms Without Clear Patient Benefits

“…15,16 Our study does not reproduce these findings, with pneumonia being diagnosed as often despite increased utilization in CT. With increases in the number of nonspecific diagnoses and no improvements in clinically significant diagnoses such as PE and pneumonia among patients presenting with CC symptoms, increased utilization seems to provide little to add in the diagnostic work-up and certainly is not altering treatment in the setting of inappropriate ordering. Furthermore, with the escalating rates of CT utilization, a high number of clinically significant incidental findings have been reported, 6 which has led some physicians to argue that CT is useful in patients even when clinical suspicion of more concerning diagnoses (eg, PE) is high.…”

Lung ultrasound characteristics of community‐acquired pneumonia in hospitalized children

“…Furthermore, the percentage of false-negative CXR of this study concerning diagnosis of pneumonia is consistent with literature data. 28 Syrjala et al 28 comparing chest CT with CXR ability in the diagnosis of pneumonia, found 8 (30.8%) negative CXR cases out of 26 confirmed pneumonias. Another limitation of our study is that only one experienced operator performed all LUS, and it is reasonable to hypothesize that similar results cannot be immediately achieved by less experienced operators.…”

Community-acquired pneumonia by Chlamydophila pneumoniae: a clinical and incidence study in Brazil

“…We think that the definition of asymptomatic infection should be reserved to the culture or PCR-positive patients without symptoms who have either seroconversion of antibodies or any lung infiltrate at thorax HRCT consistent with pneumonia-since it has been reported that HRCT has greater sensitivity than Chest X-Ray in diagnosing pneumonia [29,30].…”