Ability of high-resolution computed tomography to distinguish Mycoplasma pneumoniae pneumonia from other bacterial pneumonia: Significance of lateral bronchial lesions, less air bronchogram, and no peripheral predominance
Autor: | Masanori Nakanishi, Takeo Yagi, Hiroki Yamada, Takao Kiguchi, Kiyoshi Nakashima, Tadashi Nakayama, Masafumi Takeshita |
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Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
High-resolution computed tomography Pathology medicine.medical_specialty Air bronchogram Bronchi Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Community-acquired pneumonia Pneumonia Mycoplasma Pneumonia Bacterial medicine Humans 030212 general & internal medicine Mycoplasma pneumoniae pneumonia Bronchus Bronchial wall medicine.diagnostic_test business.industry Bacterial pneumonia Bronchography respiratory system medicine.disease respiratory tract diseases Peripheral Radiographic Image Enhancement medicine.anatomical_structure 030228 respiratory system Tomography X-Ray Computed business |
Zdroj: | Respiratory Investigation. 58:169-176 |
ISSN: | 2212-5345 |
Popis: | Background No study has investigated the capability of high-resolution computed tomography (HRCT) to detect a lateral bronchus abnormality, degree of air bronchogram, and distribution of affected lesions in the diagnosis of Mycoplasma pneumoniae pneumonia (MPP). Methods We prospectively enrolled patients with serologically-confirmed MPP or culture-confirmed other bacterial pneumonia (OBP). The distribution of affected areas, abnormalities in lateral bronchial lesions, the degree of air bronchogram, and previously reported findings on HRCT were evaluated for MPP and OBP. Predictive HRCT findings for MPP were determined by logistic regression analysis. We provisionally designed our HRCT criteria (negative, probable, or highly suspected) for diagnosing MPP and investigated the diagnostic yield of the HRCT criteria. Results Sixty-three MPP and 126 OBP patients were included in this study. Logistic regression analysis showed that the absence of peripheral predominance, bronchial wall thickening, lateral bronchial wall thickening, intralobular or lobular ground-glass opacities, intralobular ground-glass opacities connected to a lateral bronchus, and less air bronchogram in infiltrates were significant predictors of MPP. Our HRCT criteria showed that the sensitivity and specificity in negative, probable, and highly suspected MPP were 0.0 and 0.33, 1.0 and 0.69, and 0.5 and 0.98, respectively. Conclusions HRCT had considerable ability to detect a lateral bronchial abnormality and to diagnose or rule out MPP based on the distribution of affected areas, abnormalities in lateral bronchial lesions, and the degree of air bronchogram in the infiltrates. |
Databáze: | OpenAIRE |
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