Pneumonia CT

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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

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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

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* A chest CT could be useful when a chest x-ray has inconclusive signs of pneumonia but the clinical manifestation suggest pneumonia.
* CT findings in pneumonia include:[1]
* Airspace consolidation
* Ground-glass opacities
* Pleural effusion
* Hilar 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.

Areas of consolidation Source: Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 32998

#### Comparison Between CT Findings in Viral and Bacterial Pneumonia

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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

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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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