Radiographic and CT Features of Viral Pneumonia
Radiographic and CT Features of Viral Pneumonia
复制标题
DOI：
10.1148/rg.2018170048
复制
发表时间：
2018-05-01
期刊：
影响因子：
5.5
通讯作者：
Do, Kyung-Hyun
中科院分区：
文献类型：
--
作者：
Koo, Hyun Jung;Lim, Soyeoun;Do, Kyung-Hyun
病毒是呼吸道感染最常见的原因。病毒性肺炎的影像学表现多种多样，与其他非病毒性感染和炎症性疾病重叠。然而，识别潜在的病毒病原体可能并不总是容易的。有许多用于基于成像模式识别病毒病原体的指标，这些指标与病毒感染的发病机制相关。同一病毒家族的病毒具有相似的肺炎发病机制，并且成像模式具有可区分的特征。虽然并非所有病例都表现出典型的模式，但病毒性肺炎的大多数典型影像学模式可以根据病毒家族进行分类。尽管仅凭影像学特征无法做出明确诊断，但识别病毒性肺炎模式有助于鉴别病毒性病原体，从而减少抗生素的使用。最近，发现了与最近爆发有关的新病毒，包括人偏肺病毒、严重急性呼吸综合征冠状病毒和中东呼吸综合征冠状病毒。这些新出现的病原体的影像学表现已在最近的一些研究中描述。本文综述了由不同病原体（包括新病原体）引起的病毒性肺炎的影像学和计算机断层扫描模式。可能影响成像的临床特征，如患者的年龄和免疫状态，季节变化和社区爆发，和发病机制，也进行了讨论。本综述的第一个目标是指出，有影像学特征，应提高病毒感染的可能性。第二，为了帮助放射科医生区分病毒感染，显示具有相似发病机制的相同病毒科的病毒，并且可以具有相似的成像特征。通过综合考虑临床和影像学特征，放射科医生可以建议诊断为病毒性肺炎。(C)RSNA，2018年。
Viruses are the most common causes of respiratory infection. The imaging findings of viral pneumonia are diverse and overlap with those of other nonviral infectious and inflammatory conditions. However, identification of the underlying viral pathogens may not always be easy. There are a number of indicators for identifying viral pathogens on the basis of imaging patterns, which are associated with the pathogenesis of viral infections. Viruses in the same viral family share a similar pathogenesis of pneumonia, and the imaging patterns have distinguishable characteristics. Although not all cases manifest with typical patterns, most typical imaging patterns of viral pneumonia can be classified according to viral families. Although a definite diagnosis cannot be achieved on the basis of imaging features alone, recognition of viral pneumonia patterns may aid in differentiating viral pathogens, thus reducing the use of antibiotics. Recently, new viruses associated with recent outbreaks including human metapneumovirus, severe acute respiratory syndrome coronavirus, and Middle East respiratory syndrome coronavirus have been discovered. The imaging findings of these emerging pathogens have been described in a few recent studies. This review focuses on the radiographic and computed tomographic patterns of viral pneumonia caused by different pathogens, including new pathogens. Clinical characteristics that could affect imaging, such as patient age and immune status, seasonal variation and community outbreaks, and pathogenesis, are also discussed. The first goal of this review is to indicate that there are imaging features that should raise the possibility of viral infections. Second, to help radiologists differentiate viral infections, viruses in the same viridae that have similar pathogenesis and can have similar imaging characteristics are shown. By considering both the clinical and radiologic characteristics, radiologists can suggest the diagnosis of viral pneumonia. (C) RSNA, 2018.