Pneumonia CT

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.

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.


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]

↑ 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.
↑ 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.