High resolution CT features and differential diagnosis of bacterial pneumonia, viral pneumonia and mycoplasma pneumonia
ZHAO Zhiyong1, ZHENG Haoyu2, ZHANG Wei2
1. Department of Medical Engineering,2. Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People’s Armed Police Force, Leshan 614000, China
Abstract：Objective To analyze the high resolution CT signs and differential features of bacterial pneumonia, viral pneumonia and mycoplasma pneumonia. Methods The high resolution CT imaging data of 192 patients with pneumonia confirmed by clinical examination or pathology was analyzed retrospectively. According to etiology, they were divided into the bacterial pneumonia group (n=84, 43.8%), viral pneumonia group (n=58, 30.2%) and mycoplasma pneumonia group (n=50, 26.4%). The clinical data, lesion localization and CT signs of the three groups were compared. Results The WBC count, CRP and PCT associated with bacterial pneumonia were significantly higher than those related to viral and mycoplasma pneumonia (P<0.05). The WBC count of mycoplasma pneumonia was higher than that of viral pneumonia (P<0.05). In terms of lesion distribution, viral pneumonia showed multi-lobe (40/58,69%,P<0.05) and peripheral distribution (39/58, 67.2%, P<0.05), while mycoplasma pneumonia showed multi-lobe (28/50, 56%, P<0.05) and lower lobe distribution (31/50, 62%, P<0.05). There was no significant difference in ground-glass opacity or macadam signs between viral pneumonia and mycoplasma pneumonia(P>0.05), but the above signs were more common in CT signs than in bacterial pneumonia (P<0.05). In addition, there was more intralobular interstitial thickening in viral pneumonia (32/58, 55.2%, P<0.05) and bronchial wall thickening in mycoplasma pneumonia (29/50, 58%, P<0.05). Conclusions The combination of clinical manifestations, laboratory examination and high resolution CT can contribute to the early diagnosis and differential diagnosis of bacterial, viral and mycoplasma pneumonia.
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2020, Vol. 31 
