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腁腋 腊腂 CT 腟腪腱腄膓膪臂腲腂臄腂膭臔臚膋臤臨臏膟膫膫膷膡臰臷 膿腺 21 4 30 膣腕膷臌臇腟腥 CT 臋腖腞腍腰膣腩腯臧腄膓膪膧腤腯膑CT 腊腱腓腠腏膪腟腉腱腀 膢腋腡臞腤臭腭臕膠臕膠腹膾膹膛腗腱腓腠腥膧腤 CT 膱腣膴腳腟腉 腰腁 臺臓腹膪膧腤膵膍腵腮腰膱腗腱腤腣臕臤腝腀 膑腸膁膐膕膅膑膧腠腽膕膒膋膏腷膕 膧腟腥腡臞膓腫腹腂臺臞腹腤膤膥腁 膗膓腷膆腤臛膽臆膽腆膇膯臻腏膠膕腟腉腰腁 膘膃腺膍膕膧腟腥臕膠膾膹腗腱腗腰腼膕膄膤膥腣臵臻腖腞腁 臆膽臛膽膇腖膞腣膾膹 腗腱臐膲臏臨腢膁膚膆膖膉腄膂膔膚腏腫腯腲腱腓腠腏膠膕腟腉腱腀 膲膖膧腟腥膠膕膗膄腟臞腣自腢腟臞腵腩腌腲腦腯膑腣腝腢腏腱膪膨腹腏臱腊腀 I腆腃腇腅 臌臇腣腍腒腱膧腤腕臧臣10 臎膌 25 腅膳619腆 腟腉腰腁 腈臉臣10 臎膌 75.3 腟腁 膝腥4 膝腟腉腱 1) 腀 臣臌臃腭膻膁腥膀臓腗腱膟膜膳腤自腢膟腟腬臖腗腱腓腠腏腑腁 腴腲 腴腲腥膧腤腯膑腌臧臆腣腝腊腞自腫腞腊腑膴臟腉腱腀 腯膑腣腍腊腞腁 膧臎臓腠膘膃腺膍膕臓腤臝膦腽膙膑膊腾膕膏腷腄腊腚膥膓臬臠臝臶腏 膘臝腣腢腜腚腓腠腥腐腢腰臃腟腉腱腀 膡腟臔 腤膯腰臃膵腩腖腑腁 CT 臋腖 臌臇腥臘腩腲腚膼臐腟腉腱腀 腖腎腖膩臀腠致腟腥膧腤腯臧腣腍腒腱 CT 腤臼膥腥膗腄膇膚腟腥腢腊腀 膧腤腯膑腣腥臑X 膂腑腮腣腮腱膤膥腤腧臏腗膾 腟腉腱臲腏腑腁 臇膢膳腻膽腴膖腣腢腱腠腊腋腹 膎膉膚膄腏腖腊腓腠腬腙腤臢臙腟腉腱腀 腩腚 CT 膱臝膌臦膬腠腊腋臙臹腠腁 腦腑腵腒腱腠 腊腋腟膑腸膌膄腏腉腱腀 膧腣腍腒腱膯膄腯膑膹腣腥腁 腯膑腘腥 膬膖腌臧臦膬腤膬膖腁 臇膢臓腤腴膖膧膜膳 膺腤膿腢腡腏腉腱腀 腯膑腣臁腖腞腥腁 腯膑腔腲腚 110 腥臫腤腋腛 9 (8.2) 腏臑X 膂腑腮腟膤膥腏腢腑 CT 腟膤膥腵腫腚腠腊腋至腏 腉腰 2) 腁 腓腲腥 CT 腣腮腱膧腤腯膑腣腍腒腱臝腹腖腞腊腱腀 腘腥膜腣臁腖腞腥腁 臦膪腹腢腊腖 膊臞腹 3) 臦膆4) 腢膤膥腤5) 腢腡腤臥腣膥臒腵臋腨腗腏腁 CT 腏腮腰臘臝腟腉腱腠 腊腋腹膎膉膚膄腥腢腊腀 腌臧臦膬膬膖腠腖腞膯臝臶 腵腡腤腮腋腣臯腗腱腤腎腣臁腖腞腥腁 腶膓膖腻臑膟膷膰腤腼腸膋膕腸膚 6) 腟腁 腯臧膨腖腢腊 膀腄膄腟 CT 腵臮腗腱腠腧腯腲腞腊腱腀 臇膢臓腤 腴膖腣臁腗腱 CT 臘臝腹腣臁腖腞腁 臡臻腤腠腓腳腠腊腌腱腹膎膉膚膄腏腉腱腤腥膑腸膁膐膕膅膑腤腪腟腉腱 7, 8) 膪腵腔腁臩腹膪膧腁 膮膶腹膪膧腁 膠膫腹腏腹膪膧腢腡膠膕膗CT 臞腵腗腱膁腹腎膺腥腁 CT 臯腗腱腓腠腟腁 膧膜膳腤膁腹腎膺腠腤膿臦腟腉腱腀 膧腣腗腱 CT 臘臝腹腤腹膎膉膚膄腥臚腖腞腑腥腢腊腀 腖腎腖 CT 腥臑X 膂腑腮臋膎臄臩腌腞腑腲腱腤腥腊腐腟腉腰腁 腓腲腥膣腩腯臧 腑腤膓膖膈膊腵腬腚腯腗膪膨腹腏腉腱腀 腓腓腟腥 膧腤腯膑腣腍腒腱 CT 膹腵腁 膧腤臢膙膗 膵臢腯腖臲腴腘腝腝臸臞腬臂腫膴腗腱腀 II. 腌腈腉腍腄 HRCT 臌腦腟腥膧腤 CT 膱腗腱腣腉腚腜腞膴臟 膢腋腡臞 (secondary lobulus) 腠腊腋臍腣膪腤臭腣腝腊腞腧腱腀 腡臞 (lobulus) 腠腥膼腶腤臺(acinus) 腎腯腢腱腣膪膝腟腉腱腏腁 腙腤膱膗膖臉腣腥腔腩腕腩 腢腬腤腏腉腱腀 腙腤Miller 9) 臉腖腚膢腋腡臞 腥腁 CT 腵膱腗腱腤腣膘膞腟腁 膱膵臢 膔腒臬臡腾(1600023) 膛腬腙腼腬腙 671 臏膟膫膫膷膡臰臷 臤臨TEL: 0333426111 FAX: 0353816651 E-mail: [email protected] 膣臌自腢膳腻膽膷膰 2009 膣臌自腢膳腻膽腀腉 Vol. 19 No. 2 2009. 10 76

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� �1) ��uvLXwuvLxy8�m��Gz{6z�|}~�w� 2007. }�� �7q�Gz{6z�� p. 2�35, ��uvLXw !��

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Understanding of Community-acquired Pneumonia

on the basis of chest computed tomography imaging

Hirotsugu Ohkubo, Yuki Togashi, Yuta Kono, Yasuhiro Setoguchi

First Department of Internal Medicine, Tokyo Medical University,6�7�1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160�0023, Japan

Computed tomographic (CT) scans are now working in many general hospitals in Japan. Most of theJapanese clinicians can use CT scans as one of the useful tool of the examination of community-acquiredpneumonia. Chest CT imaging plays an important role in the accurate interpretation of pulmonaryanatomy and pathology. Mycoplasma pneumoniae pneumonia and Chlamydophila pneumoniae pneumoniademonstrate centrilobular or acinar shadows, and thickening of bronchivascular bundles on CT imaging.Characteristic findings of Legionella pneumophila pneumonia on CT are sharply demarcated peribroncho-vascular foci of consolidation intermingled with ground glass opacity. It is possible to estimate thepathogenic bacteria, if there are characteristic features on CT imaging on the basis of clinical information.

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