Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population—From Chest Radiography to MRI
Efthymia Alexopoulou,
Spyridon Prountzos,
Maria Raissaki,
Argyro Mazioti,
Pablo Caro-Dominguez,
Franz Wolfgang Hirsch,
Jovan Lovrenski,
Pierluigi Ciet
Affiliations
Efthymia Alexopoulou
2nd Department of Radiology, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece
Spyridon Prountzos
2nd Department of Radiology, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece
Maria Raissaki
University Hospital of Heraklion, Medical School, University of Crete, 70013 Heraklion, Greece
Argyro Mazioti
2nd Department of Radiology, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece
Pablo Caro-Dominguez
Pediatric Radiology Unit, Radiology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain
Franz Wolfgang Hirsch
Department of Pediatric Radiology, University Hospital, Liebigstraße 20a, 04107 Leipzig, Germany
Jovan Lovrenski
Radiology Department, Faculty of Medicine, Institute for Children and Adolescents Health Care of Vojvodina, University of Novi Sad, 21000 Novi Sad, Serbia
Pierluigi Ciet
Department of Radiology and Nuclear Medicine, Erasmus MC—Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands
The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not respond to treatment, need hospitalisation, or have hospital-acquired pneumonia. This review discusses the imaging findings for acute CAP complications and the diagnostic role of each imaging modality. Pleural effusion, empyema, necrotizing pneumonia, abscess, pneumatocele, pleural fistulas, and paediatric acute respiratory distress syndrome (PARDS) are acute CAP complications. When evaluating complicated CAP patients, chest radiography, lung ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) can be used, with each having their own pros and cons. Imaging is usually not needed for CAP diagnosis, but it is essential for complicated cases and follow-ups. Lung ultrasound can supplement chest radiography (CR), which starts the diagnostic algorithm. Contrast-enhanced computed tomography (CECT) is used for complex cases. Advances in MRI protocols make it a viable alternative for diagnosing CAP and its complications.
