摘要
目的：探讨危重症甲型H1N1流感病毒肺炎患者的多层螺旋CT的影像学特点。方法：回顾性分析21例确诊的危重症甲型H1N1流感患者的64层螺旋CT影像资料。结果：21例患者中，①所有病变均表现为双侧分布，且主要为弥漫性分布，多灶性病变以中下肺叶为主。其中累及右肺上叶9例，右肺中叶14例，右肺下叶19例，左肺上叶9例，左肺下叶19例。②病变形态表现为：支气管血管束增粗（21/21，100%），小叶中心结节（12/21，57.1%），小叶间隔增厚（9/21，42.9%），网状结节（3/21，14.3%），磨玻璃样密度影（14/21，66.7%），斑片融合影（7/21，33.3%），大片实变密度影（9/21，42.9%），支气管气象（5/21，23.8%）。③胸膜腔积液（8/21，38.1%，其中5例单侧，3例双侧）；淋巴结肿大（9/21，42.9%，其中5例腋窝淋巴结肿大，3例纵隔淋巴结肿大，2例腋窝、纵隔均淋巴结肿大）；胸膜肥厚（12/21，57.1%）；心包积液（1/21，4.76%）。④9例复查危重症甲型H1N1流感患者中3例死亡者首诊MSCT见双肺中下叶斑片及实变密度影、磨玻璃密度影。复查见病变进展迅速，双肺实变明显，死于呼吸衰竭。6例好转者肺内病变明显吸收，仅遗留少许索条或小斑片状影。结论：危重症甲型H1N1流感病毒肺炎64层螺旋CT主要表现为双肺内弥漫分布的磨玻璃密度影及多灶性实变影，多同时累及肺实质及肺间质，可伴有胸膜腔积液、淋巴结肿大、胸膜肥厚等。病程进展以磨玻璃密度影及实变影范围扩大为主要标志。
Abstract
Objective: To explore the MSCT features in patients with severe influenza A(H1N1) virus pneumonia. Methods: The 64 multi-slices spiral CT images in 20 patients diagnosed as severe influenza A(H1N1) in our hospital were studied retrospectively. Results: ①Most of the lesions in all cases were distributed diffusely and bilaterally, the others located in the middle and lower lobes. ②The CT findings including airway thickening(21/21, 100%), centrilobular nodules(12/21, 57.1%), interlobular septal thickening(9/21, 42.9%), intralobular thin reticulation and micro-nodules(3/21, 14.3%), ground-glass opacity(14/21, 66.7%), single-lobular inflammation(7/21，33.3%), large consolidation(9/21, 42.9%), airway dilatation(5/21, 23.8%). ③Pleural effusion(8/2, 38.1%); lymphadenopathy(9/21, 42.9%); pleural thickening(12/21, 57.1%); effusion of pericardium(1/21, 4.76%). ④The 9 re-examed cases, the imaging findings of the pheumonia changed quickly during the follow-up accompanied with the improvement of clinical symptoms. Three death cases showed centrilobular nodules, consolidation and ground-glass opacity. The others resolved quickly after anti-virus treatment. Conclusions: The 64-slice spiral CT findings of patients with S-OIV(H1N1) are diffuse distribution of bilateral ground-glass opacities and consolidations of lung, most of them showed abnormalities of parenchymal and interstitial tissues. Pleural effusion, lymphadenopathy and pleural thickening were observed. The increasing of ground-glass opacity and consolidation’s range could be the marker of progression of H1N1 infection.
关键词
流感病毒A型 /
肺炎 /
病毒性 /
体层摄影术 /
螺旋计算机
Key words
Influenza A virus /
Pneumonia /
viral /
Tomography /
spiral computed
郭兰田;姜兴岳;谢庆芝;张 林;范万峰;马珍珍;邢成颜.
危重症甲型H1N1流感病毒肺炎的多层螺旋CT表现[J]. 中国临床医学影像杂志. 2011, 22(2): 92-95
GUO Lan-tian;JIANG Xing-yue;XIE Qing-zhi;ZHANG Lin;FAN Wan-feng;MA Zhen-zhen;XING Cheng-yan.
MSCT findings in severe influenza A(H1N1) virus pneumonia[J]. Journal of China Clinic Medical Imaging. 2011, 22(2): 92-95
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