6例重症甲型H1N1流感的肺部CT影像分析

摘要

Purpose To evaluate the CT features of lung in patients with severe influenza A(H1N1). Materials and Methods Clinical and CT findings of 6 patients,who were comprehensive clinically diagnosed with severe influenza H1N1, including 4 men and 2 women,aged from 25 to 61 years old, mean(39. 83 ± 12.41 ) years, were retrospectively analyzed. 64 multi-slice spiral CT chest scan was performed 2 to 4 times on all the patients during hospitalization. Results All patients had significant shadow on lung and developed rapidly. It showed local or multiple lesions of multilobes of bilateral lungs and mostly located in the middle-inferior lung field with peripheral distribution. The abnormal chest CT features included multi-patchy ground-glass opacifications(6 cases), single small round ground-glass opacification(4 cases), small nodular high-density opacity ( 4cases), large high-density nodular opacity ( 3 cases), appeared nodular or coarse rope or band opacity inside the ground-glass shadow(1 cases),irregular consolidation(3 cases), partly atelectasis(2 cases), bronchiectasis(2 cases), small pleural effusion (3 cases), pleural thickening (2cases), mediastinal lymph nodes enlargement(3 eases). When the lesions disappeared gradually, the chest CT showed some residual reticular coarse rope or band or patchy opacity on bilateral lungs. Conclusion Rapid development, double lung exhaust, diffuse distribution, large multipatchy ground-glass opacifications with consolidation,nodules,most of which located in the middle-inferior lung field with peripheral distribution, were the relative characteristic features in the diagnoses of severe influenza A(H1N1).%目的:探讨重症甲型H1N1流感患者的肺部CT影像表现.材料和方法:回顾性分析6例经临床综合确诊的重症甲型H1N1流感患者的临床和CT资料,男4例,女2例,年龄25～61岁,平均39.83±12.41岁,所有患者均于住院期间行2～4次胸部64层螺旋CT扫描.结果:所有患者肺部阴影均较明显,发展迅速,表现为两肺多叶弥漫性渗出,病灶位于中下叶并呈外周分布居多.异常胸部CT表现包括:多发斑片状磨玻璃阴影6例,单发小圆形磨玻璃阴影4例,小结节状高密度影4例,大结节状高密度3例,磨玻璃密度影内出现结节或索条影1例,不规则肺实变3例,部分肺不张2例,细支气管扩张2例,少量胸腔积液3例,胸膜增厚2例,纵隔淋巴结肿大3例.当病变逐渐吸收后主要表现为两肺残留索条状或斑片状阴影.结论:发展迅速,双肺受累,弥漫分布,大片磨玻璃阴影伴有实变、结节,多累及两肺中下叶呈外周分布是诊断重症甲型H1N1流感的相对特征性表现.