甲型H1N1流感的CT征象分析

总结分析甲型H1N1流感(甲流)的影像特征。方法回顾性分析36例甲流疑似住院患者的胸部X线片和CT资料。结果甲型H1N1病毒核酸分离检测(+)病例29例中,胸部X线片或CT呈阴性8例;合并肺炎21例,11例伴胸水。轻度7例表现为肺纹理增粗模糊或中心性小结节,或伴胸膜下轻度间质性炎症;中度6例表现为沿肺纹理或胸膜下多发小叶性补丁状斑片影,可伴空气支气管征的肺段性实变;重度8例表现为两肺弥漫性斑片影融合,伴两下肺实变。甲型H1N1病毒核酸分离检测(-)病例7例中3例出现酷似甲流的胸膜下斑片影,4例节段性实变。结论甲型H1N1流感性肺炎具有较特征CT征象,但胸膜下斑片影并非特异表现,单纯节段性实变常不考虑甲流。

CT Findings of Influenza A H1N1

Objective To analyze the imaging features of influenza A H1N1.Methods Chest X-ray radiography and CT data were retrospectively analyzed in 36 patients with suspected H1N1 influenza.Results Among the 29 patients with influenza A positive,chest X-ray or CT scan was negative in 8,and the pneumonia occurred in 21 and pleural effusion in 11.Six patients with mild pneumonia showed blurred lung markings,central nodules or complicated subpleural interstitial inflammation.Six patients with moderate pneumonia showed subpleural multiple lobular patch-like shadow along lung markings or under the pleura accompanying with air bronchograms in pulmonary segmental consolidation.Eight patients with severe pneumonia displayed diffuse patches of shadow integration accompanying with consolidation in both lower lung zones.Among the 7 patients with influenza A negative,3 showed subpleural patche shadow of resemble influenza and 4 displayed segmental consolidation.Conclusion Influenza A H1N1 pneumonia has typical imaging characteristics,but features of subpleural plaques are not specific.Influenza A is not considered in patients with simple segmental consolidation.