重症甲型H1N1流感并肺炎的CT表现

目的探讨甲型H1N1流感并肺炎的CT表现。方法 5例临床确诊甲型H1N1流感的重症患者共8次胸部CT扫描(复查3例)资料。结果 5例中均为双肺多叶、多段实变灶,无明显肺叶、肺段或特定体位分布趋势;大片肺实变表现为双侧沿支气管树分布的肺段实变;内有明显的空气支气管征;相邻肺段实变融合或在叶间裂处相邻的肺叶实变扩展,于影像接触部位融合,形成更大片实变影;肺内小病灶均为双肺多发,呈类圆形或棉团状,沿肺纹理分布最多见;大片肺实变可呈均匀致密实变、磨玻璃样变、蜂窝状实变,小病灶与大片实变灶一致,磨玻璃样变可出现在初诊和吸收期病例;反应性胸膜增厚及胸膜积液常见;无纵膈、肺门淋巴结肿大。结论 CT改变提示:甲型H1N1重症病例并肺炎在病程发展阶段,病变有经支气管肺泡系播散的特点。

Severe influenza H1N1 influenza and pneumonia CT performance

Objective To report the CT appearance in Influenza A H1N1 and pneumonia.Methods Eight chest CT scanning examinations were performed in 5 cases of Influenza A H1N1 and pneumonia that were verified by the clinic.Results In all of the 5 cases,multilobar or multi-segmental consolidations of bilateral lungs were detected.There was no distribution tendency for any specific pulmonary lobes or segments.The big range of consolidation manifested as the bilateral pulmonary segment consolidation that distributing along the bronchi tree.There was the air bronchogram in the consolidation.Each consolidation expanded along the pulmonary segment and mixed together to form a pulmonary consolidation,or even a whole pulmonary lobe consolidation.The small foci manifested as the bilateral multiple oval foci,which distributed along the lung markings.The big consolidation could appear as homogeneous densification,ground-glass appearance,or honeycomb consolidation.The ground-glass appearance could appear in cases of first visiting and in cases of recovery period.The pleural thickened and hydrothorax were common.The mediastinal lymph node enlargement was not observed.Conclusions The limited Influenza A H1N1 and pneumonia cases show a tendency that the pathological changes disseminate along broncho-alveolar system when Influenza A H1N1 and pneumonia is developing.