甲型H1N1肺炎的影像学特征

目的 探讨甲型H1N1病毒所致肺炎的影像学特征。方法 回顾性分析27例经实验室证实的甲型H1N1肺炎患者的胸部X线及CT影像学表现。结果 按照甲型H1N1病毒肺炎的受累面积，将27例患者按初诊时肺部的影像改变程度分为轻、中、重度3种类型。轻度者10例，表现为散在分布的、斑片状磨玻璃样阴影；中度者9例，表现为双肺散在分布的、多发片状实变阴影及结节影，5例合并胸腔积液，并伴有轻、中度代偿性肺气肿；重度者8例，表现为双肺大片实变阴影伴有空洞，其中2例合并霉菌球，3例伴有支气管扩张，4例合并纵隔及胸壁皮下气肿，均伴有双侧胸腔积液及中、重度肺气肿。6例死亡病例中，1例为轻度肺炎恶化死亡，1例为中度肺炎转化为重度肺炎后死亡，其他4例为重度肺炎病例。结论 甲型H1N1肺炎表现为多肺段受累的磨玻璃样变和实变，重度者常伴有空洞、支气管扩张、胸腔积液、纵隔皮下气肿及霉菌感染，死亡率高。

Imaging characteristics of pneumonia from influenza A(H1N1) virus

Objective To explore imaging characteristics of pneumonia secondary to influenza A (H1N1) virus infection. Methods Chest X-ray films and CT images were retrospectively reviewed in 27 patients with pneumonia from influenza A (H1N1) virus infection confirmed by laboratory tests. Results According to the involved area, imaging findings were divided into 3 types: ① mild degree manifested as scattered ground-glass opacity (GGO) in 10 patients, ② moderate degree manifested as scattered patchy consolidation or nodes in 9 patients, 5 of whom with pleural effusion, ③ severe degree manifested as patchy consolidation with cavity, pleural effusion and compensating emphysema in 8 patients, of whom 2 with mycotic infection, 3 with bronchodilatation, 4 with subcutaneous and mediastinal emphysema. Six patients died of pneumonia-related respiratory failure, including 1 case of mild degree, 1 case of moderate degree and 4 cases of severe degree. Conclusion Pneumonia secondary to influenza A (H1N1) virus infection presents as multi-segment involved GGO and consolidation. Cavity, broncho-dilatation, pleural effusion, subcutaneous emphysema and mycotic infection, which lead to poor prognosis, are found in severe patients.