甲型流感病毒肺炎的影像学特征分析

目的]探讨甲型流感病毒肺炎的高分辨率CT 影像特征.方法]回顾性分析临床诊断甲型流感病毒肺炎患者10例CT图像,分析CT表现形态（实变、磨玻璃影、结节、网格状改变）、病变分布、淋巴结肿大、胸腔积液、病变转归等.结果]10例患者均为双侧肺部受累,其中周围型8例（80%）、周围＋中央型2例（20%）;双侧对称性分布7例（70%）,双侧不对称分布3例（30%）;磨玻璃影10例（100%）,同时合并实变影5例（50%）,合并网格状改变3例（30%）,4 例（40%）病人出现胸腔积液;本组病例均未见明显肿大的淋巴结;10例患者经治疗8例（80%）病变范围缩小,2例（20%）病变范围进展.结论]与既往流感相关的病毒性肺炎对比,本组甲型流感病毒肺炎起病急、病程进展迅速和严重,首发CT表现以双肺弥漫分布的磨玻璃影为主,恢复过程中出现了不同程度的纤维化,对抗病毒药物和糖皮质激素治疗有较好反应.

Analysis of Imaging Characteristics of Influenza A Virus Pneumonia

Objective]To investigate the high resolution CT findings of influenza A viral pneumonia. Methods] The high resolution CT images of 10 patients with influenza A viral pneumonia were analyzed retrospectively. The CT manifestations（consolidation, ground-glass, nodules and reticulation）, lesion distribution, lymph node enlargement, pleural effusion and the turnover of the lesion were analyzed. Results] Ten pa tients presented the involvement of bilateral lungs including peripheral type in 8 cases（80 % ） and peripheral and central type in 2 cases（20%）. Among them, 7 cases（70%） presented symmetrical distribution and 3 cases （30%） presented asymmetrical distribution. Ground-glass shadow was seen in all 10 cases in which 5 cases （50%） were complicated with consolidation shadow, and 3 cases （30%） were complicated reticular shadow. Four cases（40%） occurred pleural effusion. No obvious lymphadeneetasis was found in all these cases. After treatment, the extent of lesions of 8 cases（80%） decreased and that of 2 cases（20% ） enlarged. Conclusion] Compared with previous influenza-related viral pneumonia, the onset of influenza A viral pneumonia is more abrupt, and the progress is n＇lore rapid and serious. The first CT manifestation is mainly ground-glass shadow with diffuse distribution of bilateral lungs. Different degree of fibrosis is seen during the recovery process. An tiviral drugs and glucocorticoid therapy is effective for the treatment of influenza A viral pneumonia.