甲型H1N1流感肺炎治疗后转归CT影像表现

目的:观察甲型H1N1流感肺炎治疗前后影像变化,探讨其转归影像表现。方法:回顾性分析25例甲型H1N1流感并发肺炎患者临床及治疗前后影像资料,其中男18例,女7例。结果:轻症12例,病变仅限于1个肺叶内,表现为片状磨玻璃密度影,临床以流感样症状为主,治疗后9例完全吸收,3例基本吸收。重症6例,病变累及单侧2个或双侧2个肺叶的片状阴影,以肺实变为主,临床表现为重症肺炎,治疗后1例炎症基本吸收,2例部分肺叶病变基本吸收,部分肺叶病变吸收后残留间质增生及纤维化,另3例炎症吸收后残留间质增生及纤维化。危重症7例,表现为双肺广泛分布的大片状实变影和/(或)磨玻璃密度影,临床表现为病情危重,治疗过程中3例病情存在反复,无明显吸收;4例治疗后炎症部分吸收并残留间质增生及纤维化。结论:甲型H1N1流感肺炎以磨玻璃密度影及斑片状阴影为主,影像表现多样,治疗后轻症者多完全吸收,重症及危重症者多残留间质增生及纤维化。

CT imaging manifestations of A H1N1 influenza with pneumonia after treatment

Objective： To investigate image changes of pneumonia caused by A H1N1 influenza virus before and after treatment. Methods： Clinical and imaging data of 25 patients with pneumonia caused by A H1N1 influenza were retrospectively reviewed. Results： Mild type （n= 12） showed patchy ground-glass attenuation and were absorbed completely （n= 9） or almost absorbed （n=3） after treatment. Severe type （n=6） showed bilateral multiple ill-defined patchy shadows and nodules with almost absorption （n= 1）, residue of stroma proliferation and fibrosis after treatment （n =3） or both of them （n = 2）. Critical type （n= 7） showed diffuse ground-glass attenuation with partial consolidation with progress （n= 3） or residue of stroma proliferation and fibrosis after treatment （n=4）. Conclusion： The most common radiological findings of A H1N1 influenza with pneumonia are ground-glass opacities with or without associated areas of consolidation. Mild type can be absorbed completely after treatment. Residue of stroma proliferation and fibrosis after treatment were common in severe and critical types.