甲型H1N1流感病毒肺炎的CT表现

目的：探讨甲型H1N1流感病毒性肺炎CT表现,提高对该病的认识。方法：回顾性分析34例经临床、实验室证实的甲型H1N1肺炎胸部CT表现。结果：34例中累及两肺5个肺叶17例,占50%;累及4个肺叶3例,占8.8%;累及3个肺叶6例,占17.6%;累及2个肺叶5例,占14.7%;累及1个肺叶3例,占8.8%。单纯毛玻璃样阴影15例,占44.1%,表现为斑片状及云雾样淡薄影,边缘模糊,病灶中心密度相对较高,可见血管纹理通过;单纯实变阴影5例,占14.7%,表现为团片状、斑片状及棉球样影,密度较高;毛玻璃影与实变阴影同时存在14例,占41.2%,表现为云雾样淡薄影、棉球样实变影同时存在,肺周边区域及下叶基底部的病灶密度高于其它部位。实变阴影中可见支气管充气征12例,占35.3%;病灶内合并网格样改变19例,占55.9%;小结节影3例,占8.8%;支气管壁增厚3例,占8.8%;两侧胸腔少量积液1例,占2.9%。结论：甲型H1N1肺炎病变分布范围广,变化快,CT表现具有一定特征性。

CT manifestations of influenza A (H1N1) virus pneumonia

Objective：To investigate the CT features of influenza A （H1N1） virus pneumonia,and to improve the knowledge of this disease.Methods：CT features of 34 cases with influenza A （H1N1） virus pneumonia confirmed by clinical and laboratory findings were reviewed and analyzed retrospectively.Results：Of the 34 cases,there were bilateral pulmonary involvement of all 5 lobes （17 cases,50%）,4 lobes （3 cases,8.8%）,3 lobes （6 cases,17.6%）,2 lobes （5 cases,14.7%）,1 lobe （3 cases,8.8%）.The CT findings included pure ground-glass opacities which were manifested in 15 cases （44.1%） as patchy and clouding shadows with ill-defined margin and relatively high attenuated center,vascular markings could be seen penetrating through;pure pulmonary consolidations were assessed in 5 cases （14.7%） and manifested as patchy and cottonball-like shadows,with relative high density,14 cases （41.2%） had co-existed ground-glass opacities and pulmonary consolidation,which manifested as mixed clouding and cottonball-like shadows,the density of periphery and basal segments of the lower lobes of the lung were higher than the other areas.Air-bronchogram within the pulmonary consolidation could be revealed in 14 cases （35.3%）,associated recticular changes within the pulmonary lesions could be seen in 19 cases （55.9%）,small nodular lesions in 3 cases （8.8%）,thickening of bronchial wall in 3 cases （8.8%）,minimal bilateral pleural effusion in 1 case （2.9%）.Conclusion：Pulmonary lesions of influenza A （H1N1） virus pneumonia were extensively distributed,changing rapidly,with certain characteristic CT features.