儿童H5N1禽流感肺部影像学表现及动态变化(附3例报告并文献复习)

Pulmonary imaging appearances and dynamic changes of highly pathogenic avian influenza A(H5N1)in children(a report of 3 cases and a review of the literature)

目的:探讨儿童高致病性禽流感的肺部影像学表现及动态变化。方法:报告3个病例,2例治愈为确诊病例,1例死亡为疑似病例,回顾性分析其肺部影像表现及动态变化。结果:肺部病变主要的影像学特点为弥漫性肺实变和间质改变伴广泛的纤维化和肺叶萎陷以及进展迅速,吸收缓慢。病变早期为上肺片状渗出,随后迅速扩大,临终期表现为两肺弥漫性实变;病变吸收缓慢,先为渗出病灶,下肺早于上肺,肺的前外侧先于内后侧,临床症状消失后肺部仍有较多纤维化病灶,且肺部纤维化病灶的吸收持续时间长。结论:胸部X线检查是发现H5N1高致病性禽流感最基本的影像学检查方法,可显示病变密度、形态和范围的动态变化,有助于判断病情,指导治疗和估计预后。

Objective： To study the pulmonary imaging appearances and dynamic changes of highly pathogenic avian influenza A （H5N1）in children. Methods：The pulmonary imaging appearances and dynamic changes in 2 confirmed patients and 1 borderline patient was retrospectively analyzed. Results：The major imaging features of the pulmonary lesions included diffuse consolidation, interstitial shadowing bilaterally, extensive fibrosis, lobar collapse. The lesions progress quickly and absorb slowly. In the early stage the lesions appeared infiltrates , sucoedently progress quickly and in the terminal stage diffuse consolidation bilaterally. The absorption of the lesions in the lower and anteroexteral parts is easier than that in the upper and posterointeral parts. The fibrosis of the pulmonary lesions absorb slowly and persistently.Conclusion：Chest radiography was an elementary imaging means of choice for detecting the disease and was able to distinctly demonstrate the dynamic changes of the density,shapa,and range of pulmonary lesions. It is helpful for assessing the disease condition, planning the therapy and evaluating the prognosis.