甲型H1N1流感合并肺炎的影像表现

Imaging manifestation of A H1N1 influenza with pneumonia

目的探讨甲型H1N1流感合并肺炎的影像表现。方法分析确诊的甲型H1N1流感合并肺炎患者51例，均摄床旁x线胸片，44例同期行胸部CT检查。按肺内病变程度将所有患者分为轻度、中度、重度3型。结果轻度患者4例，表现为肺内局限片状阴影；中度33例，肺内片状阴影超过2个肺野，其中双侧病变30例，单侧病变3例；重度14例，肺内广泛分布片状及磨玻璃密度阴影，可以合并间质改变，其中2例合并感染，成人呼吸窘迫综合征（ARDS）6例，并发皮下气肿1例。结论甲型H1N1流感合并肺炎以片状影及磨玻璃密度阴影为主，可见间质病变，合并感染后影像表现多样，部分患者可进展为ARDS。

Objective To evaluate the imaging features of pneumonia caused by A （H1N1） influenza virus. Methods Imaging data of 51 patients with pneumonia caused by A HIN1 influenza were retrospectively reviewed. All patients underwent mobile chest radiographs and 44 patients underwent CT as well. On the basis of the lesion degree in the lung,the patients were classified into mild,moderate and serious types. Results Mild type showed patchy consolidation at chest imaging in 4 patients. Moderate type demonstrated consolidation and（or） ground -glass opacities more than 2 lung fields in 33 patients, including 30 bilateral and 3 unilateral. Serious type displayed diffuse consolidation and ground-glass opacities, probably accompanying with interstitial lesions in the lungs in 14 patients, including 6 patients with ARDS, 2 with infection and 1 with cutaneous emphysema. Conclusion The imaging features of pneumonia caused by A H1N1 influenza mainly manifest as consolidation and ground-glass opacities, probably accompanying with interstitial changes. The imaging findings show various in patients with infection. Some serious patients even develope to ARDS.