甲型H1N1肺炎初诊CT表现

CT fingdings of influenza A (H1N1) pneumonia on initial presentation

目的:探讨甲型H1N1肺炎特征性CT表现。方法:回顾性分析46例经咽拭子RT-PCR法检测确诊的甲型H1N1流感病毒肺炎的临床与CT资料,CT检查包括常规平扫、高分辨力CT(HRCT)及多平面重组(MPR),4例行CT增强扫描。结果:46例H1N1肺炎累及双侧45例、累及单侧1例,40例侵犯3个肺叶及以上、6例侵犯2个肺叶及以下,均呈多灶性与弥漫性,32例沿支气管血管束分布、其中28例合并胸膜下分布,39例为GGO或GGO合并实变,20例可见马赛克征,15例见少量或中等量胸腔积液,仅1例合并肺栓塞。HRCT显示26例小叶间隔及小叶内间隔增厚、2例小叶中心模糊结节。结论:H1N1肺炎具有较特征性的CT表现,HRCT与MPR有助于其肺内病变的评价。

Objective：To study the characteristic CT manifestations in patients with influenza A （H1N1） pneumonia. Methods：The clinical and CT materials including conventional plain CT,high resolution CT （HRCT） and multi-planar reformation （MPR） of 46 patients with influenza A （H1N1） pneumonia proved by positive real-time RT PCR of nasopharyngeal swab were retrospectively analyzed.4 patients had contrast enhanced CT.Results：Of the 46 patients,there were bilateral （n=45） or unilateral （n=1） lung involvement;More than 3 lobes were involved in 40 patients and less than 2 lobes in 6 patients,all showed multi-focal and diffuse lesions.Peri-bronchovascular distribution of lesions was found in 32 patients,including 28 cases with combined subpleural distribution.The density of the lesions included ground-glass opacity （GGO） or GGO in combination with patchy consolidation in 39 patients and mosaic pattern in 20 patients.Minimal or moderate pleural effusion was found in 15 patients.Multiple pulmonary embolism was found only in 1 patient.Thickening of inter-and intra-lobular septum （n=26） and ill-defined centrilobular nodules （n=2） were detected on HRCT.Conclusion：Relative characteristic CT features could be revealed in influenza A （H1N1） pneumonia.HRCT and MPR are helpful to evaluate the pulmonary lesions.