45例成人7型腺病毒肺炎的胸部CT表现

Chest CT findings of type-7 adenovirus pneumonia in adult patients

目的：探讨腺病毒肺炎（AdVP）的胸部CT 表现。方法：回顾性分析一次聚集性发病的45例AdVP 患者病程早期阶段临床和胸部CT资料，首次胸部CT检查时间为发病后1～6d，平均（2．22±1．37）d。主要观察肺部感染性病变的部位、形态、数量、分布和主要征象如实变影、磨玻璃影（GGO ）和间质性改变等。结果：4 5例中轻症肺炎39例，重症6例。45例共83个病灶，均表现为肺部局灶性病变，以双肺下叶多见（61／83，73．5％），其中单发24例（53．3％），多发21例（46．7％）；大叶性病灶8个、段或亚段性23个、斑片状48个、单纯小结节性4个。以实变为主的病灶28个，以GGO 为主30个，以间质改变为主25个；肺叶、肺段性病灶31个，其中表现为实变伴 GGO 20个、单纯实变4个、单纯间质性改变4个及单纯肺段性GGO 3个，病灶密度不均，多不占据整个肺叶或肺段；斑片状病灶4 8个，其中表现为实变伴或不伴GGO 30个、间质性改变18个，病灶倾向于沿支气管血管束分布19个（39．6％）、沿肺外周区域分布25个（52．1％）。8例病情有进展的患者复查胸部CT，表现为GGO病灶扩大、密度增高和多种形态的新发病灶。结论：AdVP 的主要胸部CT表现为肺部单发或多发的叶段性或斑片状实变、GGOs或间质性改变，病变多位于两肺下叶分。

Objective：To explore the manifestations of chest CT features of type-7 adenovirus pneumonia （AdVP）in adult patients.Methods：The clinical and chest CT data of 45 adult patients in a clustering outbreak of type-7 AdVP were retrospectively studied.The first CT examination time in all 45 cases was within 1--6 days from the onset,mean value was （2.22±1.37）days.The location,pattern,number and distribution of lung infection lesions were described,especially the imaging signs such as consolidations,ground glass opacities （GGOs）and interstitial changes were analyzed.Results：There were 39 cases of mild pneumonia,6 cases of severe pneumonia.83 focal lesions in 45 cases were found as single （24 cases）or multiple lesions （21 cases）with various forms,including lobar lesions in 8 cases,segmental or sub-segmental lesions in 14 cases,locally patchy shadows in 20 cases and only small nodules in 3 cases.The lesions of various forms were more common in the lower lobes of bilateral lungs （61/83,73.5%）.Of the 31 lobar or segmental lesions,20 presented as consolidation with GGO,4 as consolidation （4/31）,3 as GGO （3/31）and 4 as interstitial changes,the density of these lesions were une-ven and usually they did not occupy the entire lobe or segment of lung;In 48 patchy lesions,consolidation （16 lesions）, GGOs （14 lesions）and interstitial changes （18 lesions）were all common,and they dominantly distributed around the bron-chovascular bundles （39.6%）or within the peripheral region of the lung （52.1%）.In 8 severe cases with progression of the disease,the follow-up CT showed enlargement of GGOs or many new lesions.Conclusion：The main CT features of Ad-VP were single or multifocal lesions of consolidation,GGOs or interstitial changes which mainly distributed in the lower lobes of lung.